Is air polishing effective for treating peri-implantitis?

Air polishing for peri-implantitis shows modest and inconsistent clinical benefits compared to conventional mechanical debridement. In non-surgical treatment, erythritol air polishing was as effective as piezoelectric ultrasonic scaling for reducing bleeding on probing (BOP), suppuration, plaque scores, and probing pocket depth, but neither therapy reliably resolved peri-implantitis, with only 18.4% of patients achieving treatment success at 3 months ^[1]. Similarly, a meta-analysis found airflow produced a statistically significant reduction in BOP compared to mechanical debridement, but differences in pocket depth, bone level changes, and patient-reported outcomes were not statistically significant ^[2]. In surgical treatment, erythritol air polishing was not more effective than saline-soaked gauze for implant surface cleansing during resective surgery, with only 19.2% of implants meeting success criteria at 1 year ^[3]. A broader systematic review confirmed that air polishing did not result in more favorable outcomes than comparative modalities overall, and statistical differences between air polishing and other treatments were not detected ^[4]. An earlier 2015 systematic review did suggest a possible benefit of glycine powder air polishing over mechanical debridement at peri-implantitis sites in BOP reduction, but noted that complete disease resolution was rarely achieved ^[5]. A 2023 systematic review of non-surgical submarginal instrumentation found only one study reporting a statistically significant BOP reduction favoring an air-polishing device over control, and overall evidence remains limited by heterogeneity and small study numbers ^[6]. In summary, air polishing appears comparable to, but not superior to, conventional approaches, and peri-implantitis frequently requires surgical intervention regardless of the decontamination method used ^[4][1][3].