Air abrasion is a technique used for the removal of enamel and dentin during tooth restoration. It can be used to remove external tooth stains and tooth decay without compromising healthy tissues of the tooth. Air abrasion is best suited for the restoration of small lesions. The benefit of air abrasion is that it does not require injection. It is also kinder to the pulp of the tooth because the generated heat is significantly less than a rotary drill. Air abrasion can be used on enamel and dentine.

Sealant material is used to cover non-carious pits and fissures of the tooth.

Dental abrasion is tooth preparation without bur or rotary drill. With air abrasion, an air compressor generates a stream of the tiny particle made out of aluminium oxide or silica. It is like sandblaster but in miniature scale. Unlike a dental drill, with microabrasion, a nozzle is used to gently wear away decayed tissues of the tooth. The nozzle strikes this stream for selective removal of the tooth tissues. The air pressure and the cross-sectional area of the nozzle determine the speed of the abrasive particles.

Dr Robert Black started studying the application of air abrasion for dental treatments in the 1940s. The first air abrasion unit was named AirDent. AirDent was introduced to the commercial market in 1951. Air abrasion predates air-turbine rotary handpieces but it has recently gained attention. This technique has been around for more than 70 years but its wide application in dentistry began a decade ago.

• Preparing a tooth for dental sealants
• Removal of old cement remnants from crowns or inlays
• Intraoral repair of porcelain restorations
• Failed bonded metal bracket reuse
• Remove old composite resin fillings
• Increasing the effectivity of acid etching (for composite resin restorations)
• Dental bonding and increase of bond strength
• Decrease of microleakage

This technique is a well-suited technique for preparing the root surface. It is also  well-suited for bonding restorations in view to restore abrasion or abfraction lesions without cutting the tooth tissue for mechanical retention of the restorative material.

• Air abrasion can be used for the following dental treatments:
  • Sealants
  • Quick removal of external localised tooth surface stains
  • Class I through Class VI preparations
  • Dental crown margins
  • Tooth prep for cementation of a dental crown or dental veneers
  • Cleaning of excess cement from the tooth surface prior to  recementing a crown or veneer that has come off. 
  • Better re-bonding of dental crown or bridge

Lidocaine patches can be used to control the discomfort caused by the rubber dam clamp.

The interest to use air abrasion for selective dental treatments has increased recently because modern air abrasion units can:

• conserve the tooth structure (compared to rotary drills)
• be used to bond adhesive restorations to the enamel or dentin
• Consume less powder compared to the old air abrasion units

These days flowable composite resins are available in the market which can be used to restore much smaller preparations

The nozzle of the air abrasion unit is used with a light intermittent pressure to remove the tooth tissues. When using the nozzle the typical range of operating distances from the nozzle to the tooth surface can range from approx. 0.5mm to 2 mm. Longer distances don’t have much cutting power.

 Air abrasion is not an alternative for all procedures. According to Dentists in Brisbane Pure Dentistry, the sight of a needle can cause dental anxiety in patients. Air abrasion can be an alternative solution for children who are fearful of the needle or injection because it reduces the need for local anaesthesia and injection, Brisbane Kids Dentist says. The air nozzle can be aimed directly at the stain or decay and it has minimal impact on the health of the enamel. It keeps the surface dry and ready for adhesive restoration placement. According to Pure Dentistry dental anxiety in children can be managed by using techniques suitable for children.

When caries have not progressed into the dentin and are limited to the enamel then a flowable resin-based composite or a sealant can be used with a heavily filled resin in deep or wide areas of the tooth which are exposed to chewing forces.

• Patient selection
• Verbal preparation of the patient
• Operating in low pressure and use of the correct angle for the nozzle

Majority of the patients prefer air abrasion to injection and drill technique because of the reduced need for injection and no vibration. But this technique has its limitations and patient selection is necessary for a successful desirable outcome.

Amalgam removal because it results in more mercury vapour than with bur and drill.

Air abrasion is a technology that adds a new dimension to conservative dentistry. It is described as a minimally invasive caries removal for tooth restoration.

Preventive resin restoration can be used when caries has progressed and have penetrated the dentin.

This unit is a new generation cutting tool made by Velopex International. In this unit, fluid is added to the original concept of air abrasion. Some call it aquabrasion. It can cut, clean, polish and dry the tooth. It can be used for cosmetic dentistry and minimally invasive dentistry. There is no direct contact with the tooth structure eliminating the risk of stress fractures or accidental chipping. There is no annoying vibration, no burning smell and no turbine noise and a greatly reduced requirement for the injection of local anaesthesia which means less dental anxiety for the patients. The unit can increase the bond strength because it can texture the surface of the cavity for a stronger bond. It is fast and efficient for removing external tooth stains. It can access difficult crevices or pits on the tooth. It can treat sensitivity. No bulky attachments and the handpiece is autoclavable.

This is another term that has the same meaning as air abrasion. Air abrasion has been shown to increase the retentiveness of the treated tooth surface for bonding of the adhesive restorations.

Microabrasion is another name for air abrasion. A method for the removal of tooth structure. It is an effective alternative for rotary drill and bur system. It works on the same principle as sandblasting. With enamel microabrasion, a microscopic layer of the enamel is eroded and abraded at the same time

• Eye protection goggles to avoid irritation to the eyes
• Rubber dam protects surrounding tissues from abrasion material
• High-speed suction to prevent the entry of particles into the lungs

Firstly, with air abrasion using aluminium oxide particles, the particles scatter onto the patient face and other working areas, the floor and dentist outfit and gloves. The particles absorb moisture and grow in size. They can contaminate the cement. They are a nuisance to the dentist and they create a mess. But this is a dusty past. Modern air abrasion systems have water to control the dust.

The next generation of air abrasion units like PrepStart H2O Hydro Abrasion unit or RONDOflex plus 360 can capture the dust generated by the air abrasion stream. Modern air abrasion units use the combination of the air abrasion stream and a covering cone of warm mist which can be pleasing to the patient. H2O can be added to an existing PrepStart unit. Water used by the unit is stored in a tray inside the unit. It does not require a dedicated water connection.

 There are advantages with using the combination of air and water in a spray. It is recommended to use the water because it acts as a cooler and it also keeps the tooth in a hydrated state. 

 Secondly, air abrasion is not able to provide a finely-cut preparation wall and margin details. For such applications, rotary cutting provides a much better outcome.

• Air abrasion generates no heat, no annoying noise or vibration
• Reduces the need for anaesthesia injection
• Reduces dental anxiety in the patient by avoiding the sight of the needle
• It is kinder to the tooth structure and preserves more of the tooth compared to bur and drill
• Reduces the risk of cracks in the tooth
• Allows treatment of multiple teeth in the mouth
• It is usually simple and quick but particles may scatter on the working area, patient face, etc
• The particles can cause pollution and be annoying

Air abrasion should not be used close to the pulp of the tooth or for large cavities.

Air abrasion should not be used with silver fillings (amalgam fillings) because amalgam still requires bur and drill.

• No heat or vibration is created on the cutting surfaces when using air abrasion
• Abrasive particles compact the dentin and close tubules
• There is no annoying whine or vibration of the air turbine rotary hand pieces

It is used in dental labs, orthodontic labs, or general practices for preparing surfaces and making adjustments to dental appliances and materials. It is used for precision blasting. They are easy to maintain and have a low cost of ownership.

These units are self-contained and don’t make a mess like the previous generation of sandblaster machines. They are stationary machines and are designed for a benchtop installation.  They are not used as a portable unit that can be moved from room to room. It can be used easily and does not require a lot of training for staff.

Microetcher is a lighter version of an air abrasion system. In general, they can be used for sandblasting inside the mouth or dentine bonding.

This intraoral autoclavable sandblaster supplied by Amalgadent is used for precise surface micro-roughening and can improve the bond strength by 400% by creating an etch-like frosty look with increased surface area and improved mechanical bonding.

It can be used for:

• Quick abrasion of surfaces
• Removal of stains from deep occlusal grooves
• Old resin
• Old cement and debris
• Improving intraoral porcelain repair
• Preparation of pit and fissure sealants
• Removal of dark grooves to reveal decay
• Roughening the surface for bonding of brackets and bands
• Cleaning excess material for re-bonding
• Increasing the mechanical retention of the bond by roughening the surface of crowns, bridges and posts

Remnants of an old failed dental crown cementation can be removed, conservatively cleaned and etched using this sandblaster instead of an ultrasonic cleaner. Excess enamel can be removed conservatively using this machine instead of using a diamond bur.

This handpiece is almost maintenance-free even when used daily. It has a replaceable cartridge, and a fine slim rotatable nozzle design for an intraoral application. It can be installed in the dental chair delivery system using a quick-disconnect kit or a high-speed handpiece adapter.

It has stainless steel construction and therefore it is autoclavable. The plastic jar that contains the powder is not autoclavable and must be removed before putting the unit in the autoclave machine for sterilisation. The tip should be autoclaved separately.

This sandblaster is portable and can be moved from room to room.