Is trehalose powder effective for air polishing?

Based on the indexed literature, trehalose is an effective subgingival air-polishing powder, though with some nuances worth noting.

Trehalose is a non-cariogenic disaccharide with a particle size of 25–35 μm, giving it a similar grinding effect on dental materials to glycine ^[1]. It can produce a statistically significant reduction in total bacterial load, though it is considered less antibacterial than glycine, and importantly has no significant impact on wound healing ^[1].

In the network meta-analysis of nine RCTs (462 patients), there was no statistically significant difference among erythritol, glycine, and trehalose when comparing PPD, CAL, and BOP outcomes ^[1][2]. However, when ranked by SUCRA values for PPD reduction, trehalose (SUCRA = 48.0) ranked second after erythritol (SUCRA = 84.1) and ahead of glycine (SUCRA = 28.5) ^[1][2]. Based on this ranking, the authors recommended a priority order of erythritol, then trehalose, then glycine ^[2].

It is worth noting that the evidence base is limited - only nine RCTs with 462 patients were included, making publication bias testing difficult, and most data came from the 3-month time point, limiting conclusions about long-term efficacy ^[1]. Powder selection should ultimately consider disease severity, patient oral hygiene habits, treatment tolerance, and the physicochemical properties of each powder ^[1].