Fissure Sealants

Question 1

definition of a fissure sealant?

Answer 1

a hard insoluble resin material in liquid for, to fill pits and fissures without cutting the enamel surface

Question 2

functions of fissure sealants?

Answer 2

eradicate fissures
aid cleaning
prevent caries

Question 3

history of fissure sealants?

Answer 3

1920’s - prophylactic odontomy - applications of black copper cement
1955 - buonocere - acid etch technique
1970’s - bowens bisgma

Question 4

clinical technique?

Answer 4

mech cleaning
isolate
dry
etch
wash
isolate
dry
apply resin
polymerisation
check occlusion

Question 5

evaluation of sealant?

Answer 5

smooth?
occlusal harmony
under/overextension
under curing

Question 6

acid etch technique?

Answer 6

30-50% phosphoric acid
approx 8um of enamel dissolved
creates porosities of 50um deep

Question 7

what products should you not use?

Answer 7

self etch products

Question 8

type 1 etch patter?

Answer 8

prism core removed
peripheral material left
most common

Question 9

type 2 etch pattern?

Answer 9

prism core left and peripheries removed

Question 10

type 3 etch pattern?

Answer 10

haphazard effect

not related to prism morphology

Question 11

what does etched enamel look like?

Answer 11

white chalky appearance

Question 12

classifications of sealants based on?

Answer 12

light cured/self cured
clear/tinted/opaque
filled/non filled

Question 13

what are self polymerised sealants like?

Answer 13

2 solutions mixed together
no visual light
limited application time

Question 14

what are UV polymerised sealants like?

Answer 14

not common nowadays
longer application time
may cause retinal damage

Question 15

what are white light polymerised sealants like?

Answer 15

largerly replaced UV sealants
longer application time
no retinal damage

Question 16

advantage of clear sealants?

Answer 16

can see fissures underneath

Question 17

advantage of tinted/opaque sealants?

Answer 17

can see loss of fissure

Question 18

what can sealants be filled with and what does this do?

Answer 18

lithium alumina silicate
increase resistance to abrasion
increase wear of opposing teeth

Question 19

what pt’s to use sealants on?

Answer 19

high caries risk patients
limited manual dexterity
medically compromised
tooth can be isolated
deep fissure pattern

Question 20

problems with patients with limited dexterity?

Answer 20

unable to clean well
reliance on others
higher caries risk

comes with physical problems and age

Question 21

what kind of medically compromised patients need sealants?

Answer 21

cardiac
immunosuppression
bleeding disorders
blood dyscrasias
metabolic/endocrine problems

Question 22

what are sealants trialed to find out?

Answer 22

seal/no seal compare
trials related to caries
compared to diff types
asses cost effectiveness 
asses progression of lesions
asses effects of etch

Question 23

results of trials?

Answer 23

sealants are progressively lost
light cure sealants more retenitve
chem cured 60% retention
retention best at mandibular molars and premolars
caries progression halted
acid etch doesnt increase susceptibilty
more cost effective

Question 24

recent advances with sealants?

Answer 24

compomers - dycat seal
not as hard wearing
flouride releasing
good for shallow fissures

Question 25

when to recall/reassess?

Answer 25

if leaking - will promote caries
review 6monthly
repair if broken - new sealant will bond to old
bitewings for suspected caries