Air Abrasion – Dental Treatment

Introduction –Air Abrasion

Air abrasion, is also called as micro-abrasion. It uses a high powered air stream which blows the fine particles to remove dental decay in various procedures. It is an alternative to the drilling necessary in these procedures. Air abrasion can be used to repair small surface cavities and cracks or in preparation of teeth for bonding and other cosmetic procedures.

Removal of superficial enamel defects is very easy with the air abrasives since it causes less removal of tooth structure than the drill.
The air abrasion is non-invasive in nature and it has almost replaced the use of the drills or needles in the dental procedures. There is also no vibration or pressure on the tooth which is associated with traditional drilling. It can often be used on children’s cavities as they are found in the early stages of progression due to more regular dental visits.

Mechanism of action

Air abrasion removes the tooth structure using a stream of aluminium oxide particles which are generated from compressed air or pressurized carbon dioxide or nitrogen gas. The abrasive particles strike the tooth with high velocity and thus, remove small amounts of tooth structure. Efficiency of removal depends on the hardness of the tissue or material to be removed and the settings of the air abrasion device.

Device parameters

  1. The air pressures range from 40 to 160 psi.
  2. The most common particle sizes are either 27 or 50 micrometer in diameter.
  3. Higher particle flow rate means more particles to abrade the working surface faster.
  4. The speed of hitting of the abrasive particles on the tooth depends on the gas pressure, nozzle diameter, particle size, and distance from the surface.
  5. Typical operating distances from the tooth range from 0.5 to 2 mm.
  6. A number of variations in tip angulations and nozzle diameters are available. Various tip angulations allow easy placement and orientation of the hand-piece and reduce the strain on the operator’s hands. Smaller nozzle diameters can be used for areas that are difficult to access.

Uses and applications - Air Abrasion

  1. Caries removal
  2. Removal of small old restorations
  3. Preparation of tooth structure for cutting or etching for the placement of composites, porcelain and ceramics
  4. As an aid to the conventional hand-piece bur.

Advantages

  1. Removal of superficial enamel defects is very easy with the air abrasives since it causes less removal of tooth structure than the drill.
  2. Air abrasion can detect pit and fissure caries definitively when clinical and radiographic findings suspect them. Air abrasion removes the organic debris and determines if caries is present. Also, less enamel is removed with this process.
  3. Caries detector dyes can be used in conjunction with air abrasives to detect a developing lesion and treat it appropriately.
  4. It can be used for removal of pits and stains on enamel before placement of a resin-based composite restoration or porcelain veneers.
  5. In Dentin-bonding process, a highly polished surface is not suitable. Air abrasion produces a highly textured surface that is excellent for this technique.
  6. Air abrasion is used to remove old amalgam restorations and composites as well as glass ionomers, and porcelain restorations
  7. Local anesthesia while working on dentin can be avoided because of cooling action of high pressure air.

Limitations

  1. It cannot remove large amalgam restorations efficiently and there is also a concern for the levels of mercury released when amalgam is abraded. Air abrasion of amalgam for 1 min releases excessive quantity of mercury vapors.
  2. It is not very effective in removal of hard caries as it does not cut resilient structures. In such cases, small instruments like spoon excavators can be used to scoop out the soft lesions followed by air abrasion.
  3. Depth of the penetration during cavity cannot be controlled in air abrasion, so intermittent inspection is necessary.
  4. The blown powder particles can be accidentally ingested. This is prevented by using a rubber dam.
  5. The patient, operator, and helping staff must wear protective eyewear to prevent the abrasive particles from entering the eyes.
  6. The exposure to aluminum oxide particles is considered a health hazard. This can be reduced by proper elimination with high-volume suction.
  7. Caution should be exercised with patients having known respiratory diseases such as asthma. Good suction and a rubber dam that extends over the nostrils can take care of this.
  8. Air abrasion cannot be usedwith magnification devices or dental operating microscopes as the rebound particles can cause damage to the lenses.
  9. Careful abrasion is necessary near soft tissues due to risk of laceration, air dissection, and emboli.
  10. It is also not suitable for crown preparations for metal or porcelain coverage.

- Link of interest: Twitter Air Abrasion – Dental Treatment.

 

This article is not medical advice nor a substitute to professional health advice. Always consult a doctor.

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