Air-Polishing in Subgingival Root Debridement: A Critical Literature Review

Aims: The objective of this literature review was to assess the new powders used in air polishing (AP) for subgingival debridement in terms of their debridement efficiency, effects on oral hard and soft tissues, and adverse effects. Also, to determine the disadvantages of this technique together with other relevant clinical considerations regarding its use. Methods: A literature search of five databases (PubMed, Scopus, The Cochrane Library, Web of Science, Embase) was conducted. The keywords used were air polishing, air abrasion, scaling, and subgingival debridement. This was supplemented with hand search of the bibliography or reference list of the relevant papers. Studies not reporting the full text in English, or not evaluating AP in the subgingival environment of natural tooth surfaces were excluded. Results: Of the 65 abstracts screened, 32 studies were included in the qualitative analysis. Several air polishing powders were assessed in terms of their debridement efficiency, effects on oral hard and soft tissues, and adverse effects. Conclusion: The current literature indicates that AP is a valid, highly efficient, and convenient treatment approach to subgingival debridement. It also appears to be superior to conventional treatment with respect to patient comfort, safety, and time efficiency. Moreover, air polishing with sodium bicarbonate appears to be the most abrasive procedure to both the soft and hard tissues in the oral cavity.