Joseph J. Massad, DDS
Welcome back! This month my discussion addresses a 1980s technology that has been of concern to many in the profession in recent years for creating tooth abrasion. This has led many practitioners to avoid using the air polisher systems. I believe it is time to revisit this apparatus for renewed benefits since both the delivery systems and the cleaning agents have been improved in an attempt to decrease abrasiveness.
With the advent of increasing cases of peri-implantitis being reported, and with newer, less abrasive powders in conjunction with an improved air polisher delivery system, I believe an investigation for its indications is warranted.
It has been reported in articles that the degree of abrasiveness makes air polishing a contraindication for implants; however, there have been no studies as yet to validate this claim. I believe that if utilized with a judicious protocol, the air polisher can benefit the cleansing of overdenture implant abutments while not creating accelerated wear to the metal structure.
However, we must instruct our patients to follow a daily hygiene regimen, thus decreasing the frequency for more aggressive in-office hygiene procedures.
Recently, in an effort to improve implant patients’ home care, I published a patient in-home protocol describing the use of different brush head configurations in conjunction with a rotating, oscillating rotary brush to match the various implant abutment styles for optimal access. This protocol is available on DVD or downloadable at no fee to the dental practitioner (Fig. 1 – Oral-B Professional SmartSeries 5000). These instructions were designed for patient viewing in the dental office. Dentists, hygienists, and assistants can familiarize implant patients with a method specifically designed for them. There are numerous implant prosthetic scenarios that make daily cleaning a necessity to prevent buildup of calculus and stains on the implant interface, and to decrease the frequency of peri-mucositis which, if left untreated, can result in more serious problems.
Figure 2 shows one of the newer air polisher systems that can assist the operator to focus the stream more accurately (Bosworth Company, Skokie, Ill.). The tips are autoclavable and the handle is ergonomically designed for easy handling. The tip turns 360 degrees, thereby allowing the dental operator to point it in the appropriate direction and decrease the possibility of abrasion into dentogingival areas.
When air polishers are utilized in the appropriate fashion, they can be a wonderful adjunct for flushing out those hard-to-access areas without creating adverse wear. If abused, like anything in dentistry, problems can and do occur. Many systems today offer enhanced features that are designed to control both precision positioning and the velocity of spray, thereby reducing or eliminating the fears of the past. I encourage all dentists to follow practical approaches in all treatment for their patients.
See you next month. I hope my pleasure in dentistry will also be yours.
Dr. Joseph Massad may be reached by phone at (918) 749-5600 or by email at [email protected].
To see Dr. Massad’s video tips, visit www.DentalLibrary.com
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