Conventional versus comprehensive dental prophylaxis: comparing the clinical outcomes between rubber cup and air polishing and the importance of plaque disclosure

Objective: This study aimed to compare the clinical outcomes in dental prophylaxis between rubber cup polishing and an air polishing system using erythritol powder, with or without prior dental plaque disclosure. Method and materials: In this single-blind, randomized, controlled, split-mouth clinical trial, healthy participants with full-mouth plaque score ≥ 60% were recruited. Quadrants in each participant were randomly assigned to four treatment groups: air polishing with prior plaque disclosure; air polishing without plaque disclosure; rubber cup polishing with prior plaque disclosure; or rubber cup polishing without plaque disclosure. Plaque scores and treatment time for each quadrant were recorded. Posttreatment satisfaction questionnaires for both the participants and operators were also completed.
Results: In total, 88 participants consisting of 42 men and 46 women (mean age 23.1 ± 2.0 years) were recruited. Air polishing with prior plaque disclosure had significantly lower posttreatment marginal mean plaque score (21.7 ± 17.5%) compared to air polishing (33.5 ± 23.4%) or rubber cup polishing (34.5 ± 19.7%) without prior plaque disclosure (P < .001). Marginal mean treatment time for air polishing (325 seconds; SE = 10 seconds) was significantly shorter compared to rubber cup polishing (407 seconds; SE = 15 seconds) (P < .001). Both the participants and operators preferred air polishing over rubber cup polishing (P < .001). Conclusion: Prior plaque disclosure enhanced the effectiveness of plaque removal. Air polishing exhibited better treatment efficiency than rubber cup polishing and was the patients’ and clinicians’ preferred treatment modality. (Quintessence Int 2021;52:264–274; doi: 10.3290/j.qi.a45602)