The benefits of using glycine powder are twofold: it provides a safe alternative to sodium bicarbonate for effective removal of biofilm and stain, and it allows for subgingival removal of biofilm without risk of harming oral tissues such as dentin and cementum. Glycine is a nonessential amino acid and the substance is significantly smaller in particle size when compared to sodium bicarbonate powders. New technologies have now been created for subgingival polishing with glycine powder as the main polishing agent. When used effectively, subgingival air polishing can safely remove biofilm from enamel and root surfaces, and within the periodontal pocket. New technology has expanded the traditional method of biofilm and stain removal from only supragingival removal to include subgingival surfaces. 2,17,18 While benefits exist for the use of conventional sodium bicarbonate air polishing, studies have shown that it is not possible to adjust the working field to be safe for effective debridement of biofilm from root surfaces or subgingival surfaces. 16 This is a particular concern for patients with periodontal disease, as there is a high incidence of coexisting gingival recession in these patients. Research has shown that air polishing using sodium bicarbonate led to root structure loss and, therefore, cannot be recommended in patients with exposed root surfaces. In addition, sodium bicarbonate air polishing can lead to erosion or dulling effects of filling materials. 2–10 Disadvantages include salty taste, large particle size, aerosol production, unpleasant stinging sensation, potential for soft tissue trauma, and contraindicated for use on root surfaces, demineralized surfaces, and restorative materials. Research also shows that sodium bicarbonate air polishing is approximately one-third less time consuming when compared with hand instrumentation and rubber cup polishing. Advantages include safe and efficient removal of extrinsic plaque and stains on intact enamel surfaces. Table 1 lists the contraindications for sodium bicarbonate air polishing powder. 2 Aluminum trihydroxide is an alternative type of low abrasive powder that may also be used for supragingival air polishing, but it is not water soluble. Sodium bicarbonate is nontoxic and water soluble, thus making it ideal for intraoral use. The traditional supragingival air polishing powder is sodium bicarbonate. Supragingival air polishing is technique sensitive but offers an alternative to traditional rubber cup polishing for removal of biofilm and extrinsic stain. Indications for use include removal of biofilm and stain on enamel surfaces, and cleaning of pits and fissures prior to sealant placement. CONVENTIONAL SUPRAGINGIVAL AIR POLISHINGĬonventional supragingival air polishing uses a combination of air, water, and abrasive powders. The use of air polishing can also provide benefits to both patients and clinicians. 1 Traditionally, biofilm management has been professionally disrupted using ultrasonic instrumentation, hand instrumentation, and rubber cup polishing. Goals of periodontal debridement include removal of calculus and biofilm, elimination of inflammation, removal of infection, and maintenance of a healthy periodontium. Professional removal of biofilm is an integral aspect of nonsurgical periodontal therapy and the preventive services provided by oral health professionals. Most subgingival biofilm within pockets cannot be reached by conventional toothbrushes, floss, interdental aids, or mouthrinses. Plaque biofilm is the primary etiology for gingival diseases therefore, disruption and removal slow down progression of the inflammatory process. One of the greatest challenges for achieving and maintaining a healthy periodontium is biofilm management. List strategies for implementing air polishing into the dental hygiene process of care.Discuss the type of equipment needed in air polishing.Compare and contrast conventional supragingival air polishing with subgingival air polishing.Identify the role of biofilm management in periodontal health.This 2 credit hour self-study activity is electronically mediated.Īfter reading this course, the participant should be able to: The authors have no commercial conflicts of interest to disclose. This course was published in the October 2018 issue and expires October 2021.
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