Mectron COMBI touch combines a multifunctional piezoelectric scaler and a jet polisher in a single device designed for complete dental prophylaxis. To achieve excellent results, this article discusses the operating procedure of this device and how air-polishing can be reliable, effective and efficient in the mechanical removal of bacterial biofilm.
By Prof Gianna Maria Nardi
Air-polishing can be used on healthy patients as an alternative to the use of curettes, scalers or abrasive paste to remove stains caused by tea, coffee, red wine, tobacco or other staining substances.
Since the diseases of the oral cavity with the greatest epidemiological significance (caries, gingivitis and periodontitis) are induced by bacterial biofilms, mechanical control of bacterial biofilms is fundamentally important in the prevention and management of these diseases.
Air-polishing has been found to be effective in removing biofilms from above and below the gums and acquired dyschromia (Europerio 2012, Vienna).
The air-polishing systems
The air-polishing systems use compressed air, water and various types of powder with different particle sizes, specifically designed for different treatments, to emit a well-controlled jet, which sprays particles at the surfaces of the teeth (Barnes et al., 2004).
The abrasive flow therefore consists of water, compressed air and specific powders with a controlled particle size (Black R. Technique for non-mechanical preparation of cavities and prophylaxis. J Am Dent Assoc 1945; 32:955-965).
Currently available on the market, there are numerous devices with an air/water jet for preparing cavities, polishing tooth surfaces and eliminating extrinsic stains in patients that have trouble maintaining adequate oral hygiene (Kozlovsky et al. 1989; Horning et al. 1987).
In addition, the shape and design of the spray nozzle are important characteristics that may influence the abrasive properties of the powders used.
In fact, minor changes in the size of the nozzle, such as the diameter of the opening or the length of the tube or its curvature may cause significant changes to the efficacy of the instrument (Momber A, 2008).
This factor underlines the importance and responsibility of having an in-depth knowledge of the instrumental technique used on any type of tooth or root surface.
To determine how to treat each specific case, the operator may be faced with the challenge of excess deposits which require removal.
In such cases, the more difficult treatment areas will certainly require a more thorough and lengthy treatment. It is therefore important to avoid directing the jet directly at the edge of the gums, on the necks of exposed teeth and the mucosa.
Mectron COMBI touch
Mectron COMBI touch combines, in a single device, a multifunctional piezoelectric scaler and a jet polisher, designed for a complete dental prophylaxis, above and below the gums. The polisher supports the use of two types of powder according to the type of treatment to be performed: sodium bicarbonate powder for supragingival prophylaxis, and glycine-based powder for subgingival treatment.
The operating principle of the polisher is based on the mechanical action obtained from a jet of crystals in various kinds accelerated by a compressed airflow. The kinetic energy applied to the particles is dissipated almost completely when they strike the enamel surface, producing a gentle but effective cleaning action.
The action is completed by a water jet, which, using the pressure drop created around the nozzle, is arranged in the form of a bell around the main flow. Thus, it produces a dual effect: it largely prevents the cloud of powder from bouncing and being expelled; and continually washes the treated area by dissolving the powder.
The COMBI touch device operates at a working water pressure of one to six bars and an input air pressure of between four to eight bars (“Prophy” function = 3.5 bars; “Perio” function = 2.7 bars). The direct jet should not be directed at the gums while the peripheral jet can be used close to the gingival margin.
COMBI touch air-polishing produces excellent hygienic and cosmetic results: it removes even the most stubborn extrinsic stains quickly, gently and under conditions of absolute safety.
The enamel surfaces of the teeth remain intact and shiny. When used below the gums, it removes bacterial biofilms from the periodontal and peri-implant pockets. The abrasive nature of the jet of powder is directly proportional to the selected level of irrigation. In this way, by increasing the level of irrigation at the end of the treatment, the teeth above the gums can also be cleaned.
Mectron recommends exclusive use of their prophylaxis powder and glycine powder. The manufacturer declines all liability and the guarantee becomes null and void if non-original Mectron powders are used, in that they could irreparably damage the spray nozzles and/or handpiece of the polisher, thus jeopardising the operation and creating a risk of injury to the patient.
With the supra- and subgingival technique, the spray nozzle of the instrument must be kept constantly rotating at a distance of 4-5mm from the tooth surface for about five seconds per tooth.
For maintenance treatment, the instrument should be held at an angle of incidence of between 30° and 60° between the powder jet and the axis of the tooth; the correct angle of the handpiece is essential to avoid damaging the soft tissues and to reduce the quantity of aerosol emitted (Barnes, 1991; Worrall et al, 1987).
The Mectron COMBI touch offers three spray nozzles at different angles to allow the operator to customise the operating procedures according to every clinical need.
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