Trehalose powder for subgingival air‐polishing during periodontal maintenance therapy: A randomized controlled trial

Abstract

Background Air‐polishing appears to be a promising procedure for subgingival biofilm removal in periodontal treatment. The aim of this study was to compare trehalose powder for subgingival air‐polishing with sonic debridement in residual periodontal pockets during maintenance therapy. Methods In this blinded, randomized, controlled clinical trial conducted over 6 months with a split‐mouth design, single‐rooted teeth in 44 participants with residual pocket depths of 5 mm and bleeding or >5 mm with and without bleeding were included in this study. Subgingival debridement was carried out using either trehalose powder with an air‐polishing device (test) or a sonic device (control). The reduction in the probing depths after 3 and 6 months was defined as the primary endpoint. A visual analog scale was used to evaluate the discomfort of both procedures. Results Both procedures showed statistically significant intragroup reductions in probing depths (test baseline [BL] 5.52 ± 0.93, 6 months 3.66 ± 0.81, control BL 5.55 ± 0.9, 6 months 3.68 ± 0.86, P < 0.001), clinical attachment level (test BL 6.93 ± 1.5, 6 months 5.3 ± 1.52, control BL 7.27 ± 1.8, 6 months 5.84 ± 1.71, P < 0.001), and bleeding on probing (test BL 86%, 6 months 41%, control BL 89%, 6 months 34%, P < 0.001) after 6 months with no significant intergroup differences (P > 0.05, respectively). The visual analog scale showed a significantly lower incidence of discomfort for air‐polishing compared with sonic scaling (test 2.33 ± 2.14, control 4.91 ± 2.65, P < 0.001). Conclusions Subgingival air‐polishing with trehalose powder showed comparable clinical outcomes to sonic scaling. Sonic scaling evoked more discomfort compared with air‐polishing.

Cellular effects of glycine and trehalose air-polishing powders on human gingival fibroblasts in vitro

“…Within the last decade, more powders such as trehalose have been established. Mechanical efficiency of both glycine and trehalose powders has been shown in detail [10,17]. Surprisingly, data regarding the effect of these powders on periodontal cells are scarce, although these powders get into direct contact with the respective cells.…”

Antimicrobial Impact of Different Air-Polishing Powders in a Subgingival Biofilm Model

“…This is why most studies have strongly emphasized the view of APDs as an adjuvant treatment method following the removal of mineralized bacterial deposits using conventional subgingival debridement [ 26 ]. This is the main reason why there has been a search for new low-abrasion powders for subgingival application that are equally effective [ 33 ].…”

“…Patients perceive the use of hand instruments or ultrasonic scalers for subgingival debridement as unpleasant, while the use of air-polishing devices is often reported to be more comfortable and less painful [ 25 , 33 ]. A systematic review of patients’ perception of the use of air-polishing devices during periodontal treatment by Bühler et al reported that discomfort was consistently equivalent or lower when air-polishing powders consisting of glycine or erythritol were applied in comparison to root surface instrumentation using hand instruments or ultrasonic devices [ 46 ].…”

“…With an average particle size of 30–65 µm, it can be used for supragingival and subgingival applications in accordance with the manufacturer’s instructions [ 25 ]. The manufacturer’s data from preliminary in vitro trials indicate that the abrasive effect on dental hard substance is comparable to that of glycine, and it has a comparable particle diameter [ 33 ]. Only a few studies are to date available on the trehalose air-polishing powder.…”

“…Only a few studies are to date available on the trehalose air-polishing powder. A study by Kruse et al reported that subgingival air polishing using trehalose powder showed comparable clinical outcomes (probing depth, clinical attachment level, and bleeding on probing) to subgingival ultrasonic scaling [ 33 ]. These results were confirmed by another recently published study by Kruse et al that also found no statistically significant differences in clinical parameters (probing depth, clinical attachment level, and bleeding on probing) between patients treated with ultrasonic scaling and those receiving air polishing using trehalose powder [ 25 ].…”