Does air polishing damage titanium implant surfaces?

Air polishing with certain powders can cause surface changes to titanium implants, but the degree of damage depends heavily on the powder used. Harder powders such as sodium bicarbonate tend to damage the surface more than softer powders such as glycine, while erythritol and calcium phosphate-based powders appear even gentler ^[1]. Overall, air abrasion was considered "almost safe," particularly for nonmodified titanium surfaces, and produced surface changes comparable to those caused by plastic curettes or Er:YAG lasers ^[1].

Erythritol air polishing specifically has shown promising safety data: systematic review evidence indicates it does not cause significant damage to the implant surface or peri-implant tissues, and it promotes a good biological response ^[2]. Among the powders studied, erythritol- and osteoinductive powder-based air abrasion was also more successful in preserving surface biocompatibility compared to harder abrasives ^[1].

It is worth noting that while cleaning efficacy is generally good, a key limitation identified across in vitro studies is that air abrasion may not reliably restore the biological biocompatibility of a contaminated implant surface, regardless of the powder used ^[1]. Clinically, erythritol air polishing used during surgical treatment of peri-implantitis did not result in significantly different outcomes compared to saline irrigation at 12 months, suggesting surface cleansing method alone may not be the dominant factor in clinical success ^[3].