sealants

Question 1

sealant rationale

Answer 1

1) conservative and preventative
2) both permanent and primary molars, and premolars if warranted
3) caries susceptible
4) micromechanical locking by etching

Question 2

the explorer

Answer 2

1) gently evaluate enamel surface
2) minimal downward pressure
3) bad
- do not drag through uncured sealant on tooth
4) overly aggressive use
- creates cavitation

Question 3

isolation is essential

Answer 3

1) do not want to create a pool
2) putting too much can cause fracture

Question 4

when sealants fail

Answer 4

1) contamination and putting too much

Question 5

clinical example

Answer 5

1) 7 yr old, #19 and #30 just erupted
2) note deep grooves and fissures and some staining in these areas
3)caries risk is moderate
4) treatment, sealant, or PRR?
-

Question 6

types of sealants

Answer 6

1) resin
- light cured
- clear, opaque
- fluoride
- unfilled -> partially filled
2) ultraseal XT plus
- partially filled
- BPA free
- visible light cured
- opaque
- etch, primer, and sealant
- contains fluoride
- or the 2-step: hydrophilic component that doesn’t need a primer
3) glass ionomer
- isolation may be critical
- lower compressive strength
- adjacent enamel protection
- retention
- fluoride release
- handling properties
- caries prevention equivalent to RBS

Question 7

isolation

Answer 7

1) rubber dam
2) isolite
- suctions, bite block, isolates

Question 8

surface prep?

Answer 8

1) suspicious pits and grooves?
- staining and suspicious
- enameloplasty/ fissureotomy
2) 1/4 round bur slow speed

Question 9

steps

Answer 9

1) etch 15 sec
2) prima dry 5 sec
3) place sealant
4) cure for 20 seconds
5) carefully check

Question 10

evaluation

Answer 10

1) isolation adequate
2) no plaque trapped
3) smooth

Question 11

rational for PRR

Answer 11

1) carious lesion, little stick
2) cannot be through dentin

Question 12

PRR indications

Answer 12

1) isolated carious area
2) no pulp involvement
3) permanent and primary
4) adequate isolation
5) patient cooperation

Question 13

types of PRR

Answer 13

1) various designs
2) composite + sealant (most common)
- flowable or packable
3) GI + sealant

Question 14

PRR technique

Answer 14

1) local anesthesia?
- probable depth of caries
2) prep the carious area
3) etch, prime/dry, and add composite and cure
- check occlusion

Question 15

post op instructions

Answer 15

1) slight occlusal disharmonies
2) will be checked at recalls
3) continued importance of home oral hygiene
4) sealant abrades quickly
5) composite does not
- adjust

Question 16

rubber dam

Answer 16

1) quadrant dentistry
2) improved working conditions and safety

Question 17

rubber dam armanentaria

Answer 17

1) 5x5 non latex
2) 2 step technique
3) anterior
- single tooth isolation
- multiple teeth, retained with floss

Question 18

clamps

Answer 18

1) winged vs wingless
- wingless is for smaller mouths
- pre-ligate

Question 19

placement and removal

Answer 19

1) TSD, use euphemisms
, hugging tooth, stretching as dam is placed over clamp
2) practice swallowing under the dam!
3) make sure clamp is not rocking
4) first dam on the frame, and the dam over the clamp

Question 20

sequencing restorations in the quadrants

Answer 20

1) distal to mesial
2) efficiency
- complete all preps first
3) terminal tooth isolation problems
- place sealant while waiting for anesthesia
- can lead to salivation
4) SSCs before class II alloys

Question 21

restorative case I

Answer 21

1) is rubber dam possible on #14?
- if yes, do PDLs around the clamped tooth
2) A and B need class II alloys, #14 needs a PRR
3) do the PRR first, you need isolation!
4) alloys do not need as much isolation

1) no rubber dam possible
- use cotton rolls, dri angles

Question 22

case II

Answer 22

1) rubber dam on #19?
2) need SSC and sealant, and class II alloy
3) start with the sealant, most distal, needs isolation
4) do the SSC and alloy prep at the same time
5) place SSC first

1) no rubber dam possible
2) do sealant first with cotton roll
3) place clamp on K, not L
4) do as much as you can with the clamp on, and then take it off, finish the ssc
5) place the ssc
6) replace the dam, and finish the alloy

Question 23

case III

Answer 23

1) rubber dam on #3?
2) A and B are getting SSC

1) clamp A if cant clamp #3
2) do your preps as much as possible

Question 24

which clamp is best for small mouths with limited posterior space

Answer 24

1) W8A, 8A, 14A
2) wingless, W8A

Question 25

which one for primary incisors

Answer 25

1) just use floss