Air abrasion use in dentistry
Air abrasion use in dentistry is a nice tool with various applications from hygiene, clinical, and laboratory.
What are the different materials in use for air abrasion?
The material choice decides what the goal of air abrasion is. The more coarse material is the more it cuts into tooth structure.
Aluminum oxide air abrasion
This is the main type of particle we use to cut into tooth structure or other materials. Particles come in sizes from 30-90 μm. The larger particles are more abrasive. We use aluminum oxide to roughen old composite when adding new composite to it. Other uses include roughening of metal, ceramics, and acrylic before adding anything to them or bonding to them. Aluminum oxide does a great job of cleaning any surface.
So what is the ideal size for aluminum oxide air abrasion?
That is a debatable topic. Typically research shows better bonding with air abrasion but differences in findings on particle size. Shimoe JPD 2019 finds size differences from 25-125μm and pressure differences between .1-.4 MPa do not result in clinical differences. They did find that there are significantly higher bond strengths after cycling with the alumina air abrasion.
Aluminum oxide in tribochemical treatments of zirconia
When we want to bond to zirconia the gold standard is tribochemical. We accomplish this bonding with CoJet sand, which consists of 30 μm silicanized Al₂O₃ particles. Bielen 2015 J Ad Dent For the exact steps you can check out our zirconia page.
Typically these particles are 50-90 μm. They are less abrasive than aluminum oxide. We can use these products to clean temporaries or plaque from dentures. If going to bond or add to these then we prefer just using the aluminum oxide.
Bioactive glass particles for air abrasion
Bioactive glass particles have a use as a tool to prevent sensitivity. We can also use them to help treat peri-implantitis. Bioactive glass 45S5 and S53P4 are well known bioactive glasses but there are many variations that are similar. Adding ZnO to bioactive glass is useful in treating dental implants with peri-implantitis. Abushahba JOI 2019 For more information on bioactive materials check out our blog.
This category is for cleaning only. Some use these for their cleaning appointments to remove the biofilm or to remove biofilm before bonding to uncut enamel. Products in this category include sodium bicarbonate, glycine, calcium sodium phosphosilicate, calcium carbonate, and aluminum trihydroxide. A nice review of these are in J Dent Hyg 2013 Graumann. Glycine is the only one that has not been found to abrade to any extent at all on glass ionomer or composite according to Barnes J Clin Dent 2014. Fronchetti JOMI 22 finds no visible damage on implants from sodium bicarbonate. Some of these are even course enough to complete microscopic air abrasion. Aluminum trihydroxide is a popular product for biofilm removal prior to Bioclear composites.
Dental air polisher units and powders
Danville Micro etcher, Kavo Rondoflex, and Kavo Aqucut are the three main units. The Kavo is probably the best to use in the mouth in terms of ease of use. Brumm uses the Kavo with Cojet.
Protocols for decontamination of titanium
Sodium bicarbonate Profi II Ceramic at 70lb for 1 minute 10mm away Vieira ID ID 12
Perioflow with glycine doesn’t leave anything behind.
Fine bicarbonate powder for 60 seconds using Prophy-Jet, Dentsply with a contra-angled tip to reach all areas of the exposed implant followed by 60-second irrigation sterile saline delivered by Infinity Irrigator, Ace Surgical. Froum 2012
Most gentle air polisher powder for titanium
Glycine creates less roughness on titanium than sodium bicarbonate does according to Biazussi 2019 JOI. Matsubara 2020 CIDRR found similar but also found didn’t have great ink removal. However, air-powder abrasion with glycine is better than other methods. Iatrou JOMI 2021