Adjunctive Air-polishing with Erythritol in Nonsurgical Periodontal Therapy: a Randomized Clinical Trial

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2020 Dec 29

PMID 33372602

Citations 14

Authors

Holger F R Jentsch

Christian Flechsig

Benjamin Kette

Sigrun Eick

Affiliations

Soon will be listed here.

Abstract

Background: This study was aimed to investigate if the adjunctive use of erythritol air-polishing powder applied with the nozzle-system during subgingival instrumentation (SI) has an effect on the outcome of non-surgical periodontal treatment in patients with moderate to severe periodontitis.

Methods: Fourty-two individuals with periodontitis received nonsurgical periodontal therapy by SI without (controls, n = 21) and with adjunctive air-polishing using nozzle + erythritol powder (test, n = 21). They were analyzed for the clinical variables BOP (primary outcome at six months), probing depth (PD), attachment level, four selected microorganisms and two biomarkers at baseline, before SI as well as three and six months after SI. Statistical analysis included nonparametric tests for intra- and intergroup comparisons.

Results: In both groups, the clinical variables PD, attachment level and BOP significantly improved three and six months after SI. The number of sites with PD ≥ 5 mm was significantly lower in the test group than in the control group after six months. At six months versus baseline, there were significant reductions of Tannerella forsythia and Treponema denticola counts as well as lower levels of MMP-8 in the test group.

Conclusions: Subgingival instrumentation with adjunctive erythritol air-polishing powder does not reduce BOP. But it may add beneficial effects like reducing the probing depth measured as number of residual periodontal pocket with PD ≥ 5 mm when compared with subgingival instrumentation only.

Clinical Relevance: The adjunctive use of erythritol air-polishing powder applied with the nozzle-system during SI may improve the clinical outcome of SI and may reduce the need for periodontal surgery. Trial registration The study was retrospectively registered in the German register of clinical trials, DRKS00015239 on 6th August 2018, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL .

Citing Articles

Guided biofilm therapy versus conventional protocol-clinical outcomes in non-surgical periodontal therapy.

Cyris M, Festerling J, Kahl M, Springer C, Dorfer C, Graetz C BMC Oral Health. 2024; 24(1):1105.

PMID: 39294663 PMC: 11409476. DOI: 10.1186/s12903-024-04898-z.

The efficacy of diode laser and subgingival air polishing with erythritol in treatment of periodontitis (clinical and microbiological study).

Elmeligy S, Saleh W, Elewa G, Abu El-Ezz H, Mahmoud N, Elmeadawy S BMC Oral Health. 2024; 24(1):763.

PMID: 38965550 PMC: 11225135. DOI: 10.1186/s12903-024-04481-6.

Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial.

Alsuwaidi S, Almatrooshi A, Shah M, Hakam A, Tawse-Smith A, Alsabeeha N J Periodontol. 2024; 95(11):1048-1059.

PMID: 38830779 PMC: 11609494. DOI: 10.1002/JPER.24-0099.

Clinical evaluation of a novel protocol for supportive periodontal care: A randomized controlled clinical trial.

Stahli A, Ferrari J, Schatzmann A, Weigel L, Roccuzzo A, Imber J J Periodontol. 2024; 95(11):1025-1034.

PMID: 38291892 PMC: 11609489. DOI: 10.1002/JPER.23-0527.

Subgingival Use of Air-Polishing Powders: Status of Knowledge: A Systematic Review.

Gheorghe D, Bennardo F, Silaghi M, Popescu D, Maftei G, Bataiosu M J Clin Med. 2023; 12(21).

PMID: 37959401 PMC: 10647465. DOI: 10.3390/jcm12216936.

References

Suvan J, Leira Y, Moreno Sancho F, Graziani F, Derks J, Tomasi C . Subgingival instrumentation for treatment of periodontitis. A systematic review. J Clin Periodontol. 2020; 47 Suppl 22:155-175. DOI: 10.1111/jcpe.13245. View

Moher D, Schulz K, Altman D . The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Lancet. 2001; 357(9263):1191-4. View

Bartold P, Van Dyke T . Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000. 2013; 62(1):203-17. PMC: 3692012. DOI: 10.1111/j.1600-0757.2012.00450.x. View

Darveau R, Hajishengallis G, Curtis M . Porphyromonas gingivalis as a potential community activist for disease. J Dent Res. 2012; 91(9):816-20. PMC: 3420389. DOI: 10.1177/0022034512453589. View

Tomasi C, Leyland A, Wennstrom J . Factors influencing the outcome of non-surgical periodontal treatment: a multilevel approach. J Clin Periodontol. 2007; 34(8):682-90. DOI: 10.1111/j.1600-051X.2007.01111.x. View

Hagi T, Hofmanner P, Eick S, Donnet M, Salvi G, Sculean A . The effects of erythritol air-polishing powder on microbiologic and clinical outcomes during supportive periodontal therapy: Six-month results of a randomized controlled clinical trial. Quintessence Int. 2014; 46(1):31-41. DOI: 10.3290/j.qi.a32817. View

Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T . Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline. J Clin Periodontol. 2020; 47 Suppl 22:4-60. PMC: 7891343. DOI: 10.1111/jcpe.13290. View

Haffajee A, Cugini M, Dibart S, Smith C, Kent Jr R, Socransky S . The effect of SRP on the clinical and microbiological parameters of periodontal diseases. J Clin Periodontol. 1997; 24(5):324-34. DOI: 10.1111/j.1600-051x.1997.tb00765.x. View

Tonetti M, Greenwell H, Kornman K . Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018; 89 Suppl 1:S159-S172. DOI: 10.1002/JPER.18-0006. View

10.

Wennstrom J, Dahlen G, Ramberg P . Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol. 2011; 38(9):820-7. DOI: 10.1111/j.1600-051X.2011.01751.x. View

11.

Jentsch H, Buchmann A, Friedrich A, Eick S . Nonsurgical therapy of chronic periodontitis with adjunctive systemic azithromycin or amoxicillin/metronidazole. Clin Oral Investig. 2015; 20(7):1765-73. DOI: 10.1007/s00784-015-1683-1. View

12.

Muller N, Moene R, Cancela J, Mombelli A . Subgingival air-polishing with erythritol during periodontal maintenance: randomized clinical trial of twelve months. J Clin Periodontol. 2014; 41(9):883-9. PMC: 4287198. DOI: 10.1111/jcpe.12289. View

13.

Luchesi V, Pimentel S, Kolbe M, Ribeiro F, Casarin R, Nociti Jr F . Photodynamic therapy in the treatment of class II furcation: a randomized controlled clinical trial. J Clin Periodontol. 2013; 40(8):781-8. DOI: 10.1111/jcpe.12121. View

14.

Cobb C, Daubert D, Davis K, Deming J, Flemmig T, Pattison A . Consensus Conference Findings on Supragingival and Subgingival Air Polishing. Compend Contin Educ Dent. 2017; 38(2):e1-e4. View

15.

Munro I, BERNDT W, Borzelleca J, Flamm G, Lynch B, Kennepohl E . Erythritol: an interpretive summary of biochemical, metabolic, toxicological and clinical data. Food Chem Toxicol. 1998; 36(12):1139-74. DOI: 10.1016/s0278-6915(98)00091-x. View

16.

Hashino E, Kuboniwa M, Alghamdi S, Yamaguchi M, Yamamoto R, Cho H . Erythritol alters microstructure and metabolomic profiles of biofilm composed of Streptococcus gordonii and Porphyromonas gingivalis. Mol Oral Microbiol. 2013; 28(6):435-51. DOI: 10.1111/omi.12037. View

17.

Lang N, Bartold P . Periodontal health. J Periodontol. 2018; 89 Suppl 1:S9-S16. DOI: 10.1002/JPER.16-0517. View

18.

Griffiths G . Formation, collection and significance of gingival crevice fluid. Periodontol 2000. 2003; 31:32-42. DOI: 10.1034/j.1600-0757.2003.03103.x. View

19.

Lange D, Plagmann H, Eenboom A, Promesberger A . [Clinical methods for the objective evaluation of oral hygiene]. Dtsch Zahnarztl Z. 1977; 32(1):44-7. View

20.

Chapple I, Mealey B, Van Dyke T, Bartold P, Dommisch H, Eickholz P . Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018; 45 Suppl 20:S68-S77. DOI: 10.1111/jcpe.12940. View