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CSA clinical aspects > CSA fissure sealants and PRRs > Flashcards

CSA fissure sealants and PRRs Flashcards

1
Q

What are fissure sealants?

A

material placed into pits and fissures of teeth to prevent development into caries

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2
Q

What are PRRs?

A

restoration of carious lesion into dentine

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3
Q

what does fissure sealants inhibit progression of?

A

non-cavitated carious lesions, so caries doesn’t progress to dentine

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4
Q

Why do we do fissure sealants>

A

• Pits & fissures account for 12.5% of tooth’s surface:

o 66% of carious lesions found in pits & fissures

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5
Q

Why is there a lot of caries in fissures ?

A

o Lots of grooves being present
o Difficult to access area with toothbrush
o Anatomical features present (some people have deep fissures)

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6
Q

What is the selection for fissure sealants like?

A
  • children with high risk of dental caries

- look for susceptible tooth sites

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7
Q

what are patient factors affecting FS placement ?

A

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)

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8
Q

What are tooth factors affecting placement of FS ?

A

o Depth of fractures
o Hypo mineralisation –
o Hypoplasia
o Inaccessible for cleaning

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9
Q

what is hypo mineralisation ?

A

Enamel has developed in the right quantity, but the quality of the mineral is poor

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10
Q

What is hypoplasia?

A

ENAMEL DOESN’T develop in right quantity

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11
Q

What is the most widely used fissure sealant?

A

Resin based sealant

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12
Q

What do we use on clinic

A

Clinpro- Pink when placed onto the tooth & then cures white

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13
Q

What do GI and polyacid modified resin sealants have?

A

fluoride releasing properties

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14
Q

What are the steps of fissure sealing?

A
  1. Clean the pits and fissures
  2. Isolate the tooth for Moisture control
  3. Etch, Wash & Dry
  4. Apply bonding agent & cure (optional)
  5. Apply sealant, cure
  6. Evaluate
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15
Q

How do we clean pits and fissures?

A

pumice with a slow hand piece

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16
Q

How do we achieve good moisture control when applying FS?

A

RUBBER DAM, NEED LA for this

17
Q

When should GI sealants be used ?

A

where good moisture control can’t be achieved

18
Q

Where do we place cotton rolls?

A

o Lingual sulcus & buccal sulcus (Lower)

o Buccal sulcus & finger held in palate (Upper)

19
Q

How do we etch?

A

37.5% phosphoric acid

20
Q

What does bonding do?

A

improves retention:
o On buccal groove on lower teeth
o On palatal groove of upper teeth
• Bond should be cured for 10s

21
Q

How to apply sealant?

A

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)

22
Q

How do we CHECK AND evaluate the FS?

A

o Not flicking off

o Too bulky/changing occlusion

23
Q

What are self cure GIC sealants like?

A

o not look nice, but lasts a long time but are 5x more likely to be lost than a resin sealant

24
Q

when are failure rates high for fissure sealants?

A

o Placed on newly erupting teeth

o Placed in mouths with high previous caries experience

25
Q

how to monitor fissure sealants?

A

o Deficiencies should be corrected
o If FS lost, need to replace it
• Parents must be informed that FS must be looked after

26
Q

Why use a PRR ( PREVENTIVE resin restoration )

A
  • Better in conserving the tooth surface
  • better aesthetically
  • IMPROVED seal
  • Doesn’t wear easily
  • Stops caries progression
  • Shorter prep time
27
Q

What is a PRR?

A
  • 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
28
Q

When to use a PRR?

A
  • 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
29
Q

What do bite wing radiographs show?

A

depth of caries

30
Q

How to place a PRR?

A
  • 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
31
Q

How do we monitor patients?

A

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

CSA clinical aspects (13 decks)

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