Fissure Sealants and PRRs Flashcards
What are pits?
small pinpoint depressions located at junctions or terminals of developmental grooves
What is a fissure?
deep, narrow channel or crevice which is sometimes deep
they are formed at the depths of developmental grooves during tooth development
What is signficant about the anatomy of pits and fissures in preventative dent?*
there is an inaccessible area (0.1mm) beyond the accesible area (0.4mm) that is not visible to the naked eye
toothbrush and probe cannot reach inaccessible area
What is harboured in inaccessible areas of pits and fissures
harbours microorganisms
+
acts as trap for sugars/food particles
Why do deep fissures occur so commonly?
during tooth development, enamel calcification begins at tips of cusps and proceeds downwards, when the cusps grow they fuse at completion of the crown
-> often the fusion of 2 cusps is incomplete (causing deep fissures)
What is the type of enamel that forms at the fissures?
amorphous enamel
What is the classification of fissures? (4) Name from most to least common*
- V-type (34%)
- IK-Type (26%)
- U-Type (14%)
- I-Type (1%)
Why are fissures susceptible to caries?
they provide ideal environment for the development and progression of active caries
→ complex anatomy of fissure makes it difficult to clean, plaque retentive, periodic refined carbs for nutrition
the highest risk fissure is type IK where there is a bulbous widening and therefore very short route to the dentine for caries to progress
speed of penetration of fissure caries is very fast with devasting results
How much of a the total tooth surface does occlusal surface account for? How does this compare to the prevalence of pit and fissure caries?
only 12.5% of total tooth surfaces
BUT
accounts for nearly 80% of all caries lesions (8x more likely than smooth surface caries)
Where are you most likely to find caries in younger children with permanent teeth?
pits and fissures
Where can you find pits and fissures other than occlusal surfaces of molars/pms?
- buccal surface of lower molars
- palatal surface of upper molars
- palatal pits of anteriors
What diagnostic method is essential for early detection of pit/fissure caries?
BWs
Define fissure sealant (4)
What is key to the success of F/S? (1)
a seal in the pits and fissures of susceptible teeth, creating a physical barrier agaisnt biofilm nutrition and prevent acid-forming bacterial proliferation
adhesion to tooth
Outline the effectiveness of F/S
caries rate w F/S = 30% whereas without is 80%
protective effect is especially important in high risk population
can arrest progression of early non-cavitated lesions (study showed caries lesions that are effectively sealed dont progress)
Should you do F/S if BW shows caries progressed into dentine?
no, do conservative PRR