Fissure sealants and preventative resin restorations Flashcards

To describe the rationale for fissure sealants (FSs) and preventative resin restorations (PRRs). • To outline the evidence that supports their use in clinical practice. • To explain the steps in placement.

1
Q

what is a fissure sealant

A

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

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2
Q

what is the use of fissure sealant

A

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

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3
Q

can non cavitated carious lesions be seen on radiograph

A

no radiolucency

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4
Q

why do we use fissure sealants

A

effective at preventing decay

pits and tissues account for 12.5% of tooth surface

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5
Q

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

A

pits and tissues account for 12.5% of tooth surface

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6
Q

what % of carious lesions develop in fissures and pits

A

66%

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7
Q

who gets fissure sealants

A

patient selection-all children at high risk of dental caries

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8
Q

which teeth can get fissure sealants

A

Permanent molars

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

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9
Q

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

A

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

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10
Q

what do we clean the fissures with

A

do not clean with prophy paste

clean with just slow speed bur- and polishing brush head

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11
Q

what can we isolate the tooth with

A

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

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12
Q

should we bond teeth or not

A

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

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13
Q

what are behaviour management techniques

A

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

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14
Q

when do fissure sealants fail

A

placed on newly erupted teeth

placed in mouths with previous high caries risk

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15
Q

what is the key to success with fissure sealant s

A

monitoring and repair of deficiencies

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16
Q

what is PRR( preventative resin restoration)

A

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

17
Q

what is the uses of PRR

A

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

18
Q

why do we use PRR

A

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

19
Q

benefits of PRR

A

Aesthetics
• Shorter prep time
• Minimal wear
• Improved seal

20
Q

how do we carry out a PRR 8 stages

A

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

21
Q

what can we use for moisture control for PRR

A

dry tips
cotton wool roll
rubber dam

22
Q

how do we monitor PRR

A
  • Recall relevant to the caries risk
  • Clinical and radiographic monitoring
  • Review fissure sealants
23
Q

what are some patient factors on why we do fissure sealants

A

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

24
Q

what are some tooth factors on why we do fissure sealants

A

hyperplasia
depth of fissures
hypo mineralisation
inaccessible for cleaning