AIR-ABRASION SYSTEMS

HAMZA AJAL
Air abrasion dentistry has
over a of time evolved from
concept
period
of an alternative means
a new of
cavity preparation to an essential means
of a truly conservative
providing for preservationofa
preparation
maximal sound tooth structure.
The of bonded
development in
restorations
combination
with air abrasion dentistry
provides a truly minimal
intervention dentistry.
Air-abrasion is a great dental
advancement over the dental
drill as it allows precise removal
of decayed teeth without the use
of a local anesthetic.
The air-abrasion uses
system
blasts of pellets of air and
aluminum oxide to treat tooth
problems such as cavities.
 In spite of showing promising
results, the concept did not gain
popularity due to three major
factors;
Firstly,
not able to prepare cavities with well-
defined walls and margins,

materials during that time (mostly

amalgam and direct or indirect gold)
demanded such preparations since the
concept of bonding had not been
introduced.
• Secondly,

the introduction of the air turbine

hand piece in the late 1950s made
conventional cavity preparations
less time consuming.
Thirdly,

as high-velocity suction had

not been developed, evacuation
of the powder was difficult.
 Principles of Air abrasion

1. Accurate diagnosis of unsound tooth

structure and decay.
2. Accurate removal of unsound tooth
structure with minimal destruction of
sound tooth structure.
3. Restorative treatment planning based on
the probability of longevity of the
restorative material.
Though the basic concept of the air
abrasion device has remained the same,
it has experienced a rebirth not due to
changes in the device per se, but due to
improvements in bonding, restorative
materials, isolation, and high volume
suction.
AIR ABRASION SYSTEMS AND FEATURES

Air abrasion devices include ;

1) Cart
2) table top
3) handheld models.
System and features….
Hand held devices are generally not
suitable for restoration
preparatio but used to prepare
n
tooth, metal, or
compositesurfaces for bonding.
porcelain
System and features…
Some models have built in features and
accessories, such as
 additional compressor,
 evacuation system and
 high intensity curing light.
System and features…

Some systems (ex. AIR-FLOW Prep

K1)
capture the aluminum oxide
powder instream sprayto reduce
pollutionwater
which increases the
operation. comfort
of
AIR ABRASION
 Principle behind air abrasion is based
on the formula for;

KINETIC ENERGY
E = ½ mv2
M = mass V = Velocity

the cutting capability of air abrasive is

attributable to the energy of mass in motion unlike
conventional mechanical methods that depend on
friction .
When that rapidly moving mass
strikes its target, most of its energy
is transferred to that material,
if that material is hard the result
is removal of small amount of
material.
If, on the other hand the
material is soft,
- the energy is mostly absorbed
by the material and then the
mass rebounds.
That is why the modality
is sometimes referred to as
KINETIC
CAVITY PREPARATION (KCP)
 Air abrasion can be best described as a
pseudo-mechanical, non-rotary method
of cutting and removing dental hard
tissue.
 The terms “micro air-abrasion”
and
“kinetic cavity preparation”
have been used synonymously to
describe air abrasion.
Studies have shown that the bonding of
enamel and dentin surfaces prepared with
air abrasion is much better than that with
conventional carbide burs or acid etching ;

with the introduction of flowable and
nano-filled composites .
Another major concern regarding
the powder particles has also been
averted due to;
the use of isolation in the form of
rubber dam and
high volume evacuation devices.
PARAMETERS…….
 A number ofparameters such as the

 amount of air pressure,

 particle size,
quantity of particles passing through
the nozzle,
 nozzle diameter of the hand
piece,
parameters…
angulations of nozzle of the hand
piece,
distance from object
time of exposure to the object vary the
quantity of tooth removal and
 depth of penetration.
PROCEDURE OF AIR
ABRASION
Take preoperative radiograph to determine if interproximal
caries is present

Isolate preferably with rubber dam

Use caries detecting dye to know the carious lesions

Using air abrasive unit with high volume evacuation placed in
the proximity of the tooth prepare cavity

After a few seconds of initial preparation examine

the preparation for decay

Re-apply caries detecting dye

Complete the preparation using the caries detecting dye

until all caries is removed
Apply the etchant for 20 seconds rinse with
water spray

Disinfect the cavity preparation with chlorhexidine

or other materials

Within 10 seconds apply the dentin-bonding agent

 Immediately place the correct shade of composite
and photo-polymerize the material for 40
seconds

Use a carbide bur for initial shaping

A flexible polishing cup point or disc will provide

the final polish for the restoration

Remove the rubber dam and check occlusion

 Advantages
It is painless
Local anesthesia is rarely needed
It works quickly and the tooth with a
small lesion is ready to restore in seconds
advantages….
It work quietly without the whine of the
all too familiar dental handpiece
There is no vibration or pressure
 There is no of heat
to
production
damage the pulp
lesser sound tooth
dental a
structure
removed. n
d
 CLINICAL USES

Class I, II, III, IV, V

cavity
preparations
Sealants and
preventive restorations
Repair of composite
and porcelain
especially margin of
veneers
Removal of
clinical uses…
clinical uses…
USES/APPLICATIONS?
Specific indications for use of air
abrasion include ;

 caries removal;
 removal small existing
of
restorations;
uses…..

 preparation of tooth structure for

cutting or etching for the placement
of composites, porcelain and
ceramics; and
 as an adjunct to the
conventional handpiece bur.
 Some of the situations where
the air abrasion has particularly
proved a boon include:

Removal of superficial
enamel defects
Air abrasion is an excellent tool for
detection of pit and fissure caries –

Use of burs for this procedure would

remove far more sound enamel than
the few micrometers removed with
air abrasion.
In the event of the operator not locating
any carious lesions, the area can easily be
sealed using a pit and fissure sealant.

 If caries is limited to enamel, then a

sealant or flowable resin-based
composite can be placed.
If caries penetrates into dentin, then the
preventive restoration can be used with a
heavily filled resin in deep or wide areas
subjected to forces of mastication.

Sealant material may beusedto cover

non-carious pits and fissures.
Additionally, caries detector dyes
may also be used in conjunction
with air abrasives to detect
incipient lesion

 Air abrasion can also be used

the
for removal pit and fissure
of surface stain
on
enamel
Teeth where the caries is
restricted only to a small section of the
tooth

Box-preparations for Class II

cavities can also be prepared.
Surface preparation of abfractions and
abrasions –
- breaks the glaze of the highly
polished surface that is not suitable for
bonding and produces a highly textured
surface that is excellent for the wet dentin-
bonding technique.
Removal of
existing restorations – the
particles of the air abrasives
can be used at higher pressures
for removal of old amalgam
restorations
 The of local anesthesia
use
working in while
dentin may be avoided
because of their cooling action through
high pressure air.
disadvantages…
damage, but a prolonged direct spray
 An
could spray
potentially cause injury. to soft
tissues
inadvertent
is not to
likely cause
DISADVANTAGES

Not recommended for deep cavities that are

close to pulp

Only composite filling material can be used

coz it adheres to smooth surface created by
air abrasion
disadvantages….

Ability to accomplish only some aspects of
dentistry.

Lack of tactile sensation when using the air

abrasion handpiece, because the nozzle of
air abrasion instrument does not come in
contact with the tooth.
disadvantages…

Air can cause sensitivity

Non contact based modality,

leading to significant risk of cavity
over preparation and inadequate
carious dentin removal.
disadvantages…

Mess and spread of aluminum

oxide around the dental operatory.

Danger of air embolism

and emphysema.
disadvantages…
Impaired indirect view because
abrasive particles collect on mirror
rapidly blocking the viewing surfaces.

Damag to dentalmirrors, optical

e like magnifying
devices camera lenses loupes,
intraora
photographic equipment. or
CONTRAINDICATIONS

 Asthma patients.
 Severe dust allergy.
 Chronic pulmonary disease.
 Recent extraction.
 Open wounds in oral cavity.
 Subgingival caries removal.
BEST CANDIDATES FOR PROCEDURE

Ideal for use in children and others

who are fearful and have minimal
decay.
 OTHER PROCEDURESPERFORMED
WITH AIR ABRASION

 Remove some old composite restorations

Prepare a tooth surface for bonding

and sealants

Remove superficial stains and

tooth discolorations
 CONCLUSION

As an adjunct to traditional
restorative techniques,
air abrasion seems to be carving
out a place of itself in dental
armamentarium.
Air abrasion tooth cutting has
been accepted relatively well by a
small segment of profession.

It is growing slowly and is expected

to continue to grow in popularity
The ultimate goal is to extent life of
restored tooth with as less intervention
as possible.
When operative care is indicated it
should be aimed at
“PREVENTION OF EXTENSION”
rather than
“EXTENSION FOR PREVENTION”.