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2ND Year - CSA clinical aspects > Fissure sealants and preventative resin restorations > Flashcards

Fissure sealants and preventative resin restorations Flashcards

1
Q

What is a fissure sealant?

A

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

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2
Q

What are the uses of fissure sealants?

A

Primary prevention of caries

Secondary prevention to inhibit the progression of non cavitated carious lesions

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3
Q

Why are fissure sealents used what are their advantages?

A
  1. Fissure sealants are effective at preventing decay
  2. Pits and fissures account for 12.5% of tooth surface
    66% of carious lesions develop in the pits and fissures
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4
Q

What did the cochrane library find in regards to fissure sealants?

A

Found fissure sealants reduce the decay rate by 51%

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5
Q

How many studies did the cochrane library carry out when loooking at fissure sealants?

A

Included 38 studies and 7924 participants between age 5-16 yrs

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6
Q

Who get fissure sealants?

A

All children at high risk of dental caries

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7
Q

Which teeth do we usually place fissure sealants on?

A

Permanent molars

Susceptible sites of permanent teeth

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8
Q

List some patent factors we consider when choosing patients who may need fissure sealants

A
  1. Caries in primary teeth
  2. Caries in other permanent molar
  3. Does the patient have nay underlying medical physical ot emotional problems
  4. Risk factors
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9
Q

List some tooth factors we consider when choosing patients who may need fissure sealants

A
  1. Depth of fissures
  2. Hypomineralisation
  3. Hypoplasia
  4. Inaccessible areas that are hard to clean
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10
Q

List the steps we carry out when placing a fissure sealant

A
  1. Clean the pit and fissures
  2. Isolate the tooth
  3. Etch, wash and dry
    (4. Apply a bonding agent)
  4. Apply sealant
  5. Evaluate
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11
Q

Why do you need to isolate the tooth when carrying out a fissure sealant?

A

To achieve moisture control

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12
Q

Why is using a bonding agent when placing a fissure sealant a debated topic?

A

As some say it will make sure the fissure sealant seal better
BUT
It introduces another step and requires the child to sit still for longer

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13
Q

What does the cochrane library say about bonding fissure sealant?

A

Etching and bonding doesn’t statically improve retention of fissure sealants

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14
Q

What do we use to place our fissure sealant?

A

Use a microbrush

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15
Q

How do we evaluate our fissure sealant?

A

Can use a small spoon excavator to check for overhang and check sealing of the sealant

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16
Q

What material is the fissure sealant we use made up of?

A

Resin

17
Q

When would be use a GIC fissure sealant

A

If you have an uncooperative patient or need a quick temporary protective cover over the 6

18
Q

How would you place a GIC fissure sealant

A

Using your thumb and place the GIC onto the molar and let set
Then check occlusion

19
Q

How can we imporve behaviour management in younger children?

A
  1. Tell-show- do using a tooth model or glove
  2. Distractions (count light on the ceiling)
  3. Reinforce positive behaviour
20
Q

When are failure rates of fissure sealants higher?

A
  1. When placed on newly erupted teeth

2. Placed in mouth with previous high caries rate

21
Q

What is a preventative resin restoration?

A

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

22
Q

What is the difference between preventive resin restorations and fissure sealants

A

There’s some caries removal involved in preventative resin restoration
And PRR is more for the prevention of the SPREAD of caries

23
Q

When do we do PRR?

A
  1. When caries is minimally into the dentine

2. Lesion is limited to areas of tooth not bearing occlusal load

24
Q

What would you do if the caries lesion is too extensive for PRR

A

Do an occlusal composite restoration

25
Q

Why do we use preventive resin restoration?

A

To conserve the tooth structure

26
Q

How much of the tooth surface is removed in PRR in comparison to amalgam

A

PRR: 5%
Amalgam: 25%

27
Q

What are the advantages of PRR?

A
  1. Aesthetics
  2. Shorter prep time
  3. Minimal wear
  4. Improved seal
28
Q

How do we carry out a PRR?

A

(1. give LA)
2. Isolate the tooth
3. Use high speed ands slow speed to remove caries
4. Etch, wash and dry
5. Apply bonding agent
6. Restore with composite
7. Apply sealant
8. Evaluate

29
Q

How deep should we make our cavity to optimise PRR?

A

2mm so that the composite sets well

30
Q

How do we monitor PRRs?

A

Recall the patient according to their caries risk (6mths-2yr)
Take radiographs

2ND Year - CSA clinical aspects (4 decks)

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