Clinical and microbiological effect of frequent subgingival air polishing on periodontal conditions: a split-mouth randomized controlled trial.

The objective of this study was to evaluate the clinical effects of repeated subgingival debridement by air polishing during supportive periodontal therapy. A double-blind, randomized controlled trial of 6 months in duration was conducted on 19 recall patients who were previously treated for chronic periodontitis. Three sites with probing pocket depths (PPD) of 4-9 mm in each of the patients were randomly assigned to the following treatments: Glycine powder/air polishing every 30 days (group 1), glycine powder/air polishing at baseline and on day 90 (group 2), or water irrigation every 30 days (group 3). Clinical parameters were recorded and microbiological sampling was performed at 0, 90, and 180 days post-treatment. Subgingival samples were analyzed using real-time PCR methods for Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola. Between baseline and 90 days, group 1 showed significantly more PPD reduction compared to group 3 and no significant differences with group 2. Between baseline and 180 days, group 1 displayed a significant increase in clinical attachment level compared with group 3. No differences were observed among the groups in numbers of total bacteria or percentage of investigated bacteria at any time point. This study revealed that routine subgingival air polishing at 30-day intervals had significant clinical effects in moderately deep pockets in patients who underwent supportive periodontal therapy.

Comparison of root surface roughness produced by air polishing combined with hand instrumentation or ultrasonic instrumentation: an in vitro study.

The aim of this study was to examine the surface roughness produced by root debridement during periodontal maintenance therapy. The root surface roughness produced by hand scaling and subsequent glycine powder air polishing (GPAP) was compared with that produced by ultrasonic scaling and subsequent GPAP. Fifty extracted incisor and premolar teeth were collected and randomly allocated to the following 5 groups (n = 10 per group): 1, hand scaling followed by GPAP; 2, ultrasonic scaling followed by GPAP; 3, hand scaling alone; 4, ultrasonic scaling alone; and 5, no treatment. After the initial scaling procedure, specimens in groups 1 and 2 were incubated at 37°C for 3 days. The specimens then underwent GPAP for 5 seconds. All specimens were examined under a profilometer, and the root surface roughness was measured in micrometers. The specimens in groups 1 (hand scaling with GPAP) and 2 (ultrasonic scaling with GPAP) were studied in detail under a scanning electron microscope. The different protocols produced the following mean root surface roughness values: group 1, 2.31 µm; group 2, 4.33 µm; group 3, 5.84 µm; group 4, 6.32 µm; and group 5, 9.20 µm. The difference between groups 1 and 2 was statistically significant (P < 0.05). In this in vitro study, hand scaling with curettes produced smoother root surfaces than ultrasonic scaling. Adjunctive use of GPAP for 5 seconds along with hand scaling or ultrasonic scaling resulted in improved root surface smoothness during periodontal maintenance therapy.

The Clinical Efficacy of Subgingival Debridement by Ultrasonic Instrumentation Compared With Subgingival Air Polishing During Periodontal Maintenance: A Systematic Review.

OBJECTIVE: The objective of this review was to evaluate the effect of subgingival debridement by ultrasonic debridement (UD) in comparison with subgingival air polishing (SubGAP) during periodontal maintenance. METHODS: A systematic search of electronic databases was conducted to identify publications from January 01, 2000, to December 21, 2018. Publication selection, data extraction, and risk of bias assessment were performed by two reviewers independently. The addressed problem-intervention-comparison-outcomes question was "For patients in the periodontal maintenance phase, is SubGAP more likely to result in better clinical outcomes than UD?" RESULTS: From a total of 435 articles identified, 6 studies were included. Although none of them was evaluated to have a low risk of bias, overall, the main reason was that blinding of personnel was almost impossible to achieve for the study design. Owing to the heterogeneity, the data from included studies could not be synthesized. Most of the included studies suggested no statistical difference in pocket-depth reduction, except for one which showed UD was superior to SubGAP. In terms of clinical attachment loss and gingival regression, no treatment was indicated to have more benefits than the other based on the present evidence. SubGAP had a preferable comfort level compared with UD, as reported. It must be noted that none of included studies' follow-up time was more than 1 year. CONCLUSION: The clinical efficacy of SubGAP compared with that of UD for periodontal maintenance remains inconclusive on account of limited evidence. To date, neither SubGAP nor UD showed superior clinical effect when compared. High-quality, well-designed clinical studies are still needed to ascertain the long-term clinical stability.

[Efficacy of subgingival glycine air polishing on patients with early peri-implant diseases].

Objective: To compare the clinical efficacies of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing on patients with early peri-implant diseases (peri-implant mucositis and early peri-implantitis). Methods: Twenty-two systemically healthy patients with totally 42 implants and early peri-implant diseases, were recruited in this study. The patients were randomly divided into the test group and the control group. Patients in the test group were treated with subgingival glycine air polishing and patients in the control group were treated with ultrasonic scalers combined with 0.12% chlorhexidine rinsing. Periodontal parameters such as probing depth, bleeding index, plaque index and clinical attachment loss, at baseline and 2 months after treatment, respectively, were collected and compared between the test and control groups. Results: For the natural teeth, the parameters of probing depth, bleeding index, plaque index and attachment loss in the two groups were significantly improved after treatments (medians were 0.48 mm vs 0.22 mm, 1.00 vs-0.13, 0.38 vs 0.50, 0.48 mm vs 0.22 mm, respectively for test and control group). There was no statistical difference of median between the two groups after treatment except for that of the attachment loss (medians, 0.48 mm vs 0.22 mm, P=0.034). For the implants, differences of parameters in the two groups at baseline were insignificant. After treatments, the probing depths significantly decreased by 0.67 mm and 0.33 mm in the test group and the control group, respectively. The inter-group differences, however, were insignificant. Significant difference of the bleeding index after treatment was found in the test group (P=0.019), but not in the control group. No adverse reactions were found on patients in the two groups after treatments. Conclusions: Efficacy of subgingival glycine air polishing and ultrasonic scaling combined with 0.12% chlorhexidine rinsing is competitive on patients with early peri-implant diseases. However, the former treatment may be more effective oncontrolling the early peri-implant inflammation.