Overview
What is it?
Guided Biofilm Therapy (GBT) is a systematic protocol for professional biofilm removal using AIRFLOW (air-powder polishing), PERIOFLOW (subgingival powder delivery), and PIEZON (ultrasonic scaling) technologies, guided by biofilm disclosure.
How does it work?
GBT uses low-abrasive powders (erythritol, glycine, or chitosan-based) delivered via air-water spray to disrupt and remove biofilm from tooth surfaces, restorations, and subgingival pockets. Biofilm disclosure staining guides the clinician to target areas. Ultrasonic instruments remove calculus.
When is it commonly used?
Used for professional prophylaxis, periodontal maintenance, implant maintenance, and as preparation for restorative procedures. Suitable for both healthy patients and those with periodontal disease.
Mechanism of Action
The AIRFLOW system delivers a controlled stream of air, water, and powder particles that mechanically disrupt biofilm through kinetic energy. Erythritol powder particles (14 µm) are small enough to penetrate subgingival pockets and implant threads without damaging soft tissue or restorative surfaces. Chitosan-containing powders may have additional antimicrobial properties. The protocol emphasizes complete biofilm removal before calculus removal, preserving healthy tooth structure.
Organisms Studied
| Organism | Abbr. | Research Finding |
|---|---|---|
| Streptococcus mutans | Sm | Biofilm disclosure and removal reduces Sm on occlusal and interproximal surfaces. |
| Porphyromonas gingivalis | Pg | Subgingival AIRFLOW with erythritol powder reduces subgingival biofilm including Pg in shallow-to-moderate pockets. |
| Fusobacterium nucleatum | Fn | Biofilm disruption reduces Fn loads as part of general subgingival biofilm reduction. |
Evidence Summary
Benefits
- Efficient biofilm removal with minimal discomfort
- Safe for soft tissues, restorations, and implants
- Biofilm disclosure improves treatment precision
- Less abrasive than traditional scaling for maintenance
Limitations
- Limited long-term clinical outcome data compared to conventional SRP
- Equipment and consumable costs
- Not a replacement for SRP in deep pockets with heavy calculus
- Mostly short-term and in vitro studies
Quality of Evidence
Emerging evidence from clinical trials and systematic reviews. GBT is widely adopted clinically but high-quality comparative RCTs against conventional protocols are limited.
Key Clinical Takeaways
- 1Excellent for maintenance and prophylaxis
- 2May improve patient comfort and compliance
- 3Not a replacement for SRP in advanced periodontitis with heavy calculus
Evidence Meter
Early studies and pilot data show promise, but larger trials are needed.
Frequently Asked Questions
References
Erythritol powder air polishing for periodontal maintenance: A systematic review
Drago LK et al. (2019)
DOI: 10.1111/jcpe.13231Organisms Studied with This Therapy
Related Therapies
Educational use only. This page provides general information and does not recommend this therapy over others or provide medical advice. Always consult a licensed dental or medical professional for diagnosis and treatment decisions.