Fissure sealants and preventative resin restorations

Question 1

what is a fissure sealant

Answer 1

a material that is placed in pits and fissures of teeth in order to prevent the development of dental caries

Question 2

Types of fissure sealant

Answer 2

primary: prevent caries
secondary: to inhibit the progression of non cavitated carious lesions

Question 3

can non cavitated carious lesions be seen on radiograph

Answer 3

no radiolucency

Question 4

why do we use fissure sealants

Answer 4

effective at preventing decay

pits and tissues account for 12.5% of tooth surface

Question 5

how much % of tooth surface do pits and fissures account for

Answer 5

pits and tissues account for 12.5% of tooth surface

Question 6

what % of carious lesions develop in fissures and pits

Answer 6

66%

Question 7

who gets fissure sealants

Answer 7

patient selection-all children at high risk of dental caries

Question 8

which teeth can get fissure sealants

Answer 8

Permanent molars

- Susceptible sites of permanent teeth e.g. pits of lateral incisors

Question 9

how do we carry out a fissure sealant (6 steps)

Answer 9

1) Clean the pits and fissures
2) Isolate the tooth
3) Etch, wash and dry
4) Apply bonding agent
5) Apply fissure sealant
6) Evaluate

Question 10

what do we clean the fissures with

Answer 10

do not clean with prophy paste

clean with just slow speed bur- and polishing brush head

Question 11

what can we isolate the tooth with

Answer 11

rubber dam- might be difficult with children
cotton wool roll
dry tips

Question 12

should we bond teeth or not

Answer 12

Etch, rinse and bond
- 12 month retention: 77.1%
Etch only
- 12 month retention: 45.8%

Question 13

what are behaviour management techniques

Answer 13

show tell do- using tooth model or finger
distraction- count lights or wiggle toes
informed consent

Question 14

when do fissure sealants fail

Answer 14

placed on newly erupted teeth

placed in mouths with previous high caries risk

Question 15

what is the key to success with fissure sealant s

Answer 15

monitoring and repair of deficiencies

Question 16

what is PRR( preventative resin restoration)

Answer 16

Restoration of a carious lesion into dentine, where the lesion in limited to areas of the tooth not bearing occlusal loads

Question 17

what is the uses of PRR

Answer 17

Caries minimally into dentine.
• Lesion limited to areas of tooth not bearing occlusal load.
• If the lesion is more extensive – occlusal composite restoration.

Question 18

why do we use PRR over amalgam

Answer 18

TAKES up only 5% of the tooth surface whilst amalgam takes up 25%

Question 19

benefits of PRR

Answer 19

Aesthetics
• Shorter prep time
• Minimal wear
• Improved seal

Question 20

how do we carry out a PRR 8 stages

Answer 20

1) +/- Local anaesthetic
2) Isolate the tooth- moisture control
3) High speed and slow speed removal of caries
4) Etch, wash and dry
5) Apply bonding agent
6) Restore with composite
7) Apply sealant
8) Evaluate

Question 21

what can we use for moisture control for PRR

Answer 21

dry tips
cotton wool roll
rubber dam

Question 22

how do we monitor PRR

Answer 22

• Recall relevant to the caries risk
• Clinical and radiographic monitoring
• Review fissure sealants

Question 23

what are some patient factors on why we do fissure sealants

Answer 23

caries in primary teeth
caries in permanent molars
patients with underlying medical, physical or emotional problems
risk factors eg diet

Question 24

what are some tooth factors on why we do fissure sealants

Answer 24

hyperplasia
depth of fissures
hypo mineralisation
inaccessible for cleaning