Air abrasion: an old technology reborn

Recently, air abrasion has experienced a rebirth in restorative dentistry. Originally developed in the late 1940s, the principle of air abrasion is the imparting of kinetic energy to tiny aluminum oxide particles that are projected by a stream of compressed air or gas and expelled from a small nozzle. The force generated by the relatively hard particles striking a relatively hard surface is sufficient to cut into that surface. In the last decade, more than a dozen models of air abrasion units have been introduced into the marketplace and more are on the way. Manufacturers have developed air abrasion instruments that offer a broad range of features, from small table-top units to self-contained systems with compressors, vacuums, and curing lights. The costs range dramatically--from $1,000 to $20,000 or more--depending on the complexity of the features and attachments. Manufacturers make a variety of claims to support the value of this technology to the practicing dentist. A term often used to describe one of the benefits of air abrasion is microdentistry. The claim is that smaller, less invasive tooth preparations may be accomplished using air abrasion than with a traditional bur and air turbine. This may be true in some instances, but it would certainly depend on the operator's experience and ability to visually discern fine detail. Other claims about air abrasion are that it can be used to cut into tooth structure without local anesthesia and that it should be used on all stained grooves or fissures to determine if incipient carious lesions are present. Despite the limited number of clinical studies, the popularity of air abrasion continues to grow. To gain additional insight about these claims and to see what might be on the horizon for this technology, I spoke with three highly respected educators who are recognized for their expertise in air abrasion. What they said should give the reader a better understanding of how air abrasion might augment restorative dentistry procedures and techniques.