Interview with Dr Marcel Donnet - EMS Powder Technology Research Group Leader in Nyon, Switzerland

Marcel, firstly what is a powder engineer and what led you to this role at EMS?

We come in contact with powders on a regular basis, never the wiser. Upon closer inspection, we will realise that powders are very complex and its behavior is neither like a solid nor a liquid (despite it, in fact, being a solid). As a result, making a powder is actually complex.

A specific university tract does not exist for powder engineers; one must pursue a combined educational consisting of chemical and material engineering. I received my Bachelor’s degree in chemical engineering; I then pursued a Master’s degree and finally attained my PhD from a material science department which had a laboratory working exclusively with powders. Whilst conducting my doctorate studies, I had the opportunity to complete a lot of high-end research on powders.

This placed me in the perfect position to one day work at EMS: here we have to master the powder from the production to the month of the patient!

Air polishing has always just been seen as a hygiene product for stain removal and we’ve all heard stories of salty and gritty tasting powders. What are some of the recent advances in prophylaxis powders?

When I joined EMS in 2005, air polishing did not rank highly in terms of non-cosmetic usage. Today, AIRFLOW® is the new trend, the product of the future, and most in our industry attempt to imitate it. The shift came about, because we undertook advanced research. This research allowed the development of new applications, better understanding of past issues and highlighted the advantages powders offer.

For example, the first advancement made was EMS AIRFLOW PERIO powder, which was less abrasive than previous powders and therefore allowed a fully new application: cleaning biofilm in shallow pockets. This turned the powder from being cosmetic to becoming a treatment solution for the periodontist. This was a huge paradigm shift!

Due to this success, we developed the EMS PERIOFLOW nozzle, which allows you to easily clean biofilm inside deep pockets. Treating deep pockets became another success story thanks to its efficiency, especially in terms of treatment time and patient comfort. The shift from solely cosmetic application to an important and effective tool for patient care was complete. This paradigm shift was formally recognised when EMS received the PLURADENT innovation prize in 2007. The prize is significant because it’s based on user questionnaires at dental trade shows over a full year. It’s the voice of thousands of end users.

From there, our innovative journey progressed and lead to the new EMS AIRFLOW PLUS powder, which combines the advantages of a supragingival and subgingival powder in one.

The EMS AIRFLOW PLUS powder is unique and patented. However, it was only part of the success story. This unique, fine powder required a bespoke delivery system, the AIRFLOW Prophylaxis Master. The EMS AIRFLOW Prophylaxis Master was launched in Australia last year and is the “enabler” of GUIDED BIOFILM THERAPY [GBT], the systematic, evidence-based solution for dental biofilm management developed by EMS. GBT refers to the clinical protocol for selectively removing the biofilm that forms on hard structures of the mouth, such as teeth, restorations and removable appliances including dentures, using a colour disclosing technique to assist, so as to maintain and promote good oral, gum and teeth health over time.

How did you come up with the idea of using Erythritol as an ingredient for the AIRFLOW PLUS powder and what else distinguishes AIRFLOW PLUS powder from other powders on the market?

Innovation requires constant change and improvement. Developing a new product takes time and today, we’re developing the new products of tomorrow. When one new product finally comes on the market, we’re already working on the next generation. Based on this philosophy, when we released AIRFLOW PERIO powder, we were already searching for a new powder with hopefully even better characteristics. This research led us to the group of materials known as “polyol”, which are non-sugar sweeteners. From this group, Erythritol was chosen because the powders are chemically stable and do not cause a reaction with the body. In addition, it is impervious to humidity and tastes good. The powder has been optimised by means of various tests: we revealed that this material has low abrasivity, allowing subgingival usage, but also high efficiency, making it ideal for supragingival usage. So in the end, this material in the form that we are manufacturing it has unique balanced properties with low abrasivity and high efficiency. Therefore, AIRFLOW PLUS is the only powder you need for more than 90% of clinical cases. It really is a universal powder.

There are concerns that air polishing powders can damage soft tissues and implant surfaces. Is the AIRFLOW PLUS powder safe to use on all surfaces?

The question of powder damaging different dental materials is one of our main research focuses. We strive to offer the safest and the most efficient method for removing biofilm to our end users, hence the advent of Guided Biofilm Therapy (GBT). The GBT protocol is a scientifically validated method which instructs professionals on how to properly perform prophylaxis using our powders and devices.

We left no stone unturned. Guided Biofilm Therapy calls for the clinician to:

1. Assess the current health patient’s teeth;
2. Disclose biofilm with a disclosing agent as it is the only guaranteed way to see existing biofilm;
3. Motivate patients by showing them their dental biofilm;
4. AIRFLOW the gingiva, tongue, palate and supra and subgingivally up to 4mm;
5. PERIOFLOW pockets sized 4-9mm;
6. PIEZON pockets 9-10mm;
7. Check to ensure all biofilm is removed and accurately diagnose caries; and
8. Recall patients for continued oral and overall health.

These steps ensure the safety of patients, implant surfaces and soft tissues.

What happens to the powder in a patients’ mouths after treatment - does it dissolve?

EMS focuses on developing solutions with the long-term, systemic health of patients in mind, therefore all our powder are highly biocompatible and soluble. AIRFLOW PLUS powder dissolves in the patient’s mouth right after treatment ensuring there is no inhalation to the lungs.