fissure sealant

Question 1

describe fissure sealants

Answer 1

Hard insoluble resin material fills pits and fissures without cutting into enamel.
Aids cleaning and prevents caries.

Question 2

explain the technique for applying a fissure sealant

Answer 2

Mechanical cleansing- non fluoride paste or pumice 
Isolate 
Dry 
Etch 
Rinse 
Reisolate 
Dry 
Apply resin 
Check occlusion

Question 3

how would you evaluate a fissure seal?

Answer 3

smooth, occlusal harmony, no air bubbles, no under or over extensions.

Question 4

describe a filled fissure sealant

Answer 4

alumina silicate, stronger, resistant to abrasion but increased wear of opposing teeth.

Question 5

indications for use of fissure sealants

Answer 5

High caries risk 
Medically compromised 
Deep fissure pattern 
Limited manual dexterity 
Tooth can be isolated

Question 6

what are contraindications to using fissure sealant

Answer 6

Poor patient cooperation
Previously restored
Caries present
Under curing

Question 7

describe acid etch

Answer 7

30-50% phosphoric acid, approx. 8µm enamel dissolved, creates porosities 50 µm deep.

Question 8

describe the 3 etching pattern s

Answer 8

Type 1: 30s, prism core removed, peripheral material left
Type 2: prism core remains intact, peripheral regions removed
Type 3: haphazard effect, not related to prism morphology

Question 9

how are fissure sealants classified?

Answer 9

Polymerised- self/light cure
Colour- opaue/clear/tinted
Filler content

Question 10

describe different types of polymerisation

Answer 10

Self polymerised
Chemical cure
No light required
Limited time available

White light polymerised
Replaced UV
Longer application time
No retinal damage

UV polymerised
Longer application time
May cause retinal damage

Question 11

what were the results of fissure sealant clinical trials

Answer 11

Sealant is progressively lost
Light cure more retentive than chemical cure
Chemical cure about 60% retention after 5yr
Retention favours mandibular premolars, molars
Progression of caries is halted under intact seal.
Acid etch does not make tooth more susceptible to caries
Fissure sealing is more cost effective than filling and long term maintencance
Topical fluorides play greater role.

Question 12

what are recent advances in fissure sealants?

Answer 12

Compomers (e.g. Dyract Seal) – not as hard wearing as composite based sealants, fluoride release – recommended for shallow fissures etc..

Question 13

when to recall and assess fissure sealants?

Answer 13

if leaking. review 6monthly with bitewinfs