Background: This article critically appraises a randomized controlled trial that was conducted in 2016 to evaluate the efficacy of air polishing in peri-implant tissue maintenance compared with manual treatment.
Clinical question: In patients with implant prostheses, what is the efficacy of air polishing in maintaining periimplant tissue health when compared with a manual technique?
Summary of methods and results: The study population consisted of 46 patients, 24 in the air polishing group and 22 in the manual treatment group. At the beginning of treatment (baseline) and on a monthly basis for the duration of the study (6 months), all patients were subjected to oral hygiene sessions with either air-abrasive debridement with amino acid (glycine) powder or manual debridement and chlorhexidine treatment. The clinical measurements were performed with a plastic periodontal probe with a standardized probing force of 0.2 N. At baseline and after 3 and 6 months, the following periodontal indices were evaluated and recorded: plaque index (PI), bleeding index (BOP), probing depth (PD), clinical attachment level (CAL), and bleeding score (BS). No signs of inflammation were observed in eight patients (16 implants) in the air polishing group and no inflammation was observed in one patient (4 implants) in the manual treatment group. All subjects completed the study and no implants were lost.
Critical appraisal: This randomized controlled trial met most requirements of the Critical Appraisal Skills Program (CASP).
Practical implications: Air-abrasive debridement with glycine powder provides adequate and more effective removal of peri-implant biofilm and has lower risk of adverse effects, such as the formation of emphysema or site infection, when compared with manual treatment.