Clinical and microbiological effects of the supplementary use of an erythritol powder air-polishing device in non-surgical periodontal therapy: a randomized clinical trial

Eon-Jeong Park, Eun-Young Kwon, Hyun-Joo Kim, Ju-Youn Lee, Jeomil Choi, Ji-Young Joo, Eon-Jeong Park, Eun-Young Kwon, Hyun-Joo Kim, Ju-Youn Lee, Jeomil Choi, Ji-Young Joo

Abstract

Purpose: This study was undertaken to evaluate the clinical and microbiological effects of an erythritol powder air-polishing device (EPAP) as a supplement to scaling and root planing (SRP) therapy in patients with moderate chronic periodontitis.

Methods: Clinical and microbiological evaluations were performed at 21 sites treated with SRP (control) and 21 sites treated with SRP+EPAP (test). All examinations were performed before treatment, 1 month after treatment, and 3 months after treatment.

Results: There were no significant clinical differences between the test group and the control group. Microbiological analysis revealed that the relative expression level of Porphyromonas gingivalis was significantly lower in the test group than in the control group at 1 month after treatment. Clinical and microbiological results showed improvements at 1 month compared to baseline; in contrast, the results at 3 months after treatment were worse than those at 1 month after treatment.

Conclusions: In this study, both SRP and SRP+EPAP were clinically and microbiologically effective as non-surgical periodontal treatments. In particular, the SRP+EPAP group showed an antimicrobial effect on P. gingivalis, a keystone bacterium associated with the onset of chronic periodontitis, in a short-term period. Periodic periodontal therapy, at intervals of at least every 3 months, is important for sustaining the microbiological effects of this treatment.

Keywords: Clinical trial; Dental scaling; Erythritol; Periodontitis; Porphyromonas gingivalis; Root planing.

Conflict of interest statement

Conflict of Interest: No potential conflict of interest relevant to this article was reported.

Figures

Figure 1. Total bacterial count at baseline,…
Figure 1. Total bacterial count at baseline, 1 month after treatment, and 3 months after treatment, compared between the test and control groups.
SRP: scaling and root planning, EPAP: erythritol powder air-polishing device, 1MC: 1-month check, 3MC: 3-month check. a)Statistically significant (P<0.05). Error bars indicate standard deviation.
Figure 2. Relative levels of A. actinomycetemcomitans…
Figure 2. Relative levels of A. actinomycetemcomitans, C. rectus, E. corrodens, F. nucleatum spp., P. gingivalis, P. intermedia, T. denticola, and T. forsythia between test and control groups at baseline, 1 month after treatment, and 3 months after treatment
SRP: scaling and root planning, EPAP: erythritol powder air-polishing device, 1MC: 1-month check, 3MC: 3-month check. a)Statistically significant (P<0.05). Error bars indicate standard deviation.

References

    1. Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Brägger U, Zwahlen M, et al. Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol. 2008;35:685–695.
    1. Rosling B, Serino G, Hellström MK, Socransky SS, Lindhe J. Longitudinal periodontal tissue alterations during supportive therapy. Findings from subjects with normal and high susceptibility to periodontal disease. J Clin Periodontol. 2001;28:241–249.
    1. Wilson TG., Jr Supportive periodontal treatment introduction--definition, extent of need, therapeutic objectives, frequency and efficacy. Periodontol 2000. 1996;12:11–15.
    1. Lindhe J, Westfelt E, Nyman S, Socransky SS, Haffajee AD. Long-term effect of surgical/non-surgical treatment of periodontal disease. J Clin Periodontol. 1984;11:448–458.
    1. Zappa U, Smith B, Simona C, Graf H, Case D, Kim W. Root substance removal by scaling and root planing. J Periodontol. 1991;62:750–754.
    1. Vastardis S, Yukna RA, Rice DA, Mercante D. Root surface removal and resultant surface texture with diamond-coated ultrasonic inserts: an in vitro and SEM study. J Clin Periodontol. 2005;32:467–473.
    1. Axtelius B, Söderfeldt B, Edwardsson S, Attström R. Therapy-resistant periodontitis (II). Compliance and general and dental health experiences. J Clin Periodontol. 1997;24:646–653.
    1. Croft LK, Nunn ME, Crawford LC, Holbrook TE, McGuire MK, Kerger MM, et al. Patient preference for ultrasonic or hand instruments in periodontal maintenance. Int J Periodontics Restorative Dent. 2003;23:567–573.
    1. Rabbani GM, Ash MM, Jr, Caffesse RG. The effectiveness of subgingival scaling and root planing in calculus removal. J Periodontol. 1981;52:119–123.
    1. Eaton KA, Kieser JB, Davies RM. The removal of root surface deposits. J Clin Periodontol. 1985;12:141–152.
    1. Fleischer HC, Mellonig JT, Brayer WK, Gray JL, Barnett JD. Scaling and root planing efficacy in multirooted teeth. J Periodontol. 1989;60:402–409.
    1. Greenstein G. Periodontal response to mechanical non-surgical therapy: a review. J Periodontol. 1992;63:118–130.
    1. Moëne R, Décaillet F, Andersen E, Mombelli A. Subgingival plaque removal using a new air-polishing device. J Periodontol. 2010;81:79–88.
    1. Wennström JL, Dahlén G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol. 2011;38:820–827.
    1. Kontturi-Narhi V, Markkanen S, Markkanen H. Effects of air polishing on dental plaque removal and hard tissues as evaluated by scanning electron microscopy. J Periodontol. 1990;61:334–338.
    1. Lubow RM, Cooley RL. Effect of air-powder abrasive instrument on restorative materials. J Prosthet Dent. 1986;55:462–465.
    1. Petersilka GJ, Bell M, Häberlein I, Mehl A, Hickel R, Flemmig TF. In vitro evaluation of novel low abrasive air polishing powders. J Clin Periodontol. 2003;30:9–13.
    1. Petersilka GJ, Steinmann D, Häberlein I, Heinecke A, Flemmig TF. Subgingival plaque removal in buccal and lingual sites using a novel low abrasive air-polishing powder. J Clin Periodontol. 2003;30:328–333.
    1. Flemmig TF, Arushanov D, Daubert D, Rothen M, Mueller G, Leroux BG. Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Periodontol. 2012;83:444–452.
    1. Wennström JL, Dahlén G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol. 2011;38:820–827.
    1. Hägi TT, Hofmänner P, Salvi GE, Ramseier CA, Sculean A. Clinical outcomes following subgingival application of a novel erythritol powder by means of air polishing in supportive periodontal therapy: a randomized, controlled clinical study. Quintessence Int. 2013;44:753–761.
    1. Munro IC, Berndt WO, Borzelleca JF, Flamm G, Lynch BS, Kennepohl E, et al. Erythritol: an interpretive summary of biochemical, metabolic, toxicological and clinical data. Food Chem Toxicol. 1998;36:1139–1174.
    1. Hashino E, Kuboniwa M, Alghamdi SA, Yamaguchi M, Yamamoto R, Cho H, et al. Erythritol alters microstructure and metabolomic profiles of biofilm composed of Streptococcus gordonii and Porphyromonas gingivalis . Mol Oral Microbiol. 2013;28:435–451.
    1. Hägi TT, Hofmänner P, Eick S, Donnet M, Salvi GE, Sculean A, et al. 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. 2015;46:31–41.
    1. Pfaffl MW. A new mathematical model for relative quantification in real-time RT-PCR. Nucleic Acids Res. 2001;29:e45.
    1. Hajishengallis G. Porphyromonas gingivalis-host interactions: open war or intelligent guerilla tactics? Microbes Infect. 2009;11:637–645.
    1. Hajishengallis G, Darveau RP, Curtis MA. The keystone-pathogen hypothesis. Nat Rev Microbiol. 2012;10:717–725.
    1. Evans RT, Klausen B, Sojar HT, Bedi GS, Sfintescu C, Ramamurthy NS, et al. Immunization with Porphyromonas (Bacteroides) gingivalis fimbriae protects against periodontal destruction. Infect Immun. 1992;60:2926–2935.
    1. Persson GR, Engel D, Whitney C, Darveau R, Weinberg A, Brunsvold M, et al. Immunization against Porphyromonas gingivalis inhibits progression of experimental periodontitis in nonhuman primates. Infect Immun. 1994;62:1026–1031.
    1. Petersilka G, Panitz W, Weresch R, Eichinger M, Kem U. Air emphysema in periodontal therapy: a case series and critical literature overview. Parodontol. 2010;21:165–175.

Source: PubMed

3
Subscribe