CSA fissure sealants and PRRs Flashcards
What are fissure sealants?
material placed into pits and fissures of teeth to prevent development into caries
What are PRRs?
restoration of carious lesion into dentine
what does fissure sealants inhibit progression of?
non-cavitated carious lesions, so caries doesn’t progress to dentine
Why do we do fissure sealants>
• Pits & fissures account for 12.5% of tooth’s surface:
o 66% of carious lesions found in pits & fissures
Why is there a lot of caries in fissures ?
o Lots of grooves being present
o Difficult to access area with toothbrush
o Anatomical features present (some people have deep fissures)
What is the selection for fissure sealants like?
- children with high risk of dental caries
- look for susceptible tooth sites
what are patient factors affecting FS placement ?
o Caries in primary teeth
o Caries in other permanent molars
o Patients with underlying medical/physical/emotional problems
o Risk factors (E.g. Diet)
What are tooth factors affecting placement of FS ?
o Depth of fractures
o Hypo mineralisation –
o Hypoplasia
o Inaccessible for cleaning
what is hypo mineralisation ?
Enamel has developed in the right quantity, but the quality of the mineral is poor
What is hypoplasia?
ENAMEL DOESN’T develop in right quantity
What is the most widely used fissure sealant?
Resin based sealant
What do we use on clinic
Clinpro- Pink when placed onto the tooth & then cures white
What do GI and polyacid modified resin sealants have?
fluoride releasing properties
What are the steps of fissure sealing?
- Clean the pits and fissures
- Isolate the tooth for Moisture control
- Etch, Wash & Dry
- Apply bonding agent & cure (optional)
- Apply sealant, cure
- Evaluate
How do we clean pits and fissures?
pumice with a slow hand piece
How do we achieve good moisture control when applying FS?
RUBBER DAM, NEED LA for this
When should GI sealants be used ?
where good moisture control can’t be achieved
Where do we place cotton rolls?
o Lingual sulcus & buccal sulcus (Lower)
o Buccal sulcus & finger held in palate (Upper)
How do we etch?
37.5% phosphoric acid
What does bonding do?
improves retention:
o On buccal groove on lower teeth
o On palatal groove of upper teeth
• Bond should be cured for 10s
How to apply sealant?
t in a small dappens dish
• small spoon excavator used and micro brush to gently apply to all fissures of tooth
• Sealant should be cured for 20s (ClinPro)
How do we CHECK AND evaluate the FS?
o Not flicking off
o Too bulky/changing occlusion
What are self cure GIC sealants like?
o not look nice, but lasts a long time but are 5x more likely to be lost than a resin sealant
when are failure rates high for fissure sealants?
o Placed on newly erupting teeth
o Placed in mouths with high previous caries experience
how to monitor fissure sealants?
o Deficiencies should be corrected
o If FS lost, need to replace it
• Parents must be informed that FS must be looked after
Why use a PRR ( PREVENTIVE resin restoration )
- Better in conserving the tooth surface
- better aesthetically
- IMPROVED seal
- Doesn’t wear easily
- Stops caries progression
- Shorter prep time
What is a PRR?
- Restoration of a carious lesion into dentine, where lesion is limited to areas of tooth not bearing occlusal loads
- composite filling placed, covered with fissure sealant to prevent caries progression
When to use a PRR?
- Caries progressed into dentine
- When lesion is limited to areas of the tooth not bearing occlusal loads
- Teeth must be dry and good lighting
- bite wing radiographs first
- PRRs used on primary & permanent teeth
What do bite wing radiographs show?
depth of caries
How to place a PRR?
- LA
- Rubber dam (protect teeth from high speed bur)
- ADJ made clean & fissure pattern opened
- caries removed with high then slow speed
- etch into grooves
- bond should be placed into the white frosty area
- Composite then placed
- FS over composite
How do we monitor patients?
o High risk children seen every 3 months
o Low risk children seen every 12 months
o High risk children Bitewings taken every 6 months
o Low risk children
Bitewings taken every 12 months
