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.
what is a fissure sealant
a material that is placed in pits and fissures of teeth in order to prevent the development of dental caries
what is the use of fissure sealant
primary: prevent caries
secondary: to inhibit the progression of non cavitated carious lesions
can non cavitated carious lesions be seen on radiograph
no radiolucency
why do we use fissure sealants
effective at preventing decay
pits and tissues account for 12.5% of tooth surface
how much % of tooth surface do pits and fissures account for
pits and tissues account for 12.5% of tooth surface
what % of carious lesions develop in fissures and pits
66%
who gets fissure sealants
patient selection-all children at high risk of dental caries
which teeth can get fissure sealants
Permanent molars
- Susceptible sites of permanent teeth e.g. pits of lateral incisors
how do we carry out a fissure sealant (6 steps)
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
what do we clean the fissures with
do not clean with prophy paste
clean with just slow speed bur- and polishing brush head
what can we isolate the tooth with
rubber dam- might be difficult with children
cotton wool roll
dry tips
should we bond teeth or not
Etch, rinse and bond
- 12 month retention: 77.1%
Etch only
- 12 month retention: 45.8%
what are behaviour management techniques
show tell do- using tooth model or finger
distraction- count lights or wiggle toes
informed consent
when do fissure sealants fail
placed on newly erupted teeth
placed in mouths with previous high caries risk
what is the key to success with fissure sealant s
monitoring and repair of deficiencies
what is PRR( preventative resin restoration)
Restoration of a carious lesion into dentine, where the lesion in limited to areas of the tooth not bearing occlusal loads
what is the uses of PRR
Caries minimally into dentine.
• Lesion limited to areas of tooth not bearing occlusal load.
• If the lesion is more extensive – occlusal composite restoration.
why do we use PRR
TAKES up only 5% of the tooth surface whilst amalgam takes up 25%
benefits of PRR
Aesthetics
• Shorter prep time
• Minimal wear
• Improved seal
how do we carry out a PRR 8 stages
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
what can we use for moisture control for PRR
dry tips
cotton wool roll
rubber dam
how do we monitor PRR
- Recall relevant to the caries risk
- Clinical and radiographic monitoring
- Review fissure sealants
what are some patient factors on why we do fissure sealants
caries in primary teeth
caries in permanent molars
patients with underlying medical, physical or emotional problems
risk factors eg diet
what are some tooth factors on why we do fissure sealants
hyperplasia
depth of fissures
hypo mineralisation
inaccessible for cleaning
