Content area
Full text
In the past few years, operative-dentistry techniques have focused on minimal invasiveness and sacrifice of sound tooth structure. As new techniques emerge and are adapted into dental disciplines, the intent and purpose of the original technology often changes. Air abrasion is an old dental technology that is finding a new place in modern, science-based microdentistry, redefined from the original applications of the 1950s when dental education was dedicated to preserving the dogma and theories of prevention.
As an adjunct to microdentistry, air abrasion is now supported in the literature as the accepted alternative to traditional rotary instrumentation. According to Ferdianakis and White in a controlled study comparing air abrasion to other treatment modalities, "the trials revealed that for small or moderate cavities, the optimal method of preparation, especially for children, is with air-abrasion." The authors went on to say that "the presence of chamfer does not have any negative effects on microleakage formation and, in contrast, can increase the surface adherence, which may contribute to microleakage reduction."
In many studies, the two things patients most disliked about dentistry were the use of the needle and drill. The new microabrasion technology and its associated new techniques of air abrasion are tailor-made to frequently eliminate the need for the high-speed drill and local anesthesia. Air abrasion eliminates objectionable heat, sound, and vibrations associated with highspeed instrumentation. Still another benefit is the elimination of the recognized side effects of microfracture and microcrazing of the enamel margins and the enamel in general. It also is unnecessary to destroy important structural and substructural components when utilizing micro air-abrasion-assisted microbonding techniques. This helps maintain the biomechanical integrity of the occlusal surface.
Although I have been utilizing the concepts of microdentistry in our busy practice for more than 17 years, I still am amazed by the amount of fissure caries detected with caries-detection dye or with a diagnostic laser, particularly in newly-erupted teeth. The diagnostic technology of this past century relied on the familiar dental pick, the dentist's visual skills, and his or her ability to "feel" decay. These techniques, although still taught as part of the standard dental curriculum, have been proven time and again to be woefully inaccurate for diagnosing the early presence of decay. In fact, this old...