Air Abrasion System Research Articles

Effect of Silica-Modified Aluminum Oxide Abrasion on Adhesion to Dentin, Using Total-Etch and Self-Etch Systems

This study compared the shear bond strength (SBS) and micromorphology of composite resin to human dentin after pre-treatment with silica-modified aluminum oxide air abrasion. Forty-six molar teeth were treated with either Scotchbond Multi-Purpose (SCMP) or Clearfil SE Bond (CLSE) adhesive. Buccal surfaces were pre-treated with the CoJet air abrasion system (SB), and lingual surfaces were controls. The adhesion of light-cured resin composite to the treated dentin surface was evaluated with SBS. After debonding, substrate surfaces were examined with an optical microscope for failure analysis. In addition, 15 molar teeth were sectioned and randomly assigned to one of five groups, according to the dentin surface pre-treatment and adhesive type, and examined with high-vacuum scanning electron microscopy/energy dispersive X-rays (SEM/EDS). The type of adhesive had a significant effect on SBS (p = 0.000); CLSE had the highest values. SB did not affect SBS (p = 0.090). SEM/EDS revealed residual aluminum and/or silicon on all dentin surfaces after SB, except for the control. Treatment with 32% phosphoric acid in the SCMP adhesive decreased the amounts of aluminum and silicon compared to SB dentin only, whereas CLSE resulted in similar quantities of aluminum and silicon as air-abraded dentin. The results of this study indicate that CLSE might have a higher bond strength to dentin than SCMP. Pre-treatment with SB does not appear to affect bonding strength.

Radiographic Evaluation of Surgical Treatment of Peri-implantitis with Bone Graft Procedure: Case Report

The purpose of this case report was to radiographically evaluate the long-term effect of surgical treatment of peri-implantitis defects using bone graf t procedure for more than 3 years af ter operation. 2 cases of patients who had peri-implantitis induced intrabony defect were included in this study. Patients were treated by surgical procedure which consists of mechanical debridement with air abrasive system and titanium curette, chemical decontamination with tetracycline, and regenerative approach using synthetic bone or xenogenic bone. Clinical reduction of probing pocket depth and radiographic evidence of bone gain was observed and maintained in both patients for 3 years after surgery. Within the limitation of this case report, bony defects were managed effectively by surgical treatment with regenerative bone graft procedure.

Effect of different enamel surface preparations on the micro-tensile bond strength of resin composite to bleached enamel

Aim: This study was carried out to investigate the effect of different enamel surface treatments on micro-tensile bond strength of resin composite to bleached enamelMaterials and methods: 56 human premolars were used in this study. Teeth were divided into two main groups group 1: unbleached enamel (10 teeth) while group 2: bleached enamel (40 teeth). Then group 2 was subdivided into 4 subgroups (10 each) according the enamel surface treatment employed after bleaching and before bonding to composite either no treatment, grinding with diamond stone to remove 0.5mm of the surface, air abrasion using the air abrasion system (AquaCare-Velopex International) and combination of grinding and air abrasion. Each subgroup as well as the control group was further divided into two classes (5 each) according to the aging time either 24 hours or 3 months. Another six specimens were used as representative for the enamel surface topography after treatments for scanning electron microscopy SEM testing. Specimens of group 2 were polished and mounted in an acrylic block (five teeth in each block) with slight lingual inclination from their long axis to facilitate bleaching and light application. For in office bleaching, Philips ZOOM in-office light-activated bleaching gel was used in this study. After the in-office bleaching, teeth were subjected to at home bleaching using Night White ACP system for successive 7 days. The bleached teeth were divided into four subgroups according the enamel surface treatment employed after bleaching and before bonding as mentioned before. All enamel specimens either unbleached (control) or bleached and prepared specimens were bonded to Filtek Universal Restorative composite (3M ESPE, St Paul, MN, USA) using Single Bond universal adhesive (3M ESPE, St Paul, MN, USA). For immediate subgroups and classes, the specimens were stored in distilled water for only 24h after resin composite bonding. While for the three-month classes, the specimens were stored for three months in distilled water at room temperature. For micro-tensile bond strength test, specimens were longitudinally cut into a series of 1 mm thick slabs by means of a water-cooled diamond blade of thickness 0.5 mm in a low speed micro-slicing machine. By rotating the specimen 90o and sectioning it again lengthwise (five cuts), four sticks of about 1 mm2

Comparative evaluation of changes in the ultrastructure of tooth enamel and dental implants using air-abrasive methods of surface decontamination in the process of carrying out professional oral hygiene

Relevance. To remove above-gum deposits and under-gum deposits air-abrasive methods are widely used. However, the mechanical properties of air-abrasive products are not known to ensure professional hygiene in the feld of exposure various tooth structures. In this regard more detailed studies on these issues are therefore needed. The aim of the present study was to undertake an comparative analysis of changes in the ultrastructure of the surface of tooth hard tissues when they are processed by powders consisting of sodium bicarbonate, calcium carbonate, glycine and trehalose.Materials and methods. The production of vertical teeth grinding, thickness 1-2 mm, removed by orthopedic or orthodontic indications; the processing of these sections by air-abrasive powders in compliance with the Protocol of use of these funds from the manufacturers during the professional hygiene and the study of the samples by scanning electron microscopy (SEM) by a special technique.Results. The answer to the task was the data of comparative analysis of damage to the enamel surface as a result of processing by various air-abrasive systems and the determination of the least traumatic method of conducting professional oral hygiene in relation to the enamel surface.Conclusions. Processing of enamel by air-abrasive method using powder based on trehalose, glycine and calcium carbonate, observing the recommended conditions for the use of these systems, does not lead to a signifcant change in the enamel ultrastructure, damage or deformation, unlike powders based on calcium bicarbonate. Therefore these systems can be recommended during maintenance periodontal therapy for the prevention of periodontal diseases and dental caries for a long period of time. However, the use of powder based on calcium carbonate is not desirable in the area of dental implants and orthodontic structures such as braces, since the powder remains on these surfaces unchanged and can subsequently cause an exacerbation of inflammatory processes in soft tissues.

Enamel Remineralization with Novel Bioactive Glass Air Abrasion

Enamel demineralization or white spot lesions (WSLs) are a frequent complication associated with fixed appliance–based orthodontic treatment. The remineralization potential of a novel fluoride-containing bioactive glass (QMAT3) propelled via an air abrasion system was compared with Sylc glass and artificial saliva on artificially induced WSLs. Thirty extracted human premolars were randomly assigned into 3 groups (n = 10) per method of treatment and scanned with optical coherence tomography and noncontact profilometer in the 4 enamel states: sound, demineralized, after glass propulsion, and after immersion in artificial saliva. Knoop hardness testing was also performed. Twenty additional prepared teeth samples were also randomly selected for examination by scanning electron microscopy and energy-dispersive X-ray spectroscopy (2 teeth per technique) under each of the 4 enamel conditions. 19F MAS-NMR (magic angle spinning–nuclear magnetic resonance) was also used to detect the type of apatite formed on the enamel surface. Significant enamel remineralization with surface roughness and intensity of light backscattering similar to that of sound enamel was observed following treatment with QMAT3. In addition, mineral deposits were detected on the remineralized enamel surfaces, forming a protective layer and improving its hardness. This layer was rich in calcium, phosphate, and fluoride; 19F MAS-NMR confirmed the formation of fluorapatite. This finding is particularly beneficial since fluorapatite is more chemically stable than hydroxyapatite and has greater resistance to acid attack. Hence, a promising fluoride-containing bioactive glass for enamel remineralization has been developed, although further clinical evaluation and refinement is required.

Clinical use experience of the air-abrasive system Air-flow using material "Air-Cleans Proph" when professional oral hygiene

This work contains the description of the physical and mechanical properties of main materials used for systems. Description of clinical use experience of domestic air-abrasive material when professional oral hygiene.

Parameters That Improve Cleaning Efficiency of Subgingival Air Polishing on Titanium Implant Surfaces: An In Vitro Study.

This study aims to reveal how air polishing behaves on a titanium surface by evaluating the size and shape of the cleaned area and the influence of different device settings, probing depths, and cleaning movements. Forty-eight titanium sandblasted large-grit acid-etched surface film-coated disks were treated with an air abrasive system using a subgingival plastic nozzle. Two subgingival models were used: open-ended (step 1) and defined-size (step 2). In step 1, the most effective parameters were investigated by 5-second static applications under different settings. In step 2, the best settings were used for dynamic application to test influence of different movements (up-down, slowly up, rotation). For both steps, powder and water consumption and total cleaned area were calculated. Air pressure was the main factor with the strongest effect on cleaning. Increasing air pressure extended cleaning area. Other factors, such as nozzle depth and excessive powder flow amount, had weak influence. Cleaning effect reached deeper than the nozzle physically reached. Step 2 showed that there was no significant difference between different nozzle movements; however, cleaning efficiency decreased significantly without movement. For the most effective clinical use of air polishing, it should be applied with high pressure, deep insertion of nozzle, and enough water flow. Additionally, the nozzle has to be moved to get the best cleaning effect.

Peri-implantitis cleaning instrumentation influences the integrity of photoactive nanocoatings

ObjectiveTo determine in vitro the loss of integrity caused on photocatalytic anatase coated implant surfaces by clinical instrumentation through changes in surface topography and loss of functionality. MethodsAnatase-coated titanium discs were treated with diamond burs, polishers, plastic and metal hand instruments, air scaler and air flow devices. The pressure exerted through instrumentation was measured online. Surface topography was evaluated through scanning electron microscopy and contact profilometry, surface function through hydrophilization capacity upon UV-A activation. ResultsTreatment with diamond burs and instruments with metal tips resulted in an increase of roughness. Use of silicone polishers led to smoothening, which was more pronounced on the anatase surface. Plastic instruments, the air abrasive system and rubber cups left the surfaces intact. Functionality was partially lost on surfaces subjected to hand instruments and completely lost upon diamond burs and silicone polishers. SignificanceThe integrity of functional nanocoatings depends on the applied instrumentation. Air flow device, rubber cup with polishing paste and plastic tipped instruments prevent damage on these nanosurfaces and may be preferably used when decontaminating anatase and other nanocoatings in a clinical setting.

Cavity cutting efficiency of a BioglassTM and alumina powder combination utilized in an air abrasion system

This study investigated the attempt to replace alumina in the air abrasion system with an alternative material that is effective at cutting and also has remineralization potential. The powder samples were randomized into three groups: group 1—alumina (composed of aluminium and oxygen), group 2—45S5 (composed of 45% silica, 24.5% calcium oxide, 24.5% sodium oxide and 6% phosphorus pentoxide in weight percentage) and group 3—alumina + 45S5. Thirty human enamel blocks and microscope glass slides of 0.5 mm thickness were randomly divided into these three groups. The time taken to cut a hole through the glass slide and for the cutting of human enamel blocks was recorded, the cutting time was fixed at 15 s. The depths of the cavities were measured using a periodontal probe and the enamel blocks were then analysed by scanning electron microscope (SEM). The mean time taken to cut a hole through the microscope glass slide was 2.96, 23.01 and 3.02 s for groups 1, 2 and 3, respectively. After cutting the human enamel blocks, the mean cavity depths produced were measured to be 2.5, 1.0 and 2.0 mm for groups 1, 2 and 3, respectively. The SEM micrographs revealed that the cavities formed by 45S5 were more conical in shape, whereas cavities produced by alumina and alumina + 45S5 were more cylindrical. The combined use of alumina and 45S5 has demonstrated a promising cutting efficiency and it has the potential to achieve effective cutting with the possibility of the remineralization.

Morphological and chemical characteristics of different titanium surfaces treated by bicarbonate and glycine powder air abrasive systems.

This in vitro study investigated possible morphological and chemical changes induced by glycine or sodium bicarbonate powder air polishing on machined and acid-etched titanium surfaces. The glycine powder (granulometry <65 μm) and sodium bicarbonate powder (granulometry <150 μm) were applied on 2 machined healing abutments and on 2 acid-etched healing abutments. The samples were characterized by scanning electron microscopy coupled with energy dispersive x-ray spectroscopy. The analyses were performed at different steps: (1) as received, right after opening the abutment packaging; (2) after 20 minutes air exposure; (3) after aging in artificial saliva; (4) after glycine or sodium bicarbonate powder air polishing for 5 seconds; (5) after repetition of steps 3 and 4 with longer time of polishing (20 seconds). Air polishing using glycine and sodium bicarbonate powder seemed to be safe for professional oral hygiene of titanium dental implants, although acid-etched abutments and abutments treated with bicarbonate harbored more salts. This might indicate a greater plaque accumulation in a clinical situation. However, this result has to be investigated in vivo to understand its clinical relevance.

Comparisons of discomfort among cutting instruments for removal of carious dentine in children

To determine the properties of cutting instruments used objectively in dental treatment for children, a comparative study of erbium-doped yttrium aluminium garnet (Er-YAG) laser, air abrasion system and a rotary cutting steel bur was conducted, focussing on discomfort such as pain, vibration, noise, odour and other types of discomfort during removal of carious dentine. The subjects were 60 children and 60 adults. The visual analogue scale (VAS) was used for evaluation, yielding the following conclusions.With respect to pain, discomfort during the removal of carious dentine using the steel bur was found to have the highest VAS value, while it was milder using the laser treatment, followed by that using the air abrasion treatment. There was no significant difference in pain between children and adults. Vibration increased significantly when the steel bur was used in both groups. In addition, vibration caused more discomfort to child patients than to adults. Noise increased significantly in the air abrasion treatment and steel bur treatment in both groups. However, noise caused more discomfort to child patients than to adults. Discomfort due to odour increased significantly in the laser treatment. Other types of discomfort increased significantly in the air abrasion treatment. The degree of discomfort was significantly higher in the child patients.In conclusion, these results suggest that there were differences in the degree of discomfort between child and adult patients. Children showed characteristic responses to the discomfort in relation to mechano-chemical stimulations, while pain elicited characteristic responses in adults.

Influence of air abrasion tips and operation modes on enamel-cutting characteristics

To assess the influence of air abrasion tips and system operation modes on enamel cutting. Forty bovine teeth were abraded with the air abrasion system Mach 4.1 for 10 and 15 seconds, employing conventional and sonic tips of 0.45-mm inner diameter and a 90° angle, and 27.5-μm aluminum oxide at 5.51 bar air pressure in continuous and pulsed modes. The width and depth of the resulting cuts were measured in SEM. The multivariate analysis of variances revealed that, compared to the sonic tip, the conventional tip produced shallower cuts independent of the operation mode and the application period. The cutting patterns observed in this study suggest that the pulsed mode produced deeper cuts when both the conventional and sonic tips were used, and that the sonic tip cut more dental tissue than the conventional one.

Nonsurgical Treatment of Periodontitis

Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012.Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols.Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols.Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.

Marginal leakage in permanent teeth after dentin treatment with air abrasion and adhesive systems

Due to doubts related to the application and association of techniques for appropriate adhesion, as the air abrasion system and last generation adhesive systems, the objective of this study was to evaluate the marginal leakage in Class V composite restorations in permanent teeth prepared with rotating instruments and then submitted to air abrasion and adhesive systems. Cavities were prepared with burs in high speed in facial and lingual surfaces of 25 human third molars. The specimens were divided into 5 groups of 10 preparations each: G1 (air abrasion and Scotchbond Multi Purpose), G2 (phosphoric acid and Scotchbond MP), G3 (Clearfil SE Bond self-etching system), G4 (air abrasion, phosphoric acid and Scotchbond MP) G5 (air abrasion and Clearfil SE Bond). All groups were restored with Z100 composite resin. The teeth were subjected to thermal cycling and immerged in 50% silver nitrate solution. After sectioning, the specimens were analyzed with a stereomicroscope for assessment of microleakage according to the degree of dye penetration. The Kruskal-Wallis test followed by Dunn Multiple Comparison test were performed in order to evaluate the differences among the experimental groups. Air abrasion groups demonstrated the greatest leakage. Scotchbond MP with phosphoric acid produced the least leakage, with greater leakage in gingival margins than occlusal margins in all experimental groups. It was concluded that dentin treatment with air abrasion should not be used in permanent teeth to reduce the marginal leakage.

The solid particle erosion behaviour of dental enamel using a novel air abrasion system

The erosion rate of the enamel of human premolars, molars and canines was measured at various angles of attack using a dental air abrasion unit equipped with a novel particle containment system consisting of a conical water spray surrounding the central air/particle jet. This water curtain minimised the amount of airborne abrasive particles and erosion debris. No statistically significant difference in erosion rate was found between samples blasted with or without the particle containment system. The dental enamel was found to behave in a brittle erosive manner, exhibiting a maximum in erosion rate with the abrasive jet oriented perpendicular to the surface. The observed dependency of erosion rate on the type of tooth could be explained on the basis of differing hardness. Artificial dental block samples showed significantly lower erosion rates compared to human dental enamel, implying that they are not suitable for simulating the solid particle erosion behaviour of teeth.

Bond strength of a composite resin to an adhesive luting cement

This study evaluated the influence of surface treatment on the shear bond strength of a composite resin (CR), previously submitted to the application of a temporary cement (TC), to an adhesive luting cement. Eight-four CR cylinders (5 mm diameter and 3 mm high) were fabricated and embedded in acrylic resin. The sets were divided into 6 groups (G1 to G6) (n=12). Groups 2 to 6 received a coat of TC. After 24 h, TC was removed and the CR surfaces received the following treatments: G2: ethanol; G3: rotary brush and pumice; G4: air-abrasion; G5: air-abrasion and adhesive system; G6: air-abrasion, acid etching and adhesive system. G1 (control) did not receive TC or any surface treatment. The sets were adapted to a matrix and received an increment of an adhesive luting cement. The specimens were subjected to the shear bond strength test. ANOVA and Tukey's tests showed that G3 (8.53 MPa) and G4 (8.63 MPa) differed significantly (p=0.001) from G1 (13.34 MPa). The highest mean shear bond strength values were found in G5 (14.78 MPa) and G6 (15.86 MPa). Air-abrasion of CR surface associated with an adhesive system provided an effective bond of the CR to the adhesive luting cement, regardless the pre-treatment with the phosphoric acid.

Evaluation of the smear layer and hybrid layer in noncarious and carious dentin prepared by air abrasion system and diamond tips

To analyze the smear layer and the hybrid layer in noncarious and carious dentin prepared by different cutting instruments and restored with composite resin. Cavities were randomly prepared in 160 specimens (noncarious and artificial carious dentin) by high-speed diamond tips (KG Sorensen 1013), air abrasion system (Prepstart, Danville Engineering), ultrasonic tip (CVDentus 8.3231-1), and ultrasonic tip associated with ultrasonic cavitation by water for 10 s. Half of the cavities in each group were conditioned with 37% phosphoric acid for 15 s. The amount of smear layer and dentinal tubules present were analyzed using scanning electron microscopy and graded from 0 to 3. Cavities were prepared in another 20 noncarious specimens and 20 carious specimens and restored with adhesive composite resin system. The restorations were hemisected longitudinally and analyzed using scanning electron microscopy to evaluate the hybrid layer and resinous prolongation characteristics, using scores ranging from 1 to 6. The data were statistically analyzed using Kruskal-Wallis and Dunn tests at 5% of significance level. There was evidence that the most efficient smear layer removal was the acid etching in the noncarious dentin and the water ultrasonic cavitation in the carious dentin. The hybrid layer formed on the noncarious and carious dentin prepared by the ultrasonic tip was more regular than in the specimens prepared by high-speed diamond tip, with many resinous prolongations. The ultrasonic tip seems to be a promising tool for carious dentin cavity preparation.

An in vitro evaluation of the efficiency of an air-abrasion system using helium as a propellant

Objectives Helium is currently used as a propellant gas for air-abrasion with manufacturer claims that this affords greater cutting efficiency compared to the use of air as a propellant. Higher cutting rates, when desired, can reduce operative times. This study set out to investigate these claims by comparing the rate at which helium propelled air-abrasion cut a standard enamel analogue, Macor ®, versus that of standard air propelled air-abrasion at different propellant pressures. Methods An enamel substitute, Macor ®, was used as the substrate in order to enable a greater control of physical variables. Powder flow rate, air abrasion nozzle distance and angle to the enamel substitute were constant throughout the experiments. The cutting efficiency of air and helium with propellant pressures of 20, 40, 60, 80 and 100 PSI were dynamically investigated, attempting to replicate clinical use. Results Helium air-abrasion was significantly more efficient in cutting the enamel analogue at all pressures, with a 40% increase for 100 PSI propellant pressure. Significance This finding suggests that air-abrasion units using helium as a propellant will be able to cut enamel more quickly in the clinical setting.

Iatrogenic Subcutaneous Emphysema of Dental and Surgical Origin: A Literature Review

Subcutaneous emphysema arises when air is forced beneath the tissue, leading to swelling, crepitus on palpation, and potential to spread along the fascial planes. The goal of this literature review is to alert the oral and maxillofacial surgeon to the inciting factors, diagnosis, and management of subcutaneous emphysema. A comprehensive search of the medical and dental literature from 1993 to 2008 was performed using PubMed, and yielded 32 case reports of subcutaneous emphysema. Only cases associated with dental or surgical procedures were included. Cases of trauma were excluded. Sixteen of the 32 cases were linked to the use of air-driven handpieces. Other cases involved a CO(2) laser, a NO(2) cryomachine, an air abrasive system, endotracheal intubation/ventilation, and patient activities after surgical procedures. Of the cases reviewed, 5 resulted in significant complications after subcutaneous emphysema. Although rare, iatrogenic subcutaneous emphysema can have serious and potentially life-threatening effects. Care should be taken when using air-driven handpieces or performing endotracheal intubation/ventilation. Additionally, instructions should be given to patients after procedures violating the epithelium to reduce the incidence of subcutaneous emphysema. When subcutaneous emphysema does arise, it must be quickly diagnosed and properly managed to reduce further complications.

Efficacy of a new jet nozzle for removal of carious dentin with an air abrasion system

A new version of an air abrasion device, which expelled abrasive sodium bicarbonate powder, was fabricated to remove carious tissue. This device had a motor-driven mechanism to control the amount of powder expelled. The purpose of this study was to estimate the abrading efficacy of this device, in particular the new jet nozzle, for removal of carious dentin. Powder was supplied to the handpiece by a rotary gear attached to the powder control motor. Two types of jet nozzles, a cylinder-type and a bugle-type, were fabricated and evaluated. The duct of bugle-type nozzle had an isthmus to increase the air pressure on the powder and to spread it out in a cone-shaped flow. Results obtained showed that the bugle-type jet nozzle exhibited a more prominent abrasive capability. Compared to the cylinder-type nozzle, it was thus more effective in removing the carious dentin which remained in the undercut region of the cavities.