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Counter-Evidence Search

When Preventio Hub cites a study that favors a particular product or technique, the editorial rule is to also search PubMed for the strongest opposing or null-result literature on the same question. This page documents the results of that search across the topics covered on the site.

Some of these searches return robust counter-evidence that complicates or contradicts dominant marketing narratives. Others return nothing at all — and those empty results are published here as well, because the absence of independent evidence on a heavily marketed device is itself a finding.

1. Sodium bicarbonate in dental prophylaxis

Summary: Clinical evidence is sparse. Modern literature consistently reports that glycine and erythritol outperform sodium bicarbonate on soft-tissue tolerance and surface preservation.

Simon et al., 2015 (PMID 25727403)

International Journal of Dental Hygiene. Double-blind RCT on 22 chronic periodontitis patients. Glycine powder air polishing caused only minor gingival epithelial erosion (scores 1–2), whereas sodium bicarbonate air polishing and ultrasonic scaling caused moderate-to-severe erosions (scores 3–4). This is one of the few double-blind clinical comparisons of the two powders on real patients rather than laboratory specimens.

Biazussi et al., 2019 (PMID 30875272)

Journal of Oral Implantology. In vitro study on 15 titanium disks. Air-polishing powders containing glycine had less effect on surface roughness than sodium bicarbonate, which produced significantly higher roughness measurements.

Tamilselvi et al., 2021 (PMID 32804106)

Technology and Health Care. Atomic force microscopy analysis of enamel and cementum. Glycine air polishing was reported as "the least rough on soft tissues"; sodium bicarbonate produced significantly higher roughness values.

Cafiero et al., 2017 (PMID 27283010) — verification note

Clinical Oral Implants Research. This paper is sometimes cited as validation of sodium bicarbonate on implant surfaces. That citation is incorrect: the study tested glycine powder only at two power settings, not sodium bicarbonate. The finding that air polishing at high pressure produced the smoothest surfaces (Ra = 0.16 µm) refers to glycine. Any article using Cafiero 2017 to support sodium bicarbonate is misreading the study.

2. NSK Prophy-Mate Neo — independent clinical evidence

No independent clinical trials found on PubMed (2018–2026)

Direct PubMed searches for "NSK Prophy-Mate Neo" return product pages and dental supply catalogs — not peer-reviewed studies. Broader searches combining NSK with "prophylaxis", "clinical trial", and "implant" return studies on antibiotic prophylaxis in implant surgery and NSK as a surgical micromotor brand, but no clinical studies of the Prophy-Mate Neo itself.

Editorial conclusion: The device is marketed but not studied in the peer-reviewed literature indexed on PubMed. This is a genuine evidence gap.

3. Acteon Air-N-Go — independent clinical evidence

No independent clinical trials found on PubMed (2018–2026)

PubMed searches for "Acteon Air-N-Go" air polisher return zero results.

Editorial conclusion: Another marketed device without indexed clinical evidence.

4. Dentsply Cavitron — recent comparative evidence

Summary: Recent RCTs comparing the Cavitron to other branded ultrasonic or piezoelectric devices are sparse. Modern comparative research tests generic ultrasonic vs. piezoelectric modalities rather than branded devices, and a recent direct comparison between Mectron and EMS did not include Cavitron.

Chiesa et al., 2025 (PMID 40223867)

International Journal of Dentistry. RCT comparing Mectron Combi Touch vs. EMS Prophylaxis Master, n=20 patients and operators. Both devices were comparable on patient and operator comfort and on reduction of periodontal parameters. Cavitron is not included.

Editorial conclusion: The Cavitron is effectively absent from current comparative research literature.

5. Mectron Combi-Touch — independent clinical evidence

Summary: A single recent clinical trial indexed.

Chiesa et al., 2025 (PMID 40223867)

RCT comparing Mectron Combi Touch with EMS Prophylaxis Master during guided biofilm therapy. Both devices equally effective on clinical parameters; Mectron reported higher "airflow comfort"; EMS reported superior "ultrasonic handpiece comfort." No difference in probing depth reduction.

Editorial conclusion: A single comparative trial represents the sum of recent independent Mectron clinical evidence indexed on PubMed.

6. Lasers vs. air polishing for peri-implant mucositis

Summary: Recent RCTs and meta-analyses indicate adjunctive lasers and adjunctive air polishing provide no significant clinical advantage over standard non-surgical instrumentation.

Clementini et al., 2023 (PMID 37655744)

Clinical Oral Implants Research. RCT, n=75, comparing Er:YAG laser vs. erythritol air-polishing vs. submarginal instrumentation alone. The authors conclude that the adjunctive use of air polishing or Er:YAG laser in peri-implant mucositis non-surgical therapy does not appear to provide any significant or clinically relevant benefit beyond standard instrumentation.

Bi et al., 2023 (PMID 38258587)

Journal of Oral Implantology. Systematic review and meta-analysis. Air polishing did not demonstrate superior effectiveness compared with alternative treatments such as mechanical cleaning, implantoplasty, or Ti-brush use.

Delucchi et al., 2025 (PMID 38825804)

International Journal of Dental Hygiene. Systematic review of 15 studies on erythritol for implant cleaning. Reports erythritol air polishing as effective and safe for removing biofilm from titanium dental implants.

7. Long-term (>12 month) prophylaxis outcomes

Summary: Multiple long-term studies and meta-analyses report that air polishing is equivalent, not superior, to conventional scaling for long-term clinical outcomes. Better patient comfort is the consistently reported benefit.

Petersilka et al., 2021 (PMID 33098121)

Retrospective analysis. Median follow-up of 5.3 years of supportive periodontal therapy. In periodontal maintenance, the use of glycine powder air polishing instead of mechanical plaque removal did not improve clinical outcomes.

Sekino et al., 2020 (PMID 32072344)

Split-mouth RCT. Routine subgingival air polishing at 30-day intervals had significant clinical effects in moderately deep pockets in supportive periodontal therapy — dosing/interval matters.

Herrmann et al., 2023 (PMID 37433921)

Meta-analysis. No significant difference in efficacy of subgingival air polishing vs. subgingival debridement for probing depth, clinical attachment level, or bleeding-on-probing percentage in supportive periodontal therapy. Subgingival air polishing provided better treatment comfort.

8. Meta-analyses on erythritol vs. glycine vs. trehalose

Summary: The most recent 2025 network meta-analysis finds no statistically significant differences between erythritol, glycine, and trehalose for probing pocket depth reduction. SUCRA rankings reflect probabilistic ordering, not confirmed clinical superiority.

Abdulbaqi et al., 2022 (PMID 34318577)

International Journal of Dental Hygiene. Systematic review and meta-analysis. Erythritol powder air polishing can substitute hand/ultrasonic instrumentation for supportive periodontal therapy, with clinical attachment level gain improved when used as an adjunct during active therapy. Funding source not explicitly disclosed in the abstract.

Zi-le et al., 2025 (Frontiers in Physiology)

Network meta-analysis of 9 RCTs, 462 patients. No statistically significant differences between the three powders for probing pocket depth reduction. Erythritol ranked numerically highest on SUCRA (84.1 vs. trehalose 48.0 vs. glycine 28.5). SUCRA is a probabilistic ranking metric and, on its own, does not establish clinically significant superiority. Articles citing this paper should not present SUCRA as an effect-size measure.

Menini et al., 2019 (PMID 31286118)

Quintessence International. Split-mouth RCT on full-arch fixed implant rehabilitations. Both air-polishing powders (glycine and sodium bicarbonate) showed superior plaque reduction vs. manual cleaning. Sodium bicarbonate produced notably higher spontaneous bleeding; glycine achieved higher patient acceptance.

Menini et al., 2024 (PMID 38416003)

International Journal of Oral and Maxillofacial Implants. Split-mouth trial on full-arch implant-supported rehabilitations. Glycine air polishing produced superior plaque reduction but no statistical difference in microbial population around treated vs. control sites. The authors note the antimicrobial efficacy of glycine air polishing cannot be confirmed.

9. Glycine vs. sodium bicarbonate on implants — additional evidence

Tsang et al., 2018 (PMID 29574763)

Journal of Periodontal Research. RCT, n=27 non-smoking subjects. Subgingival glycine powder air polishing added to SRP produced greater reduction in gingival crevicular fluid volume at 3 months, but inflammatory markers decreased similarly in both groups by 6 months. Benefit may be transient without re-application at intervals.

Kargas et al., 2015 (PMID 25156125)

International Journal of Dental Hygiene. Pilot study, n=25. Glycine air polishing as a sole treatment did not demonstrate superiority over SRP or ultrasonic debridement for plaque, gingival recession, or bacterial counts. Supports using air polishing as an adjunct rather than a standalone treatment.

Overall conclusions from the counter-evidence search

Where the independent evidence disagrees with dominant narratives

Where evidence is simply absent — and that absence is the story

When a manufacturer markets a device for clinical prophylaxis but produces no independent peer-reviewed evidence, that is publishable on its own. Preventio Hub does not invent evidence to balance coverage; the gap is the finding.

Methodology

Searches were run on PubMed between April 15–16, 2026. Terms combined the device or topic with "clinical trial", "randomized controlled trial", "meta-analysis", "systematic review", "in vitro", and "air polishing" as appropriate. Filters were applied for publication dates 2015–2026 depending on scope. Only peer-reviewed papers indexed on PubMed are included on this page. Trade literature, product brochures, and distributor documents are not counted as evidence and are never cited by Preventio Hub as substitutes for peer-reviewed sources.

Last updated: April 16, 2026