###### Abstract  
This umbrella review was conducted to assess the existing literature and scientific evidence on air powder water jet technology (APWJT) in periodontal and peri-implantitis therapy. A systematic literature search for systematic reviews and meta-analyses of the last decade on the use of APWJT in periodontitis and implant patients was performed in the databases of MEDLINE/Ovid, Embase, Cochrane library and Scopus. An additional hand search on PubMed and Google Scholar was conducted. Ten articles that fit the inclusion criteria were selected after the full-text screening. Two systematic reviews, including one with a meta-analysis, investigated the use of APWJT in active periodontal therapy. The use of APWJT as an adjunct to conventional scaling and root planing (SRP) in active periodontal treatment showed improved results in the test group. Six articles, including two with a meta-analysis, reported on the use of APWJT as a stand-alone therapy or as an adjunct in supportive periodontal therapy. Similarly significant improved results were reported for the use of APWJT. Regarding the active treatment of peri-implant mucositis and peri-implantitis, four systematic reviews could not show an improved clinical outcome when APWJT was used as an adjunct to conventional treatment measures. Furthermore, one article investigated APWJT as a stand-alone therapy or as an adjunct in supportive peri-implant mucositis and peri-implantitis therapy. In systematic reviews that also investigated patient perception, APWJT was generally well-tolerated by the patient. Within the limitations of this umbrella review, it can be concluded that the use of APWJT with low-abrasive powders such as glycine, erythroid or trehalose as an adjunct in active periodontitis therapy shows similar clinical results compared to conventional SRP alone. In surgical peri-implantitis treatment, APWJT can be used adjunctly. It could be considered that the use of APWJT in supportive periodontal treatment results in a comparable clinical outcome and an enhanced patient perception, as well as a shorter clinical time. air powder water jet technology; air polishing; periodontitis; peri-implant disease; peri-implant mucositis; peri-implantitis; periodontal therapy; supportive periodontal therapy; peri-implantitis therapy +
Footnote †: journal: Applied Sciences  
are still able to efficiently remove soft deposits and biofilms from different surfaces [1]. At the same time, application devices have also undergone a significant evolution, and it is now possible to treat hard and soft tissue surfaces with a special emphasis on supra- and subgingival niches in a very targeted manner with individually adaptable output settings, handpieces and nozzles [2; 3]. Prophylactic and therapeutic treatment sequences have been advocated and adapted towards specific patient needs, mainly aiming to provide the gentlest possible treatment for patients while minimizing invasive and time-consuming treatment steps and reducing patient discomfort [4]. In this synoptic concept, different methods systematically applying APWJT try to ensure a quality-oriented and systematic process, which enables controlled biofilm elimination or at least reduction by removing biofilm and young calculus [5]. Different treatment modalities, techniques and materials have been introduced in the past years and have been well studied, and--in the meantime--even systematic reviews have been conducted and published in this context. In 2014, at a consensus conference on the supra- and subgingival use of APWJT, a group of dental professionals concluded that low-abrasive powders, such as glycine powder, are more effective in the removal of biofilm on intraoral surfaces up to 9 mm subgingivally than conventional manual or ultrasonic debridement [6].