Does air polishing remove extrinsic stain better than rubber cup polishing?

The indexed literature I have available does not directly compare air polishing versus rubber cup polishing specifically for extrinsic stain removal as a primary outcome. The studies in context focus on plaque/biofilm removal ^[1][2] and on whether the prophylaxis method affects subsequent tooth bleaching outcomes ^[3], rather than measuring stain removal efficacy as a standalone endpoint.

What can be said from the available evidence is that air polishing was significantly faster than rubber cup polishing for plaque removal (325 vs 407 seconds per quadrant) and achieved lower post-treatment plaque scores when combined with prior disclosure ^[1]. In the bleaching study, both techniques produced similar color change immediately after bleaching, though air polishing showed slightly greater color change at one week, suggesting it may support better bleaching outcomes ^[3] - but this is not the same as directly measuring extrinsic stain removal.

I could not find a direct comparison of stain removal efficacy between these two modalities in the indexed literature. A specific study measuring extrinsic stain reduction as the primary outcome would be needed to answer this question definitively, and clinical judgement should guide practice in the meantime.