MAINE DENTAL HYGIENISTS ASSOCIATION Senator Hotel and Spa April 8 2016 Augusta Maine Understand the role biofilm plays in dental disease Connect the role of air polishing to successful biofilm ID: 512612
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Slide1
BYE,BYE BIOFILM!
MAINE DENTAL HYGIENISTS’ ASSOCIATION
Senator Hotel and Spa April 8, 2016
Augusta, MaineSlide2
Understand the role biofilm plays in dental disease
Connect the role of air polishing to successful biofilm
managementDifferentiate between supragingival and subgingival biofilm removal technology
Review of power scaler instrumentation for hard deposit removalWater and plume control via high speed evacuation techniquesDiscover the “return on investment” potential for your practice
ObjectivesSlide3
CURRENT: ANTI-INFECTIVE AND BOOST HOST IMMUNITY
Periodontal debridement/biofilm removal
Goal: tissue response
, removal of all irritants
Hand instruments, micro-ultrasonics, chemicals/ medicaments, AirFlowTherapySlide4
6mm pocket for bacteria put in human terms Slide5
A FULL MOUTH PERIODONTAL INFECTION…..
Compares in size to an open wound covering the entire palm of your hand………
Jill
Rethman
RDH BA ACCESS 3-2016Slide6
AIR POLISHING – AN EVOLVING THERAPY
Traditional Approach - Esthetic
Stain removal
Supragingival useNew Approach – Therapeutic
Biofilm removal Supra and Subgingival use Perio and Implant MaintenanceSlide7
Effective
– Efficient – Safe
Product
Effective
EfficientSafe
Prophy Paste Coarse
Medium Prophy Paste
Fine
Prophy Paste
Sodium Bicarbonate
Air
polishGlycineAir polish
Unless followed by med, then fine
Unless followed by fine
Enamel only
f
ollowed by glycineSlide8
BIOFILM
Clinical studies show Air Flow Therapy is as effective as ultrasonic instrumentation in pocket resolution
Air Flow Therapy takes less time to be effective
More effective than hand instrumentationSlide9
After 1 minute 15 seconds
After 35 secondsSlide10
Grain size relates to comfort
NaHCO3 ~65 µm
Jagged particles
CaCO3 ~45 µmRounded particlesGlycine ~25 µm
Powder Selection
Kosher Salt
CornstarchSlide11
#21-795 Autoclavable
Widemouth Adaptors
$12/25
Vented HVE tips
#21-75
~~~~~~~~~~~~~~
3” vented HVE tips
Young Vento-VacSlide12
Mohs Hardness
Powder
Mohs Hardness
Particle Size
Glycine
< 2
~ 20-25
µm
Sodium
Bicarbonate
2.5
~ 40-120
µm
Calcium Bicarbonate (Pearls)
3
~ 55
µm
Aluminum
Trihydroxide (Jet Fresh)
3.5 – 4
~ 80-325
µm
Calcium
Sodium Phosphosilicate (Sylc)
4.8 – 6
~ 50
µm
Pumice
6 – 7
~ 81-120
µm
Structure
Mohs Hardness
Enamel
4 – 5
Dentin
3 – 4
Cementum
2 – 4 Slide13
Subgingival glycine-based air polishing is safe for the oral
environmentEqual subgingival biofilm removal to
ultrasonics
Considerably faster subgingival biofilm removal than curettes & ultrasonicsCan be more comfortable than hand & ultrasonic instrumentation
Summary of Clinical Evidence Slide14
Application
based on Power Dispersion
#3 Front and Back SurfacesSlide15
Tip Geometry
PL3
A
PS
1000
100Slide16
SCALING IMPLANTS
Damage from scratching studies done in vitro not in vivo-inconclusive
“No existing evidence that scratched abutments lead to increased inflammation or aggravate peri-implantitis. Removing as much biofilm and calculus as possible to decrease perio bone loss is more important than scratching a surface.”
Dr. Timothy Hempton Former Director of Post-Grad Periodontology at Tufts University 2016Slide17
3 CATEGORIES OF MAINTENANCE
Class I-no access to titanium abutment
Class II-exposure of titanium abutment
Class III-exposure of the implant itselfSlide18
Would you love to have 10-12 extra minutes per patient?Slide19
Traditional
Hygiene Appointment for
Biofilm Management (Prophylaxis/PM)
Screening/Data
CollectionCommunication/Treatment Enrollment
Biofilm/Calculus Removal with Hand and
Ultrasonic
Instruments
33 min.Rubber Cup Polishing 5 min.
ExaminationHand Off & Disinfect Room
60 min.
38 minSlide20
Biofilm Management With Glycine Powder Air Polishing (Prophylaxis / PM)
Screening/Data
Collection
Communication/Treatment
Enrollment
Coronal
and Subgingival Biofilm Removal w/ Air Polishing Using a Low Abrasive Powder
10 min.
Calculus/Stain
Removal with Hand and Ultrasonic Instruments 16 min.Examination
Hand Off & Disinfect Room60 min.
-12 minSlide21
Typical Hygiene Supply BudgetSlide22
QUESTIONS
?
njmillerdh@aol.com
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