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Operative Lecture > Pits and Fissure Sealants: Preventive Resin Restorations > Flashcards

Pits and Fissure Sealants: Preventive Resin Restorations Flashcards

1
Q

What are the two limitations that the new caries detection technologies have?

A
  1. They are only indicated for use on unrestored pits and fissures
  2. Their diagnostic accuracy has not been firmly established.
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2
Q

What are the 3 new caries detection technologies currently approved by the FDA?

A
  1. Laser-Induced Fluorescence
  2. Light-induced fluorescence
  3. AC impedance spectroscopy
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3
Q

What type of device is the DIAGNOdent?

A

Laser-induced fluorescence

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4
Q

What limits the usefulness of the DIAGNOdent machine?

A

Increased likelihood of false-positive diagnoses

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5
Q

What type of device is the spectra camera?

A

Light induced fluorescence

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6
Q

How does the light-induced fluorescence caries detection technology work?

A

LED light of a specific wavelength stimulates porphyrins that are unique to cariogenic bacteria to appear red, while healthy enamel appears green

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7
Q

What type of technology is the CareScan PRO?

A

AC Impedance

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8
Q

What is the claim of the CarieScan PRO?

A

Analyze demineralized tooth structure and report:

Tissue health
If the tissue is in the early stages of demineralization
If the tissue is already significantly decayed

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9
Q

What is Fiber-Optic Transillumination (FOTI)

A

It is a method of caries detection that uses the translucent nature of the tooth to shine a very bright light through the tooth in order to reveal discolorations and penetration from tooth surface to the inner zone of dentin

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10
Q

Besides discoloration, what else might FOTI be able to detect?

A

Enamel cracks

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11
Q

What is the main drawback of using caries detection dyes?

A

They stain anything porous, including debris that might have been left in the pulp.

Also, noncarious deep denting absorb the dye because it has larger tubules compared to more superficial dentin.

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12
Q

What does ICDAS stand for and what is the goal of the organization?

A

International Caries Assessment and Detection System

ICDAS was developed to serve as a guide for standardized visual caries assessment.

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13
Q

What does ICCMS stand for?

A

International Carries Classification and Management System

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14
Q

What is the impact of resin bonding in terms of the prep design?

A

Bonding techniques allow for more conservative preparations

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15
Q

Besides materials and bonding technology what else has reduced the need for extensive preparations?

A

New research on etiology, diagnosis, and treatment of carious lesions

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16
Q

What is the basic definition of an adhesive?

A

A material, frequently a viscous fluid that join 2 substrates together by solidifying and transferring a load form one surface to the other.

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17
Q

What are the 4 bonding mechanisms in adhesive dentistry?

A

Mechanical
Adsorption
Diffusion
A Combo of the first 3

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18
Q

What is mechanical bonding in adhesive dentistry?

A

Penetration of resin and formation of resin tags

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19
Q

What is adsorption bonding in adhesive dentistry?

A

Chemical bonding to the inorganic or organic component of tooth structure

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20
Q

What is diffusion bonding in adhesive dentistry?

A

Precipitation of substances on the tooth surfaces to which resin monomers can bond mechanically or chemically

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21
Q

What must exist for good adhesion?

A

Close contact between the adhesive and the substrate

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22
Q

What is a major problem with bonding resins to tooth structure?

A

All methacrylate based resins shrink during free-radical addition polymerization

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23
Q

Why must dental adhesives provide a strong initial bond?

A

To resist the stress of resin shrinkage

24
Q

Where are the three areas that typically lead to adhesive failure?

A

Cohesive failure in the substrate

Cohesive failure in the adhesive

Adhesive failure, or failure at the interface of substrate and adhesive

25
Q

What phenomenon allows fluid resin to penetrate into tooth structure?

A

Capillary action

26
Q

What does acid etching accomplish?

A

Transforms smooth enamel into an irregular surface and increases its surface free energy

27
Q

What did the acid-etch technique allow for?

A

The formation of resin microtags within the enamel surface

28
Q

What kind of strenghth does resin boding to acid based enamel provide?

A

Upwards of 20 MPa

29
Q

What kind of acid is used to etch enamel?

A

Phosphoric Acid 35%

30
Q

Why is beveling the enamel rods beneficial to the adhesion process?

A

The end of rods are more effectively etched then the sides. Beveling exposes many more rod ends to the acid etch that in non-beveled surfaces.

This increases retention of the restoration and prevents microleakage

31
Q

Besides increases retention, what is another benefit of beveling the enamel?

A

It helps the restoration blend more aesthetically with the natural tooth structure

32
Q

Why is gel acid preferred over liquid for etching?

A

It is easier to control

33
Q

What is the typical range for phosphoric acid concentration?

A

35-40%, 37% most common

34
Q

Why should you follow manufacturer’s recommendations for etching time periods?

A

Research has shown that 15 second etch times result in similar surface roughness as 60 second etch times

35
Q

What is the philosophy of minimally invasive dentistry

A

Integrates prevention, remineralization, and minimal intervention for the placement and replacement of restorations

36
Q

How does minimally invasive dentistry aim to conserve healthy tooth structure?

A

Assess patient caries risk factors
Try to detect potential caries disease before cavitation
Restore with max retention of sound tooth structure
Use sealant placement in unaffected areas when indicated

37
Q

Why must the size of restorations be minimized?

A

Because the restoration might have to be replaced increasing the chance of fracture in the future

38
Q

What is meant by the surgical model v medical model?

A

Surgical model: wait until cavitations were detected and restore

Medical model: treat each individual with unique treatment plan using caries management strategies

39
Q

What does CAMBRA stand for

A

Caries Managment by Risk Assessment

40
Q

What is the CAMBRA risk assessment used for?

A

To develop an individualized, evidence based caries management plan that would involve all aspects on nonsurgical therapy and surgical interventions.

41
Q

What is the caries balance model based on?

A

Minimizing pathological factors while maximizing protective factors to attain a balance that favors no disease occurring

42
Q

What are the top 6 Health History Carious Risk Factors?

A 
Age
Fluoride exposure
Smoking
Alcohol
General health
Medication
43
Q

What are the age groups that are considered risk factors for caries?

A

Childhood
Adolescence
Senescence

44
Q

What are the recommendations for a high risk patient?

A

3 months checkup
Fluoride at each visit
Dietary counseling
BW Radiographs 6-12 mos

45
Q

According to ICCMS Guidelines, cavitations should be restored if they meet on or more of these criteria?

A

Need to Restore Esthetics
Need to Restore Functionality
Need to Protect Pulp from progressing caries/decrease sensitivity
Need to Restore Cleanability

46
Q

Why is a cavitated lesion more likely to progress?

A

Self-cleaning becomes nearly impossible

47
Q

For active occlusal lesions what are the treatment summaries?

A
  1. Cavitated to dentin = Restore
  2. Cavitation limited to enamel and plaque retentive + PRR
  3. Cavitation limited to enamel only, not plaque retentive = Sealant
48
Q

What does the indication for sealant use depend on?

A

Patient Caries Risk
Tooth morphology
Presence of incipient enamel caries

49
Q

What type of xray should be obtained before sealant placment, and why?

A

Bitewing

To ensure that you aren’t sealing over an existing dentinal or proximal lesions

50
Q

Why are pits and fissures considered caries-prone?

A

They are not self-cleansing

They accumulate organic debris and bacteria

51
Q

What are the goals of a pit and fissure sealant?

A

Eliminate the geometry that harbors bacteri and to prevent nutrient reaching bacteria in the pits

52
Q

What is the main requirement for the success of a sealant?

A

Adequate retention

53
Q

When must a sealant be adjusted?

A

If it interferes with normal occlusal contacts or paths

54
Q

What are the 2 categories of Sealants?

A

Self curing

Light curing

55
Q

What is the principal monomer in the sealants?

A

bis-GMA

56
Q

What is the difference between self-cure and light cure in terms of application technique?

A

LC can be applied and allowed to flow for a convenient time before curing

SC have to be applied when fluid enough to penetrate pits so that they begin to cure before flowing out!

Operative Lecture (1 decks)

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