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LOW AEROSOL RESTORATIONS

Minimally Invasive Restorations With Reduced Aerosol Generation – A Step By Step

Optimizing your cavity preparation and choice of restorative materials can help you reducing the aerosol generation in your practice.
With GC’s convenient glass ionomer and glass hybrid restorative systems, you can provide patients with immediate, interim and/or definitive clinical solutions – all with a minimal amount of aerosol generation.

  • No need for water-cooled, high-speed drills: by using hand instruments or low-speed rotary instruments, aerosols/air-borne particles can be minimized.
  • Quick: no bonding or etching required; cavity can be cleaned using just cavity conditioner during 10s.
  • Wet and dry cotton pellets can be used to rinse and dry without an air/water syringe.
  • It can be finished with the press finger technique and hand instruments, without rotary devices.

For this technique, some requirements have to be met:

  • The teeth should be vital and pain free or merely showing signs of reversible pulpits.
  • ART should not be applied in case of irreversible pulpits or pulp necrosis.

CAVITY PREPARATION

1. Remove enamel to obtain proper access to the cavity:

  • Enlarge the opening with an enamel access cutter by twisting it slowly.
  • Remove all thin, demineralised enamel overhang with the enamel hatchet, following the prisma orientation.

2. Remove carious dentine at the dentino-enamel junction until you reach hard dentine in order to create a clean margin of 2 mm wide. 

  • This is needed to ensure a long lasting seal, which is essential for the success of this treatment.

3. Remove carious dentine at the pulpal and axial wall until you obtain firm/leathery dentine:

  • Remove soft (caries-infected) dentine: deforms when a dental explorer, can be easily scooped up.
  • Leave firmer, leathery (carries-affected) dentine: does not flake away easily with hand instruments but it can only be removed with more pressure.
  • In deep cavities, soft carious tissue can be left over the pulp to avoid pulp exposure and maintain pulp vitality.

4. Clean the floor of the cavity: 

  • Apply CAVITY CONDITIONER using a cotton pellet for 10 seconds to remove the smear layer. 
  • Avoid rinsing: use a several moist cotton pellets instead. 
  • Avoid drying with air syringe: use dry cotton pellets & air suction. 
  • Prepared cavity should appear moist to allow chemical adhesion .

5. In Class II, the use of a sectional matrix is recommended to create a proper contact point and to increase the durability of the restoration. 

6. Activate the capsule by firmly pressing in the plunger & mix the capsule for 10 seconds.

7. Injection of the glass ionomer or glass hybrid restorative material of choice.

  • Start from the bottom of the cavity & keep contact between the extruded material and the nozzle to avoid incorporation of air bubbles.
  • Apply the remaining material over the occlusal pit and tissues.

8. Contour the restoration within the working time. Press the material using the “press finger technique”.

  • Apply a very thin layer of separation medium on your glove such as Cocoa Butter. 
  • In case the restoration will be coated afterwards, the use of a neutral plastic foil is preferred over Cocoa Butter. 

9. Contour the restoration and remove excess with hand instruments.

10. After the setting time, check the occlusion.

  • Premature contact points can be removed with a manual scaler, obsolescing the use of rotary instruments.
  • Apply a protective coating (e.g EQUIA Forte Coat).

11. Light-cure the protective coating.

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