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Operative II > Sealants > Flashcards

Sealants Flashcards

1
Q

Caries Lesions represent a continuum of net mineral ____

A

loss

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2
Q

What is another name for noncavitated lesion?

A

initial caries development

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3
Q

Initial caries are characterized by change in…

A

-Color
-Glossiness
-Surface Structure

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4
Q

Inital caries occur via..

A

a result of demineralization and represent areas with net mineral loss before there is macroscopic breakdown in surface tooth structure

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5
Q

Are initial caries reversible?

A

Considered Reversible with remineralization

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6
Q

What are cavitated lesions?

A

Loss of surface integrity with inability to biologically replace the loss of hard tissue

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7
Q

Whats the difference between moderate and advanced caries?

A

Moderate Caries
-Extend into the middle third of dentin layer

Advanced Caries
-Extend into the inner third or dentin layer

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8
Q

What are the tooth surface sites or origins?

A
  1. Pit & Fissure
  2. Approximal
  3. Cervical and Smooth Surface
  4. Root
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9
Q

What are the main caries detection techniques?

A
  • tactile
  • radiographs
  • newer techniques
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10
Q

What are radiographs especially good for in terms of caries detection?

A

Especially for interproximal lesions

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11
Q

What are new techniques for caries detection?

A

Laser fluorescence, transillumination, or combo of laser luminescence and photothermal radiometry

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12
Q

What is ICDAS 0

A

clinically sound

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13
Q

What is ICDAS 1-2

A

clinically detected “intact” enamel lesions (intial stage decay)

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14
Q

What is ICDAS 3-4

A

clinically detectable early, shallow, or microcavitations (moderate decay)

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15
Q

What is ICDAS 5-6

A

clinically detectable late or deep cavitations (extensive decay)

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16
Q

What do you make a caries management plan for a patient based on?

A
  • ICDAS
  • inital patietn assessment
  • lesion detection, activity, and appropraite risk assessment
  • synthesis and decision making
  • clinical treatmetns with prevention
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17
Q

What are the high risk characteristics for caries?

A
  • Sugary food or drinks
  • Eligible for government programs (WIC, Headstart, age 0-6)
  • Caries experience of caregiver (age 0-14)
  • Special health care needs
  • Chemo/Radiation therapy
  • Restorations/Cavitated carious lesions in the last 24 months
  • New Noncavitated (incipient) lesions in the last 24 months
  • Teeth missing due to caries
  • Severe dry mouth
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18
Q

What are different caries prevention and risk management strategies?

A

-Behavioral Modification
-Topical Fluoride Application
-Pit and Fissure Sealants

19
Q

What are ways of behavioral modification to manage caries?

A

-Limiting sugary foods and drinks
-Chewing sugar-free gum with xylitol
-Brushing with fluoride toothpaste 2x/day
-Cleaning between teeth 1x/day

20
Q

What are different ways of topical fluoride application?

A

-Placement of fluoride varnish (2.26%)
-Placement of fluoride gel (1.23% acidulated phosphate)
-Daily use of 0.09% fluoride mouthrinse
-Silver Diamine Fluoride (38%) for arrest of dental caries

21
Q

Are pit and fissure sealants effective?

A

-Effectively penetrating and sealing these surfaces with dental material (sealants) has been proven effective in preventing and arresting caries in permanent molars of children and adolescents

22
Q

Why do pit and fissures need sealants sometimes?

A

Anatomical grooves (aka pits and fissures) of teeth trap food particles and promote presence of bacterial biofilm, increasing the risk or caries

23
Q

When should you place sealants?

A

-Sealants are placed on pit and fissure areas only on noncavitated teeth

24
Q

When is the best time to seal permanent molars?

A

overall higher prevalence of untreated carious lesions in 12-19 year olds (15%) compared to 6-11 year olds (6%), so best to seal soon after permanent molar eruption

25
Q

What are the different options of sealant materials?

A
  • Resin-based
  • Glass Ionomer
  • Polyacid-modified resin
  • Resin-modified glass ionomer
26
Q

What is the most common type of sealant used?

A

Resin-based

27
Q

What are resin-based sealants?

A

-Urethane dimethacrylate (UDMA) or bisphenol A-glycidyl methacrylate (bis-GMA) monomers polymerized by either chemical activator and initiator or light or specific wavelength and intensity

28
Q

What are the pros of resin-based sealants?

A
  • Good retention
  • can control working time (light-cured)
  • wear-resistant
29
Q

What are the cons of resin-based sealants?

A
  • moisture-sensitive
  • require cleaning/etching of tooth surface prior to placement
30
Q

What are glass ionomer sealants?

A

Cements with an acid-base reaction between fluoroaluminosilicate glass powder and polyacrylic acid solution

31
Q

What are the pros of glass ionomer sealants?

A
  • Moisture-friendly
  • No need for pretreatment of tooth surface due to chemical bonding to tooth surface
  • Continuous release of fluoride
32
Q

What are the cons of glass ionomer sealants?

A
  • Poor retention
  • Cannot control working time (chemical reaction)
33
Q

What are polyacid-modified resin sealants?

A

Combine resin-based material with fluoride releasing and adhesive properties of glass ionomer

34
Q

What are the pros of polyacid-modified resin sealants?

A
  • Continuous release of fluoride
  • Controlled working time
35
Q

What are the cons of polyacid-modified resin sealants?

A
  • Lower amounts of fluoride release
    vs. GI
  • retention lower than resin
  • moisture-sensitive
  • require etching prior to placement
36
Q

What are resin-modified glass ionomer sealants?

A

-Glass Ionomer sealants with resin components

37
Q

What are the pros of resin-modified glass ionomer sealants?

A
  • Similar fluoride-release properties as GI
  • longer working time than GI
  • less water sensitivity than GI
  • does not require etching prior to placement
38
Q

What are the cons of resin-modified glass ionomer sealants?

A
  • Lower retention than resin
  • lower wear-resistance than resin
39
Q

What are the sealant placement steps?

A

-Always recommend dry environment (especially resin-based)
-Clean pits and fissures with pumice and prophy brush, air abrasion, hydrogen peroxide, or enameloplasty
-Important to not use prophy paste to clean tooth because fluoride and oil interferes with etching process
-Place acid etch for 15-20 seconds, rinse, and dry (resin-based sealants only)
-Place sealant material of choice and light cure if necessary (resin sealant materials)
-Check occlusion and adjust if necessary

40
Q

What is the difference between PRR (preventitive resin restorations) and sealants?

A

-PRR’s are done on teeth that have initial caries present (not in dentin)
-PRR’s are meant to last forever, while sealants generally come out after a number of years

41
Q

What is the technique for preventitive resin restorations (PRR)

A

-Remove caries (usually with small round bur or can use air abrasion)
-Etch for 15-20 seconds, rinse, and dry
-Place bonding agent, air dry, and light cure
-Place flowable resin composite, and light cure
-Check occlusion and adjust if necessary

42
Q

How is the technique for preventitive resin restorations (PRR) different from sealants?

A

-Caries must be removed prior to placement
-Bonding agent and flowable resin composite are used

43
Q

What are some things to consider about sealants?

A
  • sealants may be placed by either
    dentist, hygienist, or assistant
    -Isolation can be difficult for sealants, so staff members may require assistance
    -Always remember your staff is working under your license, so check teeth before and after sealants placed
    -Most dental insurance only covers sealants for minors (age limits vary)
    -PRR’s can only be placed by dentist
    -PRR’s generally covered by insurance with similar reimbursement as sealant

Operative II (8 decks)

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