Comparison of treatment time and patient-reported outcomes between erythritol powder air-polishing and rubber cup polishing: a randomized crossover clinical trial.

Professional mechanical plaque removal (PMPR) is essential for the prevention of dental caries and periodontal diseases. Erythritol powder air polishing (EPAP) has recently gained attention as an alternative to conventional rubber cup polishing (RC); however, evidence regarding patient-reported outcomes (PROs), particularly using the cetylpyridinium chloride (CPC)-containing erythritol formulation available in Japan, remains limited. This randomized, single-center, two-period crossover clinical trial compared EPAP with RC in systemically healthy adults. Twenty-one participants received both interventions in a randomized sequence with a washout period of at least two weeks. The primary outcome was treatment time, while secondary outcomes included pain during treatment, taste, oral freshness, taste disturbance, discomfort, and overall treatment preference. Data were analyzed using linear mixed-effects models accounting for treatment, period, and sequence effects. Baseline plaque scores were comparable between interventions. EPAP required significantly less treatment time than RC, with adjusted mean treatment times of 438 s and 759 s, respectively, corresponding to a reduction of approximately 323 s (P < 0.001). No significant period or sequence effects were observed. No significant differences were detected between EPAP and RC for pain, taste, oral freshness, taste disturbance, discomfort, or overall treatment preference. Eleven participants preferred RC and ten preferred EPAP, with no significant difference in preference (P = 1.000). Within the limitations of this study, EPAP significantly improved the efficiency of supragingival plaque removal without compromising patient-reported outcomes or treatment acceptance. These findings support the use of the CPC-containing erythritol powder air-polishing system as an efficient alternative to conventional rubber cup polishing for professional supragingival biofilm management.