A clinical evaluation of air-abrasion treatment of questionable carious lesions. A 12-month report.

BACKGROUND: The efficacy of treating questionable incipient lesions early with air abrasion, a modality used by many practitioners, has not been adequately demonstrated. METHODS: The authors enrolled 223 teeth, each with a questionable incipient pit-and-fissure carious lesion, from 93 dental patients in a projected five-year randomized clinical trial. Caries was defined as softness, decalcification or cavitation at the base of a pit or fissure or radiographic evidence of caries. Each tooth was randomly assigned to either a treatment group (n = 113 teeth) or a control group (n = 110 teeth) (which was observed but left untreated until the definition of caries was met). Each tooth in the treatment group was air-abraded and restored with a flowable resin-based composite. The authors re-examined teeth in both groups every six months; they evaluated the restorations using a modified set of Ryge criteria and inspected teeth for caries using radiographs, mirrors and standardized explorers. RESULTS: Of the 113 teeth with questionable incipient carious lesions air-abraded in the treatment group, 50 had caries extending into dentin. After 12 months of clinical service, there were three sealants that exhibited a partial loss of sealant which did not require any re-treatment. Two restorations with penetrating staining were re-treated. In the control group at the end of 12 months, only nine of the 86 recalled teeth were diagnosed with pit-and-fissure caries and were treated with air abrasion and restored with flowable resin-based composite. There was no statistically significant difference between the volume of the treatment and control preparations. CONCLUSION: After 12 months of clinical service, two preventive resin-based composite restorations in the treatment group required re-treatment. Fewer teeth than expected in the control group were diagnosed as having caries and were treated. CLINICAL IMPLICATIONS: The merit of treating questionable incipient pit-and-fissure carious lesions early with air abrasion has not been demonstrated after 12 months in this clinical study.

The effect of air abrasive polishing on blood pH and electrolyte concentrations in healthy mongrel dogs.

The recent re-emergence of air abrasive polishing as an adjunct to professional tooth cleaning has been accompanied by a substantial amount of research. Most of this research has focused on the efficacy of the Prophy-Jet and similar devices in the removal of plaque and stain and on the effects of such devices on restorative materials and the various hard structures of the tooth. Little attention has been paid to the effects of mucosal absorption of the sodium bicarbonate in the polishing abrasive. The purpose of this study was to measure any changes in arterial blood chemistry resulting from the use of the Prophy-Jet. The values for pH, sodium, and bicarbonate, as well as other electrolytes, were measured in 10 dogs over a 2 hour period following a 5 minute timed use of the Prophy-Jet. Of all the parameters examined, only the potassium concentration showed a statistically significant change, and the magnitude of this change was not felt to be clinically significant. The pH and concentrations of sodium and bicarbonate remained essentially unchanged with the use of the Prophy-Jet.