Does Air Particle Abrasion ACTUALLY Improve Clinical Outcomes? - PDP190

Summary

In this Protrusive Dental Podcast episode, host Jaz Gulati engages in a detailed discussion with Dr. Veronica Pereira de Lima about air particle abrasion in restorative dentistry. They explore its significance for dentine bonding, the optimal sand microns for use, and the benefits of CoJet silica-embedded sand. The conversation delves into clinical applications, health concerns related to particle exposure, and whether air abrasion is a necessary investment for dental practitioners. Dr. Lima shares insights from her systematic review and personal experiences, emphasizing the need for more research while acknowledging air abrasion as a valuable tool that doesn't appear to cause harm in the absence of conclusive evidence.

Takeaways

• 📚 Dr. Veronica Pereira de Lima was the lead author of a systematic review in 2020 that investigated the impact of air particle abrasion on dentine bonding.
• ❓ The podcast discusses the importance of air particle abrasion in restorative dentistry, including its use for biofilm removal and improving adhesion in adhesive dentistry.
• 🏥 Dr. Pereira de Lima shared her academic journey from Brazil to the Netherlands, highlighting her research interests and the balance between clinical practice and academia.
• 🔍 The discussion covers the significance of air particle abrasion in clinical dentistry, with a focus on whether it provides false confidence in bonding or actual benefits.
• 🦷 The role of air abrasion in adhesive dentistry is emphasized, with the suggestion that a clean substrate is fundamental for effective bonding.
• 💭 Concerns about the health implications of using aluminum oxide in air particle abrasion are addressed, suggesting that with proper precautions, it appears to be safe.
• 👩‍⚕️ Jaz Gulati shares a clinical tip about using an ultrasonic scaler after air abrasion to ensure a clean surface for bonding.
• 🤔 The podcast questions the necessity of different particle sizes (27 microns vs. 50 microns) for various dental procedures and finds no definitive answer in the literature.
• 🛠️ CoJet, a type of air abrasion media containing silica, is discussed for its potential benefits in bonding to sealants and other materials.
• 🚫 The speakers advise against using air abrasion for diagnosing caries or in situations where there is a risk of pulp exposure or where isolation is not possible.
• 💡 The value of air abrasion as a tool in a dentist's toolkit is recognized, with the understanding that it may not be essential but can improve clinical outcomes and procedure quality.

Q & A

What is the main topic of the Protrusive Dental Podcast episode featuring Dr. Veronica Pereira de Lima?

The main topic of the episode is air particle abrasion, its significance in improving dentin bonding, and its importance in restorative dentistry.

What is the purpose of air particle abrasion in dental procedures?

Air particle abrasion is used for biofilm removal, providing a clean substrate for bonding in adhesive dentistry, and for roughening surfaces to improve adhesion in restorative procedures.

What is CoJet and how does it differ from regular air particle abrasion?

CoJet is a branded product by 3M that, in addition to alumina oxide, contains silica. This makes it potentially beneficial for improving bonding to sealants and other materials during dental repairs.

What are some of the factors that influence the effectiveness of air particle abrasion?

Factors that influence the effectiveness of air particle abrasion include particle size, pressure, distance from the substrate, angle, and duration of abrasion.

What is the significance of using a rubber dam during air particle abrasion?

Using a rubber dam during air particle abrasion helps to isolate the treatment area, prevent the spread of abrasive particles, and protect the patient's soft tissues.

What are some alternatives to air particle abrasion for surface roughening or biofilm removal?

Alternatives to air particle abrasion include using burs for mechanical roughening of surfaces and pumice or polishing pastes for biofilm removal.

What are some health concerns related to the use of aluminum oxide in air particle abrasion?

While there is no strong evidence of significant health risks, there are concerns about the inhalation of aluminum oxide particles, which could potentially be harmful if not properly controlled with suction and personal protective equipment.

How does air particle abrasion compare to Aquacare or Crystal Marks systems in terms of mess and safety?

Aquacare and Crystal Marks systems, which use water in addition to abrasive particles, are considered less messy and potentially safer due to reduced airborne particles.

What is the stance of the Ivoclar guidelines on air abrasion for Emax lithium disilicate ceramics?

The Ivoclar guidelines specifically advise against air abrasion for Emax lithium disilicate ceramics due to the risk of causing micro-fractures in the material.

What is the conclusion of Dr. Veronica Pereira de Lima's systematic review on air particle abrasion?

The systematic review concluded that while air particle abrasion does not significantly improve bond strength, it also does not harm adhesion, and its use can be beneficial for certain procedures, pending more research.

What advice does Jaz give to the Protruserati community regarding air particle abrasion units and their investment in such equipment?

Jaz suggests that while air particle abrasion units can be beneficial, they should not be considered an essential investment for every dentist. Dentists should weigh the benefits against the costs and their clinical needs before investing in such equipment.