Air polishing units typically generate a stream of pressurized air, carrying specially graded particles of a mild soluble abrasive, such as sodium bicarbonate. The abrasive is directed, in the presence of a stream of water, at a tooth surface to be cleaned. The mixture of water and powderladed stream occurs on the tooth surface and forms a “slurry” that is responsible for the cleaning action.

Air polishing was developed in the early 1970’s as a technique for fast and efficient removal of extrinsic stains, plaque and other soft deposits from the teeth. It comprises a stream of pressurized air carrying specially graded particles of a mild soluble abrasive usually sodium bicarbonate, mixed with a stream of water. This combination is directed at the tooth surface to be cleaned. The application of dental air polisher to implantology can be divided into two areas: (1) Routine maintenance of implants (2) Surface preparation in treating periimplantitis.

Dental root form implants are manufactured from a highgrade titanium alloy, the surface of which consists of  a micro layer of titanium oxide. The implant surface can also be treated by plasma spraying, acid etching, sandblasting or coated with HA. The removal of  plaque  and  calculus  deposits  from  these implant surfaces with Dental Instruments designed originally for cleaning natural tooth surfaces can result in major alterations to the delicate titanium oxide layer. Altering the surface topography by roughening the surface may enhance  calculus  and  bacterial  plaque accumulation.

Resulting scratches, cuts or gouges may also reduce the corrosion resistancy of titanium, and corrosion and mechanical debris can accumulate in the surrounding tissue. The aim of procedures for debriding dental implants should be to remove microbial and other soft deposits, without altering the implant surface, and thereby adversely affect biocompatibility. Increased surface roughness can lead to an increase in bacterial accumulation and resultant soft tissue inflammation. Because of the critical nature of the implant/soft tissue relationship, metal ultrasonic scaler tips, hand scalers or curettes should not be used as they have been shown to significantly alter the titanium surface.

In most currently available units, the water stream emits through a separate nozzle that may be concentric to that of the powderladen air stream nozzle. The resulting buildup of crystalline anhydrous sodium bicarbonate deposits in the lumen of the air/powder nozzle results in clogging.

Current methods for professional cleaning of implant or titanium transmucosal elements include the set of plastic ultrasonic tips or hand instruments followed by the prophy cup polishing method or various types of floss and buffing strips. The design of the permanently cemented super structure often does not allow adequate access for the prophy cup, especially in interproximal areas, and plastic instruments are not very efficient for the removal of plaque or mineralized deposits. In addition, the prophy cup and paste method may leave residual paste at the implant/soft tissue interface area.