Some Cavities Filled With No Drill And No Novacaine

[drsnehamaheshwari]

Specific indications for use of air abrasion include caries removal; removal of small existing restorations; preparation of tooth structure for cutting or etching for the placement of composites, porcelain and ceramics; and as an adjunct to the conventional handpiece bur.

Some of the situations where the air abrasion has particularly proved a boon include:

1.      Removal of superficial enamel defects – these are much easier with the air abrasives since they result in removal of less tooth structure than the drill.

2.     Air abrasion is an excellent tool for detection of pit and fissure caries – when clinical, radiographic, and patient risk factors make pit and fissure caries suspect, air abrasion can be used to remove the organic debris and determine if caries is present. Use of burs for this procedure would remove far more sound enamel than the few micrometers removed with air abrasion.

In the event of the operator not locating any carious lesions, the area can easily be sealed using a pit and fissure sealant.

If caries is limited to enamel, then a sealant or flowable resin-based composite can be placed.

If caries penetrates into dentin, then the preventive restoration can be used with a heavily filled resin in deep or wide areas subjected to forces of mastication. Sealant material may be used to cover non-carious pits and fissures.

Additionally, caries detector dyes may also be used in conjunction with air abrasives to detect incipient lesion and treat them appropriately.

3.     Air abrasion can also be used for the removal of pit and fissure surface stain on enamel before placement of a resin-based composite restoration or porcelain veneers.

4.     Teeth where the caries is restricted only to a small section of the tooth can also be prepared using air abrasives for conservation of sound tooth structure. Box-preparations for Class II cavities can also be prepared.

5.     Surface preparation of abfractions and abrasions – air abrasion breaks the glaze of the highly polished surface that is not suitable for bonding and produces a highly textured surface that is excellent for the wet dentin-bonding technique.

6.     Removal of existing restorations – the particles of the air abrasives can be used at higher pressures for removal of old amalgam restorations for replacing them or for removal and repair of composites, glass ionomers, and porcelain restorations.

7.     The use of local anesthesia while working in dentin may be avoided because of their cooling action through high pressure air.