Micro Air Abrasion

Before	After

• What Is Air Abrasion?
• Uses
• Advantages
• Disadvantages
• History

What Is Air Abrasion? 
The use of beam of abrasive particles (very fine aluminum oxide powder) administered with a special handpiece propelled by stream of clean, dry compressed air through a very fine tip.  Also known as micro air abrasion and kinetic cavity preparation.  Think of it as sandblasting instead of drilling.  As wonderful as air abrasion is, it is not a replacement for conventional decay removal by drilling, but rather as an adjunct.  When the situation warrants it's use this solution as an effective alternative to the dental drill.

Uses 
Air abrasion is most effectively used for:

• small, early cavities - before they enlarge
• repair of small chips on teeth
• removal of small discolorations and stains
• repair or replacement of tooth-colored fillings
• prepare teeth for cosmetic procedures

Advantages 
The advantages of air abrasion over conventional decay removal with a handpiece (drill) can be significant:

• There is no vibration and little or no heat generation, so anesthetic can often be avoided.
• It virtually eliminates any "micro-fractures" that sometimes occur with a traditional handpiece.
• After preparation, teeth are restored with strong, natural-looking tooth-colored filling materials or sealants that are bonded to the teeth.
• Because this system can be precisely directed, there's less tooth structure lost in preparing for a filling.  It removes the smallest possible amount of tooth structure.  Virtually no loss of healthy tooth occurs.
• Special stains (caries indicator) locate tiny pockets of decay.  Air abrasion gently opens and cleans out the decay, and then the tooth is bonded in place with one of the new, white filling materials or a tooth-colored sealant.
• Safe, so that it can be used on small children and pregnant women.
• Generally shorter treatment time.

Teeth that often have stained or dark grooves may not even have a sticky fissure, or show on x-ray, yet statistically 3 of 4 dark grooves have decay.  Traditionally these areas have been "watched" or "monitored" until there is a definitive cavity before providing treatment.  There are 2 reasons for this:

• Using the tools available would cause removal of too much healthy tooth structure, and
• Using the drill and an injection seemed a greater trauma than waiting until the cavity became very evident.

With air abrasion, caries indicator, laser cavity detection, and flowable composites (tooth-colored filling material that literally can flow into small crevices), just the affected part of the tooth can be cleaned out, removing any decay underneath without weakening the tooth.

Disadvantages 
The disadvantages are few:

• air abrasion does not work for preparing teeth for silver-amalgam fillings
• air abrasion also does not work well for removing silver-amalgam fillings (air abrasion works much more effectively on hard structure rather than soft structure)
• the aluminum oxide powder can be messy; however, high speed suction removes this, and sometimes a rubber dam is used to keep it out of your mouth
• because it uses a high-pressure air stream, there's a minor danger of injecting air into the cheeks or gums - this is avoided with attention to detail, in the same way care is taken when drilling or giving injections

History 
Dr. Robert Black in the 1940’s first described a device which delivered an abrasive material under high pressure, and which would cut through enamel and dentin.  It was marketed as the Airdent by SS White.  Once the Borden high speed handpiece was available, the Airdent fell out of favor.  Other limitations were the lack of suitable filling materials.

While dentistry proceeded using the new high-speed drill we all know today, other uses were found for air abrasion:

• semiconductor manufacturers use it to make microchips
• medical companies use to sharpen hypodermic needles
• the aerospace industry uses it to repair electronic circuit boards on planes, spaceships and satellites
• museums use it for restoring priceless artifacts, and preparing prehistoric fossils

In the 1970’s, Dr. Tim Rainey, Director of the Texas Institute of Advanced Dental Studies, started working with Dr. Black, and in 1985, revived the concept, as we know it today.