Parameters That Improve Cleaning Efficiency of Subgingival Air Polishing on Titanium Implant Surfaces: An In Vitro Study

Background: This study aims to reveal how air polishing behaves on a titanium surface by evaluating the size and shape of the cleaned area and the influence of different device settings, probing depths, and cleaning movements. Methods: Forty-eight titanium sandblasted large-grit acidetched surface film-coated disks were treated with an air abrasive system using a subgingival plastic nozzle. Two subgingival models were used: open-ended (step 1) and defined-size (step 2). In step 1, the most effective parameters were investigated by 5-second static applications under different settings. In step 2, the best settings were used for dynamic application to test influence of different movements (up-down, slowly up, rotation). For both steps, powder and water consumption and total cleaned area were calculated. Results: Air pressure was the main factor with the strongest effect on cleaning. Increasing air pressure extended cleaning area. Other factors, such as nozzle depth and excessive powder flow amount, had weak influence. Cleaning effect reached deeper than the nozzle physically reached. Step 2 showed that there was no significant difference between different nozzle movements; however, cleaning efficiency decreased significantly without movement. Conclusions: For the most effective clinical use of air polishing, it should be applied with high pressure, deep insertion of nozzle, and enough water flow. Additionally, the nozzle has to be moved to get the best cleaning effect