The bottom line for sustainability: totally clean and dry
Most bonding procedures include a hydrophobic phase where totally clean and dry air is required for the process to be successful.
William Strupp, DDS
Most bonding procedures include a hydrophobic phase where totally clean and dry air is required for the process to be successful. When contamination of the air source occurs during this phase, the quality of the bond can be compromised. Such compromise often leads to a host of potential failures, including, but not limited to, sensitivity, pulp death, fractured restorations, marginal staining, debonding of restorations or core buildups, and dismal color changes.
The simple solution to the problem is to use a totally clean and dry air source, where dry air is mandatory during the bonding phase. Fortunately, thanks to my late father-in-law, Peter Nardi, such a system exists.
The literature reports more than 50% of dental air lines are contaminated with water, and more than 30% are contaminated with oil. These reports concerned me about my own bonding protocol, so I investigated my air lines to see if I was an unwitting victim of the problem.
I was relieved to find that neither air nor oil was a problem in the lines in my office. However, to my dismay, I discovered that my air/water syringe was causing water contamination.
In fact, my investigation showed that 100% of my air/water syringes had a high potential to sabotage my bonding protocol. The only impediment to water squirting from the air/water syringe is a delicate “O” ring that is prone to wear rapidly and leak frequently. This issue affects every dental office because all dentists use the three-way air/water syringes as part of their basic armamentarium.
I was discussing this problem with Peter when we were out fishing one day, and he came up with a solution to achieve totally clean and dry air, regardless of air line contaminants. He explained that in the process of compressing air, water is created. In addition, with the extended use of oil-lubricated pistons and their resultant wear, there was a high probability that oil would be another air line contaminant. He said that it would be impossible to be certain that the “O” ring in the air/water syringe would work 100% of the time, even if it was brand new.
Peter suggested adding a second air/water syringe to the dental cart with both barrels hooked up only to air. He also said I should add an in-line glass bowl separation filter with a purge valve to completely eliminate the oil and water contamination so prevalent in dental air lines.
Peter designed a product he called the “Totally Clean and Dry Air System™”, and sold it through his company, Best Buy Discount Dental Supply (800-781-2226). The product consists of a preassembled DCI three-way syringe attached to a separation filter that has a glass bowl and a purge valve.
The product can be installed on a dental cart simply by inserting a “T” connector into the unit’s main air line, suspending the filter upright, and placing a holder adjacent to the existing three-way syringe to hold the new syringe.
Proper use of the system varies from office to office, depending on whether or not the air lines are contaminated. If they are contaminated with either oil or water, a dental assistant should activate the purge valve on the separation filter on a daily basis to empty the glass bowl before treatment starts for the day.
If a tissue is held under the valve when it is activated, the assistant will be able to see when the contaminants are gone. If no air line contamination is present, then it is safe for the assistant to activate the purge valve on the first workday of each workweek.
If contamination is discovered at any time while activating the valve, it should be activated more frequently to assure clean and dry air. We use green tape around the base of the syringe to differentiate the clean and dry syringe from the air/water syringe. Using the wrong syringe can result in disaster in the bonding process.
We use reusable metal syringe tips that are heat sterilized for both DCI syringes. When they are attached to the syringe, the condensed moisture in them must be blown out to achieve dry air.
I know Peter is looking down and similing on the thousands of successful bonding cases he has promoted with his system. He was a great guy.
Dr. Bill Strupp is a practicing clinician and inspirational speaker, acclaimed for his practical and predictable presentation, “Simplifying Complex Cosmetic and Restorative Dentistry.” He is an accredited fellow and founding speaker of the AACD. He is a member of the AAFP, AOD, APS, AES, AAIP, IASD, AAOSH, FACD (president and founding speaker) and other organizations. Contact him by phone at (800) 235-2515, by email at Bill@strupp.com, or visit his website at www.strupp.com.
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