# Antimicrobial Efficacy and Soft-Tissue Safety of Air-Polishing Powders in Periodontal Therapy: A Narrative Review

## TL;DR

This review examines how air-polishing powders help treat periodontitis by reducing harmful bacteria and protecting soft tissues.

## Contribution

The study provides a critical analysis of air-polishing powders' antimicrobial efficacy and soft-tissue safety in periodontal therapy.

## Key findings

- Air-polishing powders like glycine and erythritol significantly reduce periodontal pathogens.
- Trehalose shows superior biocompatibility compared to other powders in cell-type-specific responses.
- Air-polishing powders are safe and effective as an adjunct in periodontal therapy.

## Abstract

Periodontitis is a biofilm-induced multifactorial disease characterized by non-reversible damage of the periodontal tissues. Dysbiosis of the subgingival microbiota plays a crucial role in periodontitis. In this regard, conventional periodontal treatment consists of subgingival mechanical instrumentation, but adjunctive methods, such as air-polishing powders, have also sparked considerable interest due to their ability to efficiently disrupt biofilm with minimal tissue damage. The aim of this narrative review is to provide an overview and critical discussion of the recent literature on the properties and interactions of air-polishing powders with oral bacteria and soft tissues. Fifteen studies were included. Eight recent clinical studies demonstrate that air-polishing powders (e.g., glycine, erythritol) can significantly reduce periodontal pathogens, thereby supporting their role in effective biofilm control; In vitro evidence from four included studies indicates cell-type-specific responses to different powders, with trehalose demonstrating superior biocompatibility compared with glycine and erythritol/chlorhexidine formulations. This variability highlights the importance of choosing the right powder to improve clinical outcomes and reduce tissue side effects. By integrating microbiological, cellular and histological findings, the objective of this review is to clarify the antibacterial efficacy and biocompatibility of air-polishing powders. Overall, air-polishing powders have been shown to be safe and effective as an adjunctive treatment, in both active periodontal and supportive periodontal therapy.