Does air polishing damage composite restorations or ceramic surfaces?

Air polishing can adversely affect both composite restorations and ceramic surfaces, though the degree of damage varies by material and powder type. Ultrasonic instrumentation and air polishing both negatively impacted surface roughness and marginal quality across restorations, with resin-based composites and resin-modified glass ionomer cements being particularly vulnerable to increased roughness from ultrasonic scaling ^[1]. For ceramic surfaces, zirconia and lithium disilicate were less affected than resin-based materials, suggesting ceramics offer somewhat greater resistance to instrumentation damage ^[1].

Regarding powder choice, sodium bicarbonate and calcium carbonate powders caused significantly greater surface roughness compared to lower-abrasive alternatives ^[1][2]. On hard tissues such as cementum and dentine, defect depths and volumes from sodium bicarbonate or calcium carbonate were significantly greater than those produced by glycine powder ^[2]. Erythritol and glycine powders were identified as the least abrasive options and are recommended when air polishing is used near restorations to help preserve surface smoothness and marginal integrity ^[1].

In practical terms, clinicians should select the debridement method and powder type based on the restoration material present, favouring low-abrasive powders such as erythritol or glycine to minimise iatrogenic damage ^[1][2]. The authors of the systematic review note that methodological limitations in available laboratory studies mean clinical translation still requires careful judgement ^[1].