Subgingival plaque removal using a new air-polishing device

Abstract

Background: The purpose of this study is to evaluate the safety, patient acceptance, and short-term microbiologic effect of a new air-polishing device in subjects in maintenance care with residual pockets > or =5 mm.

Methods: This was an examiner-masked, randomized, split-mouth clinical trial. A new disposable nozzle, allowing the subgingival application of amino acid glycine powder at a limited pressure, was compared to scaling and root planing (SRP) in 50 subjects with residual pockets during the maintenance phase. After removing supragingival deposits, the spray was applied for 4 to 5 seconds in all sites > or =5 mm in the test quadrant, whereas SRP was used in the control quadrant. Microbiologic samples were taken from one treated test and one control site 2 days before and 7 days after treatment. Total bacterial counts and the counts of six periodontal pathogens were determined by real-time polymerase chain reaction.

Results: No adverse event was noted in any subject for the test or control treatment. Using a visual analog scale, the patients perceived the test treatment to be significantly less painful/uncomfortable than the hand instrumentation (P <0.001). Significantly less time was used by the operator for the test procedure (P <0.001). The reduction in bleeding on probing was significant for the treated sites in the test and control quadrants (P = 0.019 and P <0.001, respectively), but traditional SRP reduced the bleeding tendency significantly more than air polishing (P = 0.045). The differences in the total bacterial load and the counts of six periodontal pathogens between the test and control sites did not reach statistical significance. The longitudinal reduction was significant in control sites for total bacteria load (P <0.001), Porphyromonas gingivalis (P = 0.01), Treponema denticola (P <0.001), and Tannerella forsythia (previously T. forsythensis) (P <0.001).

Conclusion: Subgingival air polishing with a new device was safe (no adverse events were noted), perceived to be more acceptable by the patients, and was more time-efficient than SRP; however, on a microbiologic level, it was not superior to conventional SRP.