Clinical Effects and Metagenomic Analysis of Using an Air Polishing Device With Erythritol Powder Compared to Scaling and Root Planing in Periodontal Maintenance Therapy.

Clinical Effects and Metagenomic Analysis of Using an Air Polishing Device With Erythritol Powder Compared to Scaling and Root Planing in Periodontal Maintenance Therapy: A Randomized Clinical Trial

Periodontitis is a chronic, multifactorial disease primarily driven by the accumulation of bacterial deposits. Treatment involves the mechanical removal of the biofilm, traditionally performed by scaling and root planing (SRP). However, SRP is time-consuming and can cause irreversible damage to both hard and soft tissues as well as postoperative sensitivity. Consequently, adjunctive or alternative air-polishing devices have been developed. The objective of this study is to compare the clinical and microbiological efficacy of an erythritol-powder air-polishing device versus SRP in periodontal maintenance therapy.To evaluate patient-reported pain and treatment time for erythritol air-polishing versus SRP. A randomized clinical trial was designed and participants were randomly assigned to one of two groups: Intervention: Perio-Flow® (air + erythritol powder) and PIEZON PS®. Control: Ultrasonic debridement followed by SRP with Gracey curettes.At baseline and at six months, probing depth, clinical attachment level, and bleeding on probing were recorded. Saliva samples were collected to detect the most prevalent periodontal pathogens. Patient discomfort during treatment was measured by a visual analog scale, and procedure duration was timed.

Study Overview

• Status: Completed
• Conditions: Periodontitis
• Intervention / Treatment: Device: Cavitron® ultrasonic scaler; Device: AIRFLOW® Prophylaxis Master

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Spain
  • Valencia
    • Alfara del Patriarca, Valencia, Spain, 46115
      • Universidad CEU Cardenal Herrera

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients who have received basic periodontal treatment between 3-6 months before the study.

Exclusion Criteria:

• Pregnant or breastfeeding patients.
• Use of systemic antibiotics within 6 months prior to the study.
• Patients who smoke more than 10 cigarettes/day.
• Uncontrolled diabetic patients.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Periodontal maintenance with ultrasonic + scaling and root planning	Device: Cavitron® ultrasonic scaler; Periodontal maintenance with ultrasonic scaler and manual curettes in periodontal patients.
Experimental: Periodontal maintenance with erythritol air polishing	Device: AIRFLOW® Prophylaxis Master; Periodontal Maintenance with Erythritol Air Polisher in periodontal patients.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Improvement of clinical periodontal parameter: clinical attachment level	Measurement of clinical attachment level in milimeters	six months
Improvement of clinical periodontal parameter: probing depth	Measurement of probing depth in milimeters	six months
Improvement of clinical periodontal parameter: bleeding index	Measurement of bleeding index in percentage.	six months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in periodontal microbiome	We will present the following analyses: Overall and differential abundance; Comparative relative inter-group community structure differences The overall and differential abundance of taxa will be analyzed using Kruskal Wallis non-parametric test. FDR Benjamini-Hochberg correction will be used to correct for multiple comparisons. Differences in community structure between experimental and control groups will be tested using Permanova. Permdisp test will be used to identify location vs. dispersion effects . The threshold for significance for all analyses will be set at p ≤ 0.05. 'BiodiversityR' version 2.11-1, 'PMCMR' version 4.3 and 'vegan' version 2.5-5 packages of the R software package version 36.6.0 (www.R-project.org) will be used.	Six months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient discomfort	Measurement of patient discomfort during the treatment by Visual Analogue Scale (VAS) Questionnaire (from no pain (score 0) to maximum pain imaginable (score 7)).	Six months

Collaborators and Investigators

• Sponsor: Cardenal Herrera University
• Investigators: Study Director: Isidoro Cortell-Ballester, DDS, MD, PhD, Cardenal Herrera University

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2023
• Primary Completion (Actual): February 1, 2025
• Study Completion (Actual): July 1, 2025

Study Registration Dates

• First Submitted: November 19, 2025
• First Submitted That Met QC Criteria: January 8, 2026
• First Posted (Actual): January 15, 2026

Study Record Updates

• Last Update Posted (Actual): January 15, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: erythritol; periodontal maintenance; powder air polishing
• Additional Relevant MeSH Terms: Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Periodontitis
• Other Study ID Numbers: CEU-Martinez-Gonzalez-Cortell

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No