Clinical and Microbiological Study about Efficacy of Air-polishing and Scaling and Root-planing

  • School of dentistry, Chosun University
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The efficacy of air-polishing on subgingival debridement, as compared to scaling and root planning (SRP), was evaluated clinically and microbiologically. Fifteen patients diagnosed as chronic periodontitis, and having single-root tooth over 5 mm of pocket depth symmetrically in the left and right quadrant, were investigated. Subgingival debridement was performed by SRP and air-polishing. The results were evaluated and compared clinically and microbiologically. Probing pocket depth (PPD), bleeding on probing (BOP), relative attachment level (RAL) and change of gingival crevicular fluid (GCF) were assessed before treatment, and at 14 and 60 days after treatment. Microbial analysis was done pre-treatment, post-treatment, and at 14 and 60 days after treatment. Results of air polishing showed that post treatment, the PPD and BOP decreased, and attachment gain was observed. There was no clinical difference when compared to SRP. The volume of GCF decreased at 14 days, and increased again at 60 days. Compared to SRP, there was a statistical significance of the volume of GCF at 60 days in air-polishing. In the microbial analysis, high-risk bacteria that cause periodontal disease were remarkably reduced. They decreased immediately after treatment, but increased again with the passage of time. Thus, our results show that subgingival debridement by air-polishing was effective for decrease of pocket depth, attachment gain, decrease of GCF and inhibition of pathogens. Further studies are required to compare air-polishing and SRP, considering factors such as degree of pocket depth and calculus existence. Intergroup differences were more distinct through the measurements of gingival crevicular fluid. With no pre-treatment difference seen in both groups in the amount of gingival crevicular fluid secretion, this amount was lower in the SRP group on post-debridement day 14 days and days 60, but significantly different between the two groups on post-debridement day 60 (P<0.05). Gingival crevicular fluid was significantly reduced in both groups on post-debridement day 14 compared to the pre-debridement levels, probably because the periodontal therapy improved periodontal tissues. With time, the bacteria within the periodontal pocket recovered to the pre-procedure levels after SRP. This recovery was reported to take approximately 9 to 12 weeks depending on the patient [3,4]. We also found that the secretion of gingival crevicular fluid started increasing again on post-debridement day 60, and a significant difference was seen in the SRP group but no significant difference in the air polishing group compared to the amount of secretion at the time of the first visit. These results were probably because the existing bacteria in calculus affected the aggregation of colonies second times and the amount of gingival crevicular fluid secretion increased faster in the air polishing group.

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... Several studies demonstrated a reduction of enamel roughness. Although this would be beneficial after scaling [19,20], surface reduction may also increase susceptibility to erosive effects which can further increase enamel surface loss and may induce or intensify dentin hypersensitivity [21]. Our findings also revealed a loss of tooth structure with disappearance of the natural texture of enamel after the use of AP with calcium carbonate. ...
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Air-abrasion is a popular prophylactic procedure to maintain oral hygiene. However, depending on the applied air-abrasive powder, it can damage the surface of the tooth and restorations, making it susceptible to plaque accumulation. The purpose of this study was to investigate the effect of 5s and 10s air-abrasion of calcium-carbonate on surface roughness (Ra) of enamel, nan-ofill and microhybrid resin-composites and the effect of post-polishing with two-step rubber- (RP) or one-step brush polisher (BP) to re-establish the surface smoothness. Surface topography was visualized by scanning-electron-microscopy. The quantitative measurement of the Ra was carried out with atomic-force-microscopy. Air-abrasion for 10s decreased the Ra of enamel as a result of abrasion of the natural surface texture. Post-polishing with RP after 10s air-abrasion did not change the Ra, BP however, increased Ra significantly by scratching the surface. Air-abrasion increased the Ra of resin-composites significantly irrespective of the application time. While RP provided a similarly smooth surface to the control in the case of microhybrid resin-composite, BP increased the Ra significantly. The Ra for the control group of the nanofill-resin-composite was initially high, which was further increased by air-abrasion. RP and BP re-established the initial Ra with deeper and shallower scratches after BP. Both material and treatment type showed a large effect on Ra. Keywords: air-abrasion, enamel, microhybrid, nanofill, polishing, resin-composite, surface roughness
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