Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy

Wennström JL, Dahlén G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison to ultrasonic instrumentation during maintenance therapy. J Clin Peridontol 2011; 38: 820–827. doi: 10.1111/j.1600‐051X.2011.01751.x. Abstract Aim: The objective was to determine clinical and microbiological effects and perceived treatment discomfort of root debridement by subgingival air polishing compared with ultrasonic instrumentation during supportive periodontal therapy (SPT). Material and methods: The trial was conducted as a split‐mouth designed study of 2‐month duration including 20 recall patients previously treated for chronic periodontitis. Sites with probing pocket depth (PPD) of 5–8 mm and bleeding on probing (BoP+) in two quadrants were randomly assigned to subgingival debridement by (i) glycine powder/air polishing applied with a specially designed nozzle or (ii) ultrasonic instrumentation. Clinical variables were recorded at baseline, 14 and 60 days post‐treatment. Primary clinical efficacy variable was PPD reduction. Microbiological analysis of subgingival samples was performed immediately before and after debridement, 2 and 14 days post‐treatment. Results: Both treatment procedures resulted in significant reductions of periodontitis‐associated bacterial species immediately and 2 days after treatment, and in significant reduction in BoP, PPD and relative attachment level at 2 months. There were no statistically significant differences between the treatment procedures at any of the examinations intervals. Perceived treatment discomfort was lower for air polishing than ultrasonic debridement. Conclusion: This short‐term study revealed no pertinent differences in clinical or microbiological outcomes between subgingival air polishing and ultrasonic debridement of moderate deep pockets in SPT patients.