Dentaltown January 2014 - (Page 90)

hygiene and prevention perio reports New Tip for Air Polishing Reaches Subgingivally Following periodontal therapy, subgingival microflora returns within days, necessitating periodontal supportive therapy (PST) visits every few months to maintain periodontal tissue health. Mechanical disruption of the subgingival microflora has long been accomplished with hand instruments. Scraping of the root surfaces removes cementum, creating irreversible hard tissue damage and in some cases, recession. Air polishing traditionally uses a sodium bicarbonate powder that effectively removes plaque and stains from tooth surfaces, but damages gingival tissues when directed subgingivally. To solve this problem, a glycine power was recently introduced that does not cause tissue trauma when directed subgingivally. To enhance subgingival cleaning, EMS designed a tip to direct the glycine powder subgingi- vally with lower jet spray flow and lower pressure than is used supragingivally. Researchers at the University of Geneva in Switzerland compared air polishing with glycine powder using the new subgingival tip to hand instrumentation in 50 periodontal maintenance patients. These subjects all had at least two residual pockets measuring 5mm or more in two separate quadrants. Sites for each patient were randomly assigned to test and control treatments. This seven-day study measured subgingival microflora and bleeding upon probing. Air polishing time averaged 30 seconds per site compared to curette use averaging 1.4 minutes per site. Bleeding upon probing was reduced for both groups, with greater reduction in the control group. No differences were observed for subgingival microflora between test and control groups. No tissue trauma was noted with air polishing. Patients preferred air polishing over curettes. Perio Reports Vol. 26, No. 1 Perio Reports provides easy-to-read research summaries on topics of specific interest to clinicians. Perio Reports research summaries will be included in each issue to keep you on the cutting edge of dental hygiene science. www.hygienetown.com Clinical Implications: The new subgingival air polishing tip provides an alternative to hand instruments for SPT. n Moëne, R., Décaillet, F., Andersen, E., Mombelli, A.: Subgingival Plaque Removal Using a New Air-Polishing Device. J Perio 81: 79-88, 2010. Air Polishing to Replace Subgingival Instrumentation Air polishing in the past used a bicarbonate of soda powder that was effective for plaque and stain removal, but damaging for the tissues. Today, glycine powder is available for air polishing that can be used with a new tip to polish subgingivally, reaching into both shallow and deep pockets. Researchers at the University of Washington in Seattle, Washington, compared full-mouth Glycine Powder Air Polishing (GPAP) to traditional scaling and root planing with curettes plus rubber cup polishing. All patients had undergone initial periodontal therapy prior to this study. Subjects were all found positive for intra-oral levels of P. gingivalis and T. forsythia. Probing depths ranged from 4mm to 9mm. Patients were instructed to rinse twice daily with 0.12 chlorhexidine mouthrinse for two weeks following treatment. Microbial and clinical indices were repeated at day 10 and day 90. At each time point, the patients receiving the subgingival GPAP had lower total viable bacterial counts in the moderate to deep pockets compared to those receiving instrumentation with curettes and rubber cup polishing. Patients found both treatment approaches comfortable. Air polishing with glycine powder in subgingival pockets is more effective than using curettes to shift the oral flora from one conducive to infection to one more conducive to periodontal health. Clinical Implications: Despite our tradition of instrumenting all subgingival areas during a perio maintenance visit, these findings suggest that air polishing with glycine power in the subgingival areas just might be able to replace subgingival instrumentation with curettes. n Flemmig, T., Arushanov, D., Daubert, D., Rothen, M., Mueller, G., Leroux, B.: Randomized controlled trial assessing efficacy and safety of glycine powder air polishing in moderate-to-deep periodontal pockets. J Perio 83:(4)444-452, 2012. 90 JANUARY 2014 » dentaltown.com http://www.hygienetown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown January 2014

New Products
Dentaltown.com Highlights
Howard Speaks: “Go West, Young Man”
Professional Courtesy: A Treatment Plan for Your Practice
Continuing Education Update
Second Opinion: The Value of Patient Engagement and Cost Transparency
Big Case on the Go, Your Input Welcome!
Impress or Scan… What’s the General Consensus?
Corporate Profile: Centrix
The Wish List
Clutter vs. Sanity
Every Case is Unique
I’m So Tired of Her Attitude
Top 12 Best Practices for 2014
Ten Units in Five Hours with a Fast and Easy Milling Material
Seven SEO Strategies to Accelerate New Patient Acquisition
Dentaltown Research: Equipment
You Should Know: GoodMouth
Ad Index
In This Section: Polishing
Perio Reports
Profile in Oral Health: How Subgingival Air Polishing Will Turn Dental Hygiene Upside Down
Dentally Incorrect

Dentaltown January 2014