There’s only one way to etch a tooth, right? According to my dental school education, yes! Phosphoric acid etch is the way. That electric Dallas Cowboys blue color is always the first step in adhesive dentistry as I learned it. Paint that phosphoric acid etch on like a Jackson Pollock painting, and let's do this thing.
Jackson Pollock is an interesting name to bring up. Until Pollock’s time, most paintings were representational—they looked like their subject. Pollock came along and showed that there were other legitimate methods of painting, such as abstract expressionism. Because of that, he’s one of a handful of American artists who’s a household name.
What about etching? Is there another way to do it besides the tried-and-true blue? Clean & Boost by Vista Apex is the answer.
Clean & Boost was originally designed to cleanse preparations after imaging powder was used in the old CAD/CAM days. Fortunately for all, those powder days are gone. But that doesn’t mean Clean & Boost isn’t a useful product today—it absolutely is, and it has two main uses. First is still as a preparation cleanser. The second is as an etch. Clean & Boost’s combination of nitric acid, isopropyl alcohol, and HEMA makes it a very versatile product that we could all benefit from.
As a cleanser, Clean & Boost is an aqueous gel or liquid that is designed to help remove contaminants like handpiece oil and debris from our preparation. This also disinfects the tooth surfaces and minimizes post-op sensitivity, thanks to the HEMA. When used as a cleanser, Clean & Boost should be applied and agitated for 10 seconds and then rinsed.
Its use as an etchant is very similar. Just apply and agitate for 20 seconds to etch. Nitric acid is the ingredient that allows us to etch. We are obviously all used to using phosphoric acid, but there are some disadvantages. Phosphoric acid is rough on tissue. If gingiva is irritated or erythematous, phosphoric acid is very likely to cause some bleeding when it comes into contact with it. Bleeding at the worst time possible! Clean & Boost is much gentler, and the nitric acid will not cause bleeding from the gingiva. In fact, the nitric acid in Clean & Boost can actually prevent bleeding from the gingiva with some minor cauterizing. It’s gentler on both the tissue and on dentin, which means the dentin is not overetched. This is another key in preventing sensitivity.
Clean & Boost can help you in two ways. It can raise your bond strengths by cleaning off oil and debris. It can also be a gentler etch option. Like Pollock’s abstract expressionism, Clean & Boost introduced a new way of doing something that is definitely worth taking a look at. Triple to deep left for Clean & Boost!
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Editor's note: This article appeared in the September 2021 print edition of Dental Economics.
