Tooth Surface Comparison After Air Polishing and Rubber Cup: A Scanning Electron Microscopy Study

Objectives: To demonstrate, using microscopic observations, the difference between two well-known oral prophylaxis techniques: polishing paste and air polishing. The observations were performed on human enamel.

Methods: Enamel samples were obtained from plaque-rich human teeth extracted for orthodontic or clinical purposes. In order to allow a reliable comparison between different applications, each enamel sample was divided into two parts: one underwent air-polishing, whereas polishing paste was applied to the other. AIR-FLOW® Master was selected together with AIR-FLOW® PLUS for the prophylaxis powder application. For the polishing-paste application, several different pastes where used, including Cleanic®, CCS®, Proxyt®, and SuperPolish. A comparative test control was also used by cleaning the enamel with sodium hypochlorite (6%).

Results: The enamel treated with AIR-FLOW PLUS showed a similar surface when compared to the control enamel; however, there was complete cleaning down to the tooth microstructure. On the other hand, use of the polishing paste resulted in an enamel surface that appeared abraded and flattened. Moreover, some of the natural irregular enamel surfaces demonstrated some filling in with debris.

Conclusions: AIR-FLOW PLUS powder was able to more deeply clean without creating any damage to the enamel, making it suitable for regular cleaning treatments. The polishing pastes were found to abrade the enamel surface, to flatten it, and deposit debris into the microcavities. Both methods having different mechanical effects can therefore be considered as complementary, in that some patients experience a sense of "roughness" following a cleaning. A clinical recommendation for this experience would be to use the air polish first to clean the enamel surface, and follow with a little polishing paste to smooth the surface, if required.