Applications of the air-powder polisher in clinical orthodontics

Air polishers are relatively new devices that have provided dentistry with an alternative method for cleansing the tooth surface. Many publications atest to the efficacy of the instrument in plaque and stain removal while advising the practitioner of potential health risks to the patient. In spite of the information available, little research has been published concerning air polishing procedures in the treatment of the tooth surface before placement of the orthodontic bracket. In light of the research supporting the efficacy of plaque and stain removal, the use of the air polisher has been shown to have no detrimental influence on the bonding of the resin bracket cement to the tooth surface. It would appear that the system may be ideal for use in conjunction with orthodontic treatment. The air-powder polisher has been found to be the most effective method of plaque removal for orthodontic patients without causing breakage of elastics or wires or loss of zinc phosphate or composite materials. Another application for the air-powder polisher in the orthodontic practice is surface preparation of the tooth before bracket placement. The instrument should be held approximately 4 to 5 mm from the tooth surface, at a 60° angle for anterior smooth surfaces, at an 80° angle for posterior smooth surfaces, and at a 90° angle for occlusal surfaces. A constant circular motion should be used, with an exposure time of 30 to 60 seconds.