Air-Abrasive Technology for Caries Diagnosis and Fissure Sealing. A Clinical Study

Aim: The aim of this study was to evaluate the suitability of air-abrasive technology for fissure caries diagnosis and conditioning the occlusal tooth surface before sealing. Methods: Eighteen patients (age range 6-15 years) with 66 permanent molars with darkened fissures were examined for caries by visual inspection (VI), laser fluorescence (LF), and air abrasion (AA). AA was used as a reference. If there were no clinical signs of dentinal lesions after AA, occlusal surfaces were sealed. VI and LF were assessed for sensitivity and specificity. The patients were asked about the level of acceptability of AA. Six months later, sealed teeth were re-examined applying modified United States Public Health System (USPHS) criteria for retention of the sealer. Results: VI showed a sensitivity of 60% and LF of 90% in relation to the reference. The specificity of VI was 98%, whereas LF had a specificity of 75%. Of the 66 teeth examined, 56 did not show any dentinal caries and could be sealed; the remaining 10 were filled. Sixty-three (95%) of the patients rated AA as good or very good. After six months, the maintenance of the sealer could be assured in 44 teeth (83%). Conclusions: It can be concluded that current caries detection methods can be complemented by AA, which is also useful for conditioning the occlusal surfaces before sealing in paediatric dentistry. AA roughens the occlusal surface and optimises retention of the sealer. However, a small risk remains because of overcutting of sound tissue or arresting initial lesions.