Agreed, these are something you NEED to have. The ocean is always moving, and moving FAST. You want to simulate the environment as best you can.
In our 92 gallon reef tank, we have 4 powerheads, they total 1200 gallons per hour of movement, which is a lot. We have two who's flow meet at the back corner of the tank which creates a big 'disturbance' in the water, one in the front blowing across, and one in the rock that blows forward. Two of them go off at night with the lights to simulate 'calmer night seas'.
In addition to moving the water, they do keep junk from accumulating in the tank, and by blowing water on the glass it prevents film algae build up.