Clinical outcomes following periodontal surgery and root surface decontamination by erythritol-based air polishing. A randomized, controlled, clinical pilot study

Abstract

Aim To evaluate the outcomes following surgical periodontal treatment and root surface decontamination by means of air polishing using an erythritol powder or conventional mechanical root debridement. Material and methods Thirty systemically healthy patients (44.38 ± 8.2 years old, 11 smokers, 19 women) diagnosed with periodontitis stages III-IV were included. Each patient, with one single-rooted tooth, with one probing pocket depth (PD) ≥ 6 mm associated with horizontal bone loss, was treated by means of simplified papilla preservation flap (SPPF) and randomized to either test treatment (careful removal of the calculus with the tip of a blade, air polishing of the root surfaces with erythritol) or to the control group (scaling and root planing with hand curettes, ultrasonic instruments). PD, clinical attachment (CAL), bone sounding (BS), and radiographic bone level (BL) were evaluated at baseline and 12 months postsurgically. Results Twenty-seven patients completed the 12-month follow-up (test: n = 14, control: n = 13). In both groups, statistically significant improvements were obtained (p < 0.05, mean CAL gain/PD reduction: test, 2.50 ± 1.60 mm/3.00 ± 0.96 mm; control, 2.85 ± 1.21 mm/3.38 ± 1.12 mm). No statistically significant differences were observed between the groups for any of the investigated parameters (p < 0.05). Conclusion Within their limits, the present results indicate that the use of air polishing with an erythritol powder during periodontal surgery may represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus. Clinical relevance The use of air polishing with an erythritol powder during periodontal surgery appears to represent a valuable minimally invasive adjunct following calculus removal by means of hand and ultrasonic instruments or a valuable alternative to these, for root surfaces without calculus.

Efficacy of erythritol powder air‐polishing in active and supportive periodontal therapy: A systematic review and meta‐analysis

“…From the eight included studies (Table 2), four trials 19,26,27,29 were conducted during the SPT phase, and four trials 22–25 were conducted during the APT. Five RCTs 19,22–24,27 followed a parallel design, whereas three 25,26,29 used a split‐mouth design.…”

“…Every study, except one, reported gender distribution 25 . The minimum mean age was 44.3 years, 23 and the maximum mean age was 61 years 26 . Seven studies included smokers 19,22–24,26,27,29 ; however, in two of these studies, individuals smoking more than 7 24 and 10 23 cigarettes per day were excluded.…”

“…The minimum mean age was 44.3 years, 23 and the maximum mean age was 61 years 26 . Seven studies included smokers 19,22–24,26,27,29 ; however, in two of these studies, individuals smoking more than 7 24 and 10 23 cigarettes per day were excluded. In the remaining study, 25 inclusion or exclusion of smokers was not reported.…”

“…Therefore, EPAP is more acceptable as an alternative to SPT but only as adjunctive during APT due to its limitation in removing large and firmly attached masses of calculus and other hard deposits 21 . Significant improvement in periodontal clinical parameters including CAL gain and reduction of PPD and BoP was observed when EPAP was used either as adjunctive to APT 22–25 or as a monotherapy during SPT 19,26,27 . Furthermore, erythritol has antibacterial properties against periodontal pathogens 28 .…”

In Vitro Evaluation of the Abrasiveness of Novel Bioactive Glass Powders (Biominf®) on Ivory Dentine in Air Polishing Procedures Compared to Selected Reference Powders

“…Several clinical studies demonstrated that the application of air-polishing could result in similar outcomes in biofilm removal as well as clinical parameters while providing less discomfort and chair time compared to conventional methods [4][5][6]. Recently, the application of air-polishing has extended to surface decontamination during periodontal surgery [7].…”