Airflow
How does air polishing work?
kinetic energy propels the air polishing powder particles against the tooth surfaces- removing biofilm and stain
What is iatrogenic facial emphysema?
rare condition that results from accidental collection of air in the soft tissues of the face from pressurized air in dental procedures
What will arrest or slow down the progression of periodontal disease?
removal of biofilm
Air polishing: new approach
therapeutic/preventative -biofilm removal -supra AND subgingival use -perio and implant maintenance
How is airflow delivered to the tooth surface?
through metal nozzle or plastic tip
True or false: clinical require special training in the proper use of a subgingival air polishing device
true
True or false: clinical research supports airflows safety and efficacy for use in nonsurgical perio therapy
true
When is a site-specific plastic perio tip used?
when the pockets are greater than 4 mm
What is the probability of emphysema resulting from subgingival glycine powder polishing?
1 in 666, 666
Air polish uses a combo of what two things?
-abrasive powder with water -compressed air
Perio nozzle technique
-always check nozzle condition before use -never push nozzle into pocket -vertical movement from pocket base coronally -5 seconds per site -change nozzle after 20 sites -check frequently that nozzle is not bent
Primary indications of air polishing
-biofilm removal (sub/supra) -implant maintenance -stain removal -biofilm removal around orthodontic brackets -may remove soft (early stage) calculus deposits *DOES NOT REMOVE HARDENED CALCULUS*
Describe sub gingival air polishing
-excellent for implant maintenance -angles into the sulcus -uses low abrasive glycine powder -effectively reduces pathogenic bacteria -comfortable and fast
Symptoms of iatrogenic facial emphysema
-facial swelling -crackling feeling of the face and neck area -tenderness and pain
Mechanical instrumentation may disturb what? Hard tissue loss can create what?
-may disturb the epithelial attachment -create dentin sensitivity to hot and cold
subgingival technique for airflow
-pockets up to 4 mm -angled into sulcus -2 to 3 mm from tooth -follow gingival margin throughout the mouth
Indications for airflow use
-removal of plaque biofilm and stain -use on enamel, cementum, and dentin -use within sulcus or periodontal pocket -use on restorative materials -cleaning of fissures prior to sealant placement -cleaning of titanium implant surfaces -stain removal -soft calculus removal
Contraindications for glycine or erythritol powders include?
-respiratory problems -patients undergoing treatments (chemo, radiation) -pts with communicable Infection -history of allergic reaction to powder *no sodium concern and is safe on all types of restorative materials including implants*
Dental procedures associated with cases of emphysema are?
-use of high-speed dental handpieces -air/water syringes -taking impressions -air polishing
Explain deep site specific subgigival air polishing
-used only with glycine powder -used with perio handpick and nozzle -single patient, disposable -nozzle design and shape ensures low dynamic air pressure
In Canada, health Canada approved plastic perio tip for use in perio pockets up to __ mm
10 mm
Research evidence shows periodontal maintenance should be performed every ___ months or less to remove periodontal pathogens
3 months
At what angle should the powder be hitting the tooth?
30-60 degrees so it can hit the tooth then hit gingiva (tissue should flare)
A standard metal nozzle delivers a glycine-based or erythritol powder in pockets up to __ mm.
4 mm
In the US, the FDA approved plastic perio tip for use in perio pockets up to __ mm
5 mm
Studies indicate that following periodontal instrumentation subgingival pathogens return to pre-instrumentation levels in about how long?
9-11 weeks
Air pressure and water pressure for Handy 3.0 and handy 3.0 perio
air pressure: 39-51 psi water pressure: 14-32 psi
Air pressure and water pressure for Air-flow master piezo
air pressure: 80-109 psi water pressure: 15-72 psi
Airflow perio vs airflow plus
airflow perio: sub airflow plus: supra
Those that get emphysema should seek medical help immediately, what do emergency healthcare providers usually misdiagnose this as?
allergic reaction
Air polishing: traditional approach
esthetic -stain removal -supragingival use
True or false: Air polishing to remove plaque biofilm from root surfaces is old technology
false, new technology
True or false: most subgingival biofilm within pockets is easy to reach using brushes, floss, or antibacterial rinses.
false, usually cannot be reached
What is the primary cause of gingivitis and periodontitis?
formation of plaque biofilm on tooth surfaces
What is an essential component of successful periodontal nonsurgical therapy?
frequent mechanical removal of plaque biofilm
Professional biofilm removal must be performed how often?
frequently at regular intervals
What are two traditional techniques for biofilm removal?
hand or ultrasonic instrumentation has been used -technically demanding and time consuming -uncomfortable for the patients
Handy 3.0 vs Handy 3.0 perio
handy 3.0: supra gingival use and subgingival use <4 mm Handy 3.0 perio: subgingival use up to pockets 5 mm
When is there a rip of soft tissue emphysema?
if a tooth site has 3 mm or less of supporting alveolar bone *plastic subgingival tip is not recommended for use on tooth with 3 mm or less of alveolar bone support*