Subgingival Air Polishing

periodontal disease

Air polishers were introduced in the field of dentistry in 1954 for the removal of decay. Although they aren’t used for decay removal today, these devices incorporate an abrasive powder with a stream of compressed air and water to clean and polish a surface. Air Polishers are mostly used by the dental hygienist to remove stain, plaque, and polish the enamel above the gum line.

However, recent technology has been introduced in the USA regarding air polishers that employ a unique nozzle design and specialized powders to transport a very low abrasive powder into the subgingival area for the removal of biofilm. This procedure is very different from supragingival air polishing due to the specialized tip and the type of powder used.

In supragingival polishing, the powder of choice is usually sodium bicarbonate which is abrasive and helpful with the removal of heavy stains and soft deposits above the gumline. With subgingival air polishers, the tip is specialized to be able to effectively enter the periodontal pocket and deliver a very low abrasive powder. The powder of choice with subgingival air polishing is Glycine. Glycine is an amino acid and is significantly smaller in particle size than sodium bicarbonate. It appears to have an active role in the disruption of bacterial recolonization making it both preventive and therapeutic.

The main goal in subgingival air polishing is root debridement resulting in the removal of biofilm. This biofilm elimination can result in a beneficial shift in the oral microbiota. Studies have shown that subgingival air polishing tends to have less adverse effects for the patient such as pain and sensitivity versus hand instrumentation. Moreover, the subgingival air polisher is much more effective in reaching the base of pockets over 5mm and removing biofilm than hand instrumentation.

Subgingival air polishing is also proven to be clinically efficient and effective for the removal of biofilm without endangering soft tissues, enamel, dentin, or cementum. The procedure is very quick and simple. The tip is placed at a 90-degree angle to the long axis of the root, and a 5-second application disperses air, water, and glycine powder for the removal of biofilm.

These units aren’t inexpensive by any means, but they show much promise in the ongoing fight against Periodontal disease. They can also be used safely around implants perhaps preventing Peri-Implant Mucositis and Implantitis. When it comes to combating Periodontal disease, this new technology deserves a second look.

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