Does air polishing reduce bleeding on probing in periodontal maintenance?

In patients undergoing supportive periodontal therapy (SPT), air polishing devices (APDs) produce reductions in bleeding on probing (BOP) that are comparable to those achieved with conventional hand or ultrasonic instrumentation, with no statistically significant differences detected between the two approaches ^[1][2][3]. Across 14 RCTs analysed in one systematic review, APDs and conventional periodontal therapy yielded identical results on BOP as a primary outcome ^[1]. A meta-analysis likewise found no statistically significant difference in the percentage of BOP between repeated APD interventions and conventional treatments in SPT (p = 0.08) ^[2]. A further systematic review of 13 clinical studies confirmed no differences between air polishing and hand or ultrasonic instruments in reducing periodontal inflammation, of which BOP is a key indicator ^[3]. For implant maintenance specifically, APDs were associated with a reduction in BOP percentage compared to conventional interventions, though the evidence remains limited ^[2]. One systematic review did note that the clinical efficacy of subgingival air polishing versus ultrasonic debridement for BOP specifically remains inconclusive due to limited high-quality evidence and short follow-up periods across studies ^[4]. Overall, the current evidence supports air polishing as a clinically equivalent option to conventional debridement for BOP reduction during periodontal maintenance, while also offering advantages in patient comfort ^[1][2][5].