Diamond in the rough

When I recently sauntered through a jewelry store, I saw a myriad of precious stones set into rings displayed in glass counters in an exciting selection for the newly engaged.

by Karen Kaiser, RDH

When I recently sauntered through a jewelry store, I saw a myriad of precious stones set into rings displayed in glass counters in an exciting selection for the newly engaged. While emeralds, rubies, and sapphires glistened, most couples headed straight for the diamonds. And why not choose a diamond? The popularity of these gems has grown due to their increased availability, coupled with improved cutting, clarity, and polishing. The diamond is a treasured gemstone and keepsake, and the hardest known natural material. Not only do diamonds make shiny tokens of affection, they have found a following in dentistry.

Diamonds go through a mining process before they become jewelry. The mineral forms deep in the earth, where soaring temperatures combine with high pressure and the element carbon, an extremely soft material. Under intense pressure, as deep as 120 miles in volcanic pipes hidden under the earth’s crust, the carbon is altered into hard atoms known as rough diamond. Nearly half of the world’s diamonds come from Africa. It was recently reported on CNN that the world’s largest diamond mine in Botswana is more than 20 stories deep and 52 football fields wide. Here, truckload after truckload of soil is moved to the surface. The excavated soil is crushed and washed over and over to uncover the diamonds.

Unearthing diamonds is not easy work. In hygiene, many of the areas and angles we position our instruments in to reach deposits are not easy either. Furcations can be especially challenging, and diamonds can be useful, especially when placed on the working ends of dental instruments. Hu-Friedy has diamond-coated file scalers - the DiamondTec scaler and the Mesial/Distal diamond scaler - that offer 360 degrees of diamond coating. The Nabers-type DiamondTec file has universal application and is useful on roots with notable depressions, and it fits into bi- and trifurcated root furcations. This instrument is ideal for final debridement on the top of the Class III root furcation, which is a very difficult position for any standard curette to accommodate.

Also with these instruments, hygienists can scale in multidirectional, vertical, oblique, and horizontal strokes during definitive root scaling. File-type instruments by Brasseler USA have a diamond coating. Diamond Tip curettes have diamonds on the tip of the instrument, but only on the working surface, as the instrument is smooth where inserted adjacent to the tissue. These tipped instruments do not need sharpening and are intended for use as final finish applications on line angles and narrow root surfaces, and are not the customary choice for heavy deposit removal.

For dentists who opt to use ultrasonic scaling for overhang removal or recontouring during surgical procedures, diamonds are again a possible choice. After all, dentists routinely use diamond-coated burs. The diamond-coated ultrasonic scaler Vista Dental by J. Morita has piezo tips (CT-1, 2, 3, 4), which offer durability as the diamond coats these tips. DENTSPLY Professional offers the Diamondcoat insert, with diamond coating a few millimeters on the tip’s end. This insert is useful for stubborn calculus in surgically uncovered areas. Remember, though, that these diamond-type tips are to be used by dentists and could possibly cause tissue trauma during general ultrasonic instrumentation.

To remove bioburden from instruments in the ultrasonic and keep diamonds sparkling, Axis Dental offers Diamond-Zyme cleaning solution. The convenient premeasure top squeezes cleaner to the spout, which allows the correct amount of solution to pool in the reservoir prior to the pour. Because Diamond-Zyme is an anticorrosive, instruments will last longer and look nearly new over an extended period of time. After all, diamonds are forever.

When it comes to exam gloves, our hands are as precious as gems, so Diamond Grip Plus HS (hand-specific) gloves from Microflex are a great choice for mining around in the mouth. These gloves are powder-free latex with a texture grip surface so instruments do not slip during scaling procedures. The Diamond Grip glove fits the natural form of the hand and is intended to decrease the fatigue associated with repetitive motion. The fitted gloves have a good range of motion and are easy to slip on because they have a polymer agent instead of powder. These gloves are a bit thicker so the clinician may function more confidently.

Diamonds certainly do shine and are commonly used to polish restorations both in and out of the mouth. For outside of the mouth, diamonds are included in several pastes. Yates and Bird have a polish named Rapid Glaze for use on adjusted porcelain. Pulpdent has Sparkle nonsplattering diamond dust polishing paste for a glaze-like finish. Miltex has Ultralap diamond paste, with diamond particles 2 to 3 microns in size, for porcelain to avoid reglazing after any adjustments. Temrex has a nondrying polishing paste that is diamond-filled and used extraorally on cast or porcelain restorations. Shofu presents superfine diamonds in its Ultra II smooth polishing paste.

Premier offers Diamond Twist SCL for outside the mouth. Diamond Twist SCO is an intraoral polish supplied by syringe. Posterior occlusal surfaces of inlays, onlays, hybrid composites, or full crowns are polished with either the taper brush or the buffing cloth on mandrel disk. Premier Dental also has a single-step gel called Luminescence Diamond Polishing, which polishes porcelain restorations, glass ionomers, composites, metals, and tooth enamel. Sultan brand has micrograin diamonds in its paste. This nonsplattering paste improves restoration luster and has not only diamonds in the formula, but also xylitol and a refreshing peppermint flavor.

Ivoclar Vivadent has new high performance finishers and polishers, which are both autoclavable and reusable. The OptraFine kit includes a diamond high-gloss polishing paste.

When a couple finally selects just the right diamond, onlookers will assuredly admire its multifaceted glimmer. Similarly, selecting a polishing paste with diamond particles for a smooth, glaze-like finish and improved luster is also an attractive choice. Diamonds should indeed become an operatory keepsake.

The author did not receive compensation for products mentioned. For more gems, visit www.hufriedy.com, www.brasselerusa.com, www.jmoritausa.com, www.professional.dentsply.com, www.axisdental.com, www.microflex.com, www.yates-motloid.com, www.pulpdent.com, www.shofu.com, or www.premusa.com.

Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at hygienetouch@yahoo.com.

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