Manual 1: Resin fissure sealant Flashcards
when can we use resin fissure sealant?
- non-cavitated occlusal surface
- micro cavitation in enamel but not in dentine
- radiographically: caries no more than 1/3rd into dentine.
what is recommended to do prior to applying resin fissure sealant when you have a micro cavitation in enamel but not in dentine?
- use flowable composite with bonding agent first in the micro cavity
- then place resin fissure sealant over it
what are the guideline recommendations for the application of resin fissure sealant?
- permanent molars of all children as early after eruption as possible
- seal all fissures in primary and permanent teeth of patients with physical impairment
- seal all fissures of high risk patients
outline the procedure for delivering resin fissure sealant.
- clean the tooth
- dry the tooth
- isolate tooth and achieve moisture control
- apply acid etch to the tooth, use probe to ensure the etch touches enamel in all pits and fissures
- leave acid etch on for 20-30 seconds
- remove acid etch with suction first
- rinse excess acid etch and aim it into the suction to prevent it going in patient’s mouth
- tooth must be frosty, if not then re-etch
- apply resin sealant using WHO probe, use spoon excavator for larger areas
- light cure the resin
- use sharp probe to examine the seal, must have smooth margins and a firm bon to tooth
- check occlusion with articulating paper and if bite feels normal
- floss contact points
What are the different ways of delivering acid etch:
- using micro-brush then probe to put it in fissure pattern
- using syringe
how do you set up acid etch syringe?
- assemble syringe making sure tip is firmly secured
- place disposable sheath over syringe
- test flow outside the mouth
Why is it crucial to have review appointment for patients who get fissure sealants as treatment of carious lesion?
- to ensure that the caries has arrested
if on a carious lesion there is frosting on enamel, what does that indicate? would you still use fissure sealant in this case?
- indicates that lesion is spreading around ADJ
- don’t use sealant if spending along ADJ
how does fissure sealant help manage carious lesion?
- stops nutrient supply to bacteria within the lesion so they die and lesion arrests
- reactionary dentine forms and thickens up the inside of the tooth
what are tooth related factors which would indicate the use of fissure sealants?
- deep pits and fissures
- hypo-mineralised teeth
- hypoplastic teeth/enamel hypoplasia
why do we prefer using RFS opposed to GIFS?
- no difference in terms of effectiveness
- RFS is tougher and smoother
- same colour as tooth so looks better
- very small amount of fluoride released form RFS although doesnt do anything
what do you do if resin fissure sealant is too excessive?
- use composite finishing burs to reduce it
why is moisture control a problem for partially erupted teeth?
- operculum releases GCF
