Spray mist ejection
In modern dentistry water sprayed from nozzles, e.g. in handpieces, is used for a wide range of applications, in particular for cooling, rinsing and cleaning as well as an enveloping, binding medium such as for ultrasonic cavitation, polishes or abrasives.
Spray mist ejector
When compressed air is added and the water collides with rapidly rotating instruments, so-called "spray mist", i.e. (mostly contaminated) aerosols are created. They consist of finely distributed water droplets ("mist") which surround the patient's mouth up to a radius of 1.5 m during, and for some time following, the treatment. Spray mist also contains a large number of further constituents such as solid particles from the various materials employed in and reduced from the mouth and tooth structure as well as liquids such as saliva or blood containing all types of pathogen (bacteria, viruses, fungi). Although no longer visible, when atomised to form a "cloud", the minute single droplets are especially apt at contaminating surfaces of objects in the surgery, the skin of persons in the vicinity or for being inhaled ("aspirated"), swallowed or absorbed via membranes, e.g. the eyes.
Where spray mist is concerned, the most important objective of dental hygiene, i.e. avoiding contamination and preventing cross-contamination, is achieved by providing surgery staff with passive protection via a mouth/nose mask and protective glasses. The stream of air/water is guided accurately and extracted which ensures that all constituents are removed as completely as possible from the mouth immediately after being released, which shrinks the "spray mist cloud" considerably but without compromising the desired effects.
Within a few years of high speed, water-cooled dental handpieces being invented in the mid-20th century, suitable suction devices such as a mobile suction pump (1955) and a suction unit specifically designed for extracting spray mist when treating reclined patients (1961/1964) were developed.
Spray mist ejector viewed from above
Modern spray mist extractors include integral or external modules for separating air, water and solids (such as amalgam particles). The flow rate ranges from several hundred to one thousand l/min. Innovative technology (for example, the radial motor or electronic controller) greatly reduces the required space, energy consumption and noise level. Whereas previously "suction machines" were installed in the basement, nowadays they can be used in close proximity to the treatment zone.
The suction effect generated in dental units is applied via flexible suction hoses (some can be adjusted or closed off with slider valves) with adapters for fitting rigid, standard diameter (mostly 16 mm for spray mist) saliva ejectors which are normally for multiple-use and autoclavable. The ejectors (available in different sizes for children and adults) include gripping surfaces and their ends are usually formed like a flat pelotte for holding back soft structures. To prevent suck-back of liquids if the ejector becomes totally blocked it may include permanently open side air-inlets. Suction hoses for surgical purposes (often with sterile, disposable cannula) or saliva ejection (often with non-sterile disposable cannula) usually have smaller diameters.
Regular rinsing, cleaning and disinfection of the entire suction system using purpose-made, non-corrosive solutions is an important measure for avoiding blockage, damage and formation of contaminated biofilms (germ colonisation).
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Wax build-up technique Wax build-up technique The various anatomical structures (such as cusp tips and slopes as well as marginal ridges) are usually built up one after another by adding small portions of wax (often using differently coloured waxes for didactic purposes). The firm, special waxes first have to be melted at room temperature. This can be carried out by warming small portions on differently shaped working tips of hand instruments in an open flame (such as a gas burner) or using electrically heated instruments which provide for more accurate temperature control and avoid contamination (e.g. electric wax-knife, induction heaters, wax dipping units). The wax is applied drop-by-drop to ensure that the warmer molten wax added last fuses seamlessly with the firm, cooler material. After hardening, the wax pattern can be reduced by sculpting, milling guidance surfaces or drilling to add retainers. Modern procedures include flexible, occlusal preforms for adding contours to soft wax. In addition, wax preforms, such as for occlusal surfaces or bridge pontics, are available in various shapes and sizes. Recently, irreversible, light-curing materials have been introduced for use instead of reversible thermoplastic waxes. Wax preforms To ensure that the wax pattern can be released without being damaged, model surfaces, opposing dentition and preparations must be hardened/sealed with special lacquer (applied by spraying, brushing or dipping). These waxes are mostly relatively rigid/elastic after cooling. Attaching wax sprues to a removable framework supported on double crowns using a hand instrument When employing the lost wax technique, prefabricated wax sprues, bars and reservoirs are attached to the patterns. Once the pattern has been released and its sprues waxed onto the crucible former, it is invested in a casting ring with refractory investment material. The wax can then be burnt out residue-free and casting completed. Unlike standard wax build-up techniques, a diagnostic wax-up is not intended for fabricating an indirect restoration, but rather for simulating the appearance and/or external contouring for producing orientation templates. |