An Umbrella Review on Low-Abrasive Air Powder Water Jet Technology in Periodontitis and Peri-Implantitis Patients

Abstract

This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythritol or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctively. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time.

Air powder waterjet technology using erythritol or glycine powders in periodontal or peri‐implant prophylaxis and therapy: A consensus report of an expert meeting

“…In addition, due to organizational restrictions and limited time, only a modified one‐round Delphi survey was conducted. However, the obtained results seem to be underlined by the existing literature (Hatz et al, 2022 ).…”

“…The survey was based on an umbrella review project, which was performed to evaluate the actual scientific evidence on APWT in periodontal and PI therapy (Hatz et al, 2022 ). The survey consisted of nine thematic blocks and respective answers were given in a 5‐point Likert scale with values from +2 to −2, with the zero value for “Neutral” in each case dividing responses between positive and negative assessments.…”

“…T A B L E 9 Results of the first-round survey regarding study quantity and quality regarding the evaluated topics (exhaustive: 2; neutral: 0; very poor: −2). While the EFP guideline for periodontitis by Sanz et al (2020) does not specifically address air polishing as a stand-alone or adjunctive method in the treatment of Stage I-III periodontal therapy, numerous systematic reviews and randomized controlled trials provide evidence supporting the efficacy of APWT in both active and SPT (Hatz et al, 2022;Nascimento et al, 2021;Tan et al, 2022).…”