Does Air Particle Abrasion ACTUALLY Improve Clinical Outcomes? – PDP190

Air Particle Abrasion! Images of Sandblasted teeth look cool but does it ACTUALLY improve clinical outcomes? What are the indications? When is it genuinely critical to use? More pragmatically, are there any decent alternatives eg. roughening with a bur? Air particle abrasion, a technique used to prepare tooth surfaces for bonding, has sparked considerable debate among professionals. This episode discussed its effectiveness, implications, and best practices with  Dr. Veronica Pereira de Lima.  https://youtu.be/oTGQBTyuY-k Watch PDP190 on Youtube Protrusive Dental Pearl:  Two advantages of slicing off a corner of the rubber dam are: Anterior Dam Stabilization: By flossing the cut piece through the front teeth, it acts as a makeshift wedge, securely fastening the dam in place without the need for traditional wedjet. Simplified Orientation: This technique aids in aligning the rubber dam properly, streamlining the entire setup process for more efficient dental work. Check out ‘Quick and Slick Rubber Dam’ online course (on-demand) only available via the Ultimate Education Plan on Protrusive Guidance Need to Read it? Check out the Full Episode Transcript below! Highlights of this episode: 00:44 Protrusive Dental Pearl 04:16  Dr. Verônica Pereira de Lima Introduction 07:07 Journey of Dentistry in Brazil 08:34 Academia vs Clinical Practice 09:20 Journey about PhD and Work Surrounding Air Particle Abrasion 11:12 Importance of Air Particle Abrasion to Clinical Dentistry 15:57 Health Concerns Regarding Air Abrasion Particles 18:10 Air Abrasion Contraindication 20:13 Size of the Microns -  Clinical Guidelines 22:25 Pragmatic Approaches in Clinical Practice 24:28 Cojet as an Air Abrasion Particle 27:37 Improper Use of Air Abrasion 30:07 Air Abrasion Guidelines Regarding Different Ceramics 31:40 Alternatives to Air Abrasion 33:29 Dr. Veronica’s Personal Guidelines - Air Abrasion Protocol and Unit 40:27 Learning with Dr. Veronica  Access the CPD quiz either on your browser or by downloading our mobile app. For the full educational experience, our Ultimate Education Plan gives you access to all our courses, webinars, and exclusive monthly content. If you love this episode, be sure to watch Immediate Dentine Sealing Tutorial Part 1 – PDP173 Click below for full episode transcript: Jaz's Introduction: Air particle abrasion for the restorative dentist. How important is it? Hello, Protruserati. I'm Jaz Gulati and welcome back to the Protrusive Dental Podcast. In this episode, I'm joined by Dr. Veronica Pereira de Lima. Jaz's Introduction:She was the lead author and a systematic review in 2020 that looked into air particle abrasion and the significance for improving dentine bonding. Some of the key questions that we cover in this episode are how important actually is it? What micron of sand and which sand should we be using? Is there any benefit of CoJet? CoJet is like this sand with silica embedded into it. Does that really make a difference? And ultimately at the end of the podcast, we will answer the question. If you don't have it at the moment, are you really missing out? And the answer actually might surprise you. Dental PearlEvery PDP main episode, I give you a Protrusive Dental Pearl. Today's pearl, very fitting with air particle abrasion, because when do we use air particle abrasion? Well, we use it a lot when it comes to adhesive dentistry. And for adhesive dentistry, rubber dam isolation is often favourable. Now, I'm no rubber dam police, but I'm an avid user of rubber dam. And the tip I want to pass on to you today is, are you using things like Wedjet? You know, those stretchy silicon type strings that you use to anchor your rubber dam? And the terminal tooth for example, you're using a clamp on the molar and then all the way to an incisor, maybe you're using like a Wedjet or something to secure your rubber dam. Well, instead of using two clamps or a clamp and a Wedjet, I like to use a clamp. And my favorite clamp is a soft clamp. Why? Because it's softer. It's kinder. I don't need to give a lingual anesthesia. As you guys know, I'm a huge fan of buccal, articain infiltrations, even for lower molars. But that's a whole other episode. In fact, we've done that episode already. Do check out PDP 143 if you're interested in that. But back to rubber dam. So rubber dam, what I will do, instead of using a Wedjet, I will cut a corner of the rubber dam. Okay, now this serves two purposes. One is, once I've put the rubber dam on, I've got a clamp on one side, and I've got the little cut piece, that little triangle of dam that I cut away from the rubber dam. Well, that I can now floss through the anterior contacts, for example, if I'm doing a quadrant, and now the rubber dam is secured by a clamp on one side and by this makeshift Wedjet, using the dam basically to secure it. And it's super simple. It saves the environment so we don't have to buy an additional product to secure the rubber dam anteriorly. And sometimes the contacts are tight enough that you don't need anything. You just have to floss it through and it stays. But if you want that extra security, you floss through, you stretch and you floss through this piece, this little corner, this triangle of rubber dam. Now, the second benefit here is you try and cut the corner which represents the quadrant. So, for example, if I'm isolating the lower left quadrant, then when I punch my holes on the lower left quadrant, let's say I'm doing the second molar, first molar, pre molars, canine, and lateral incisor, for example, right? On the lower left side is where I'm going to cut my triangles. Why? Because you know when you sometimes put your clamp on, and then you put your dam on, and by the time you've got the dam through some of the contacts, and then your nurse is helping you, and you get the frame on, and then you're thinking, hmm, which corner of the dam goes on which part of the frame? Sometimes it happens, and sometimes what ends up happening is you end up confusing it, and you've kind of got this like twisty, funky rubber dam thing going on. Now, because you have the cut corner on the lower left, you know that the cut area of dam is the lower left, and you just put that on to the lower left corner of the frame. Now, you're much less likely to make this funky rubber dam mistake because it's aided you in orientation. So two benefits of cutting the corner of the rubber dam. One is that you can floss it through to secure your dam anteriorly instead of Wedjets. And two is it helps with your orientation. It just makes the process slicker. And talking of slicker, if you'd like to improve in rubber dam, check out the quick and slick rubber dam webinar that I did. It's available on Protrusive Guidance platform. That's www.protrusive.app. And then there's 30 plus clinical videos. These range from like two minutes all the way to 15 minutes of tricky cases, loads of different quadrants, anterior, upper left, upper right. All the mouth, basically the entire mouth uncut videos of rubber dam, which so many of you messaged to say it's really elevated your rubber dam game. So those who are interested, check out quick and slick rubber dam available on Protrusive Guidance. Now let's join the main episode and I'll catch you in the outro. Main Episode:Dr. Veronica Pereira de Lima, welcome to the Protrusive Dental Podcast. How are you? [Veronica]Hi, Jaz. Thanks for having me. Yeah, I'm doing great. [Jaz]You are in the Netherlands, but you are from Brazil. And I want to unpack a little bit about that. Actually, I want to unpack your story. I always like to learn our guest story and like why you went into academia, how much clinical you do, what is your future research interests? I have so many questions in my mind already before you can just unpack the air particle abrasion. But I just want to point out that you're the first of a guest that I sought out on LinkedIn. I read your paper. I read some study that you were involved in with to do with air particle abrasion. I found that you're doing a PhD and I thought, okay, I must reach out to you to have this geeky discussion that we're going to have today. So thank you for accepting my spam message on LinkedIn that led to a chain of events to book out time in your super busy diary to record today for the benefit of dentists. So Veronica, tell us about your journey from South America to Europe. [Veronica]Yeah, it's a quite a journey. So yeah, I'm actually from a city called Manaus, which is a capital of Amazonas, which is way in the north of Brazil. Think of Amazon. So there is where I did my bachelor and master studies and where also started developing my interest for research, of course. With some limitations, like resources and stuff. And that's why there was also no PhD in dentistry in my city back then. And then I decided, okay, I would like to go for a PhD and then I had to move out of Manaus and went way, all the way to the South of Brazil to a city called Pelotas. And then that's where I started my PhD. It was not specifically in restorative dentistry, but it was a bit more like in dental materials, more broad area. And during this time, of course, I was really mainly focused on research, not so much in the clinical practice, because of my PhD there, because of the partnership that was between the universities of Pelotas and in Nijmegen in the Netherlands. I came up here this for a period of a year, stayed 14 months and then decided later after I finished my PhD to stay here. And now it's- [Jaz]Amazing. [Veronica]Yeah. Yeah. Quite a journey when you think about it. And then, after I finished my PhD two years ago, here in the Netherlands, I decided to, okay, I want to go back to the practice. So then I had to learn Dutch.