Some Cavities Filled With No Drill And No Novacaine

[drsnehamaheshwari]

DOES IT HAVE ANY LIMITATIONS?

Though air abrasives can be used in a large number of clinical situations there certainly are some limitations to their use such as

·         Air abrasion is not an efficient means of removing large amalgam restorations especially, and there is concern for the levels of mercury released when amalgam is abraded. Air abrasion of amalgam for 1 min releases mercury vapor four times in excess of the OSHA standard. Same is true regarding removal of full coverage restorations.

·         Air abrasion is also not effective for removal of gross caries because it does not cut substances that are soft or resilient. In such cases, however, hand instruments like spoon excavators can be used to scoop out the soft lesions followed by air abrasives to remove the relatively hard carious tooth structures.

·         Also the depth of penetration during cavity cannot be controlled, so it has to be accompanied with visual inspection in regular intervals.

·         The splattering of the powder particles within the oral cavity and/or their accidental ingestion is another area of concern for which use of rubber dam isolation is a must. Additionally, patients, operator, and office staff must be equipped with protective eyewear to prevent the abrasive particles from accidentally entering the eyes.

·         Air abrasive systems also cannot be used in conjunction with magnification devices such as loupes or dental operating microscopes as the rebound particles could cause damage to the lenses.

·         Care must be taken when working near soft tissues due to risk of laceration, air dissection, and emboli. An inadvertent spray to soft tissues is not likely to cause damage, but a prolonged direct spray could potentially cause injury.

·         Air abrasion produces a rounded textured cavosurface margin and thus is not suitable for restorative preparations requiring definitive walls and sharp, well-defined cavosurface margins such as those needed for conventional amalgam and metal or porcelain inlays/onlays. It is also not suitable for crown preparations for either metal or porcelain coverage.