The efficacy of the adjunct use of subgingival air‐polishing therapy with erythritol powder compared to conventional debridement alone during initial non‐surgical periodontal therapy

Abstract

Aim To assess the efficacy of the adjunct use of a subgingival erythritol powder air‐polishing device (EPAP) in comparison to conventional subgingival instrumentation alone during initial non‐surgical periodontal therapy. Materials and Methods Twenty‐one patients with generalized Stages 2 and 3 grade B periodontitis were included in this single centre, single blinded, split‐mouth, randomized clinical trial. Teeth on the control side were treated with conventional hand and ultrasonic instrumentation, while those on the contralateral test side was treated using EPAP as adjunct to conventional subgingival instrumentation with hand and ultrasonic instruments. Three months after initial instrumentation, persisting pockets of ≥4 mm were re‐treated, in both control and test sides, again with the respective treatment approach—subgingival instrumentation alone on control, and subgingival instrumentation + EPAP on test side. Clinical parameters such as probing pocket depth (PPD), bleeding on probing, and relative attachment level were recorded at baseline and 3 and 6 months following the initial instrumentation. Subgingival plaque samples were collected at baseline, immediately post surgery, as well as at 1 week, 1 month, 3 months, and 6 months after initial instrumentation. Results In the test group after 6 months, a significantly larger number of initially deep pockets (PPD ≥ 5.5 mm) were reduced to shallow (PPD ≤ 3.4 mm), and a larger attachment gain was observed. No statistically significant microbiological differences could be found between test and control group. Conclusions The results of the present study indicate that the adjunct use of subgingival airflow therapy with EPAP during initial non‐surgical periodontal therapy might be beneficial in initially deep pockets (PPD ≥ 5.5 mm).

Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review

“…Both treatment methods significantly reduced periodontitis-related bacterial species, as well as BoP, PPD, and the relative attachment level. No significant differences were found between the various treatment methods [61].…”

“…However, it may exert positive effects, such as reducing the frequency of residual periodontal pockets with a probing depth of 5 mm [60]. Resnik et al discovered that during the initial phase of non-surgical periodontal therapy, subgingival airflow therapy combined with an erythritol powder air-polishing device (EPAP) might benefit patients with initially deep pockets (probing pocket depth of 5.5 mm) [61]. Both treatment methods significantly reduced periodontitis-related bacterial species, as well as BoP, PPD, and the relative attachment level.…”

Effectiveness and Clinical Performance of Erythritol Air-Polishing in Non-Surgical Periodontal Therapy: A Systematic Review of Randomized Clinical Trials

“…Furthermore, in the systematic review of Nascimento and coworkers [ 6 ], air-polishing showed no superior difference in comparison to SRP. Furthermore, a recent RCT published by Divnic-Resnik and coworkers concluded that EPAP could be efficient in reducing initial periodontal pockets with PD ≥ 5.5 mm [ 18 ]. On the other hand, the systematic review from Zhang and coworkers [ 19 ] concluded no efficiency of subgingival air-polishing compared to subgingival ultrasonic debridement during SPT.…”

Abalone‐Inspired Adhesive and Photo‐Responsive Microparticle Delivery Systems for Periodontal Drug Therapy

“…[ 2 ] Meanwhile, the surgical process would bring patients fear and discomfort. [ 3 ] As an alternative, antibiotics, such as minocycline, [ 4 ] metronidazole, [ 5 ] and tinidazole, [ 6 ] have shown promising potential in treating periodontitis. [ 7 ] Especially by simply adding these antibiotics to ointments and applying the resultant ointments to the target area, the release of antibiotics would kill the pathogens effectively, bringing about complete inflammatory eradication.…”