Chapter 35: Sealants Flashcards
an organic polymer (resin) that flows into the pit or fissure of a posterior tooth and bonds by mechanical retention to the tooth.
pit and fissure sealant
Topically applied fluorides protect ______ tooth surfaces more than occlusal surfaces; dental sealants reduce the incidence of occlusal dental caries.
smooth
Sealant application is a part of a complete prevention program, not an ____ procedure.
isolated
by using an acid-etchant process, the enamel could be altered to increase ____
retention
Purposes of the Sealant
- Provide a physical barrier to the pit or fissure.
- Fill the pit or fissure as deep as possible
- Provide continued protection in the depth of the micropore
purposes of acid etch
- To produce irregularities or micropores in the enamel.
- Allow the liquid resin to penetrate into the micropores and create a BOND or MECHANICAL LOCKING
The clinician decides which material will be most beneficial depending on:
- An assessment of patient needs.
- Sealant placement environment.
- Available supplies.
Criteria for the Ideal Sealant
- prolonged bonding to the enamel.
- biocompatible with oral tissues.
- simple application .
- free-flowing, low-viscosity
- low solubility in the oral environment.
A majority of sealants in clinical use are made of______
bis-GMA
Classification by the Method of Polymerization:
- Self-cured or autopolymerized
- Visible light-cured or photopolymerized
Classification by Filler Content
- filled
- unfilled
- flouride releasing
purpose of filler :
inrease bond strength and resistance to abrasion and wear
-Clear, does not contain particles.
Less resistant to abrasion and wear.
-May not require occlusal adjustment after placement, so provides an advantage for school and community health programs where sealants are placed.
unfilled
type of filler:
Purpose: to enhance caries resistance.
Action: remineralization of incipient caries at the base of the pit or fissure.
flouride releasing
Classification of fillers by Color
clear, tinted, and opaque.
Individual patient benefit of sealants will depend on the following:
- Health, diet, and lifestyle.
- Age of tooth and past caries experience.
- Tooth anatomy.
The following risk factors will lead to an increased risk of dental caries:
- Xerostomia: from medications or other reasons.
- orthodontic patient
- Incipient pit and fissure caries (limited to the enamel) with NO radiographic evidence of caries on an adjacent proximal surface.
- Low socioeconomic status.
- Diet high in sugars.
- Inadequate daily oral health care.
place sealant as soon as the tooth is ________
fully erupted
Contraindications for Sealant Placement
- Radiographic evidence of adjacent proximal dental caries.
- Pit and fissures are well coalesced and self-cleansing; low caries risk.
- Tooth not completely erupted.
- Primary tooth near exfoliation.
A pit or fissure may contain the following:
- Dental biofilm, pellicle, debris.
- Rarely but possibly intact remnants of tooth development.
why should you clean the tooth prior to acid etching?
increases sealant retention
Microscopic examination of pits and fissures after sealant application has shown the sealant material often does not penetrate to the bottom because ______ ,_____, and _________ prevent passage of the material
residual debris, cleaning agents, and trapped air
The bacteria in incipient dental caries at the base of a well-sealed pit or fissure have no access to _____ required for survival.
nutrients
Retention of sealant depends on maintaining a __ _____ during etching and sealant placement.
dry field
application method of choice for complete isolation.
rubber dam
isolation tools
rubber dam
cotton rolls
Creates micropores to increase the surface area and provide retention for the sealant.
Removes contamination from the enamel surface.
Provides antibacterial action.
etchant
Purpose:
- Prepare the tooth for acid etch.
- Eliminate moisture and contamination.
drying the tooth
Etchant solution forms
Phosphoric acid: 15%–50%,
depends on the product and manufacturer.
Occlusal wear: unfilled sealants wear down via ______ to the correct height; filled sealants require _______
normal attrition
occlusal adjustment
Dental sealants need to be in place to prevent caries, and should be checked for the following:
retention
need for replacement
Sealants are indicated for teeth with deep pits and fissures, preferably in recently _____ teeth (i.e., within previous 4 years)
erupted
____ molars also may be sealed to reduce the caries rate and premature tooth loss
primary
Sealants should be used as part of a preventive program that includes the use of:
fluorides,
dietary considerations
plaque control
regular dental examinations
Indications for Sealant Placement
- The tooth on the opposite side of the mouth has similar pits and fissures.
- Adjacent molars have or need occlusal restorations
- The tooth is newly erupted.
- The tooth is fully erupted
- No proximal decay
- Used in conjunction with a fluoride program
Contraindications to Sealant Placement
- Lack of deep pits and fissures
- Obvious dental decay
- Proximal surface decay
- Insufficiently erupted teeth
- Primary teeth expected to be lost soon
- Poor patient cooperation in the dental chair
supplied as a two-part system (base and catalyst). When these pastes are mixed together, they quickly polymerize (harden).
self cured materials
do not require mixing. polymerized by photo initiators in the resin that are sensitive to the visible blue light spectrum.
light cured sealants
these coloured sealants are more popular because they are easier to see during application and during checks for sealant retention on subsequent office visits.
Tinted or opaque
purpose of _____ material in the sealant is to make it more wear resistant.
filler
filled and unfilled sealants penetrate the fissures equally well, with no difference in
microleakage
t or f
true
Self-cured sealants polymerize to final set within approximately _ minutes from the start of mixing the two components
2
Maxillary and mandibular _____ molars are the teeth that most frequently lose sealants, probably because they are the most difficult teeth for which to maintain isolation when a rubber dam is not used.
second
What happens to the portions of the tooth that are etched and not covered with sealant material?
enamel begins remineralization after 24-hour exposure to calcium phosphate salts in the saliva.
Most sealant failures will occur within the first _ to _ months,
3-6
are sometimes used by the dentist before dental sealants are applied to open the fissures, to remove any slight decay, and/or to prepare the site for placement of a sealant.
Microabrasion (air abrasion) units
Because etching agents contain phosphoric acid, patients and dental personnel should always wear _________ when etching agents are used.
protective eye wear
the primary cause of failure of sealant retention. Inadequate etching is also a factor in loss of sealant retention.
Moisture contamination
how long the sealant remains on the tooth.
sealant retention
When dental sealants are properly placed, it is not uncommon for them to last from _ to _ years.
5-10
Sealant material contains
___ resins. Do not use sealants on patients with known ____ allergies.
acrylate
