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Operative > Sealants > Flashcards

Sealants Flashcards

1
Q

What are Sealants in definition?

A

Thin resin coatings bonded to enamel to act as a physical barrier to bacteria

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2
Q

2 types of sealants?

A
  1. Some sealants are unfilled resin
    - Bis-GMA
  2. Some have filler in the resin
    - Quartz or silica
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3
Q

2 types of curing for sealants

A
  1. Chemical-cured
    - Auto-polymerizing, 2 components must be mixed
  2. Light-Cured
    - Photo-polymerizing, 20 second setting
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4
Q

Sealant prevalence on permanent teeth of children is how much

A
  • About 30%

This is Low

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5
Q

How effective are sealants?

A
  • 60-75% caries reduction at 4 years roughly
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6
Q

What is the effect of sealing incipient caries?

A
  1. Bacteria cut off from nutrients
  2. Caries process reduced or arrested
  3. Bacteria become dormant

***Seal must be a good one

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7
Q

What teeth should have sealants placed?

A
  1. Pits and fissures of children’s primary teeth when at risk of developing caries
  2. Pits and fissures of children’s and adolescent’s permanent teeth when at risk of developing caries
  3. Pits and fissures of adults’ permanent teeth when at risk of developing caries
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8
Q

What are the first choice of material for dental sealants?

A

Resin-based sealants

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9
Q

Is there one thing that can be used to diagnose caries?

A

No, nothing has been shown to be completely diagnostic. Many things such as explorer, radiographs, technology etc.

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10
Q

6 criteria for sealant use?

A
  1. Age
  2. Oral hygiene
  3. Current caries or recent history
  4. Diet
  5. Fluoride history
  6. Tooth type and morphology
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11
Q

Caries susceptible pits & fissures by tooth type

A 
1st - Lower molars (about 50%)
2nd - Upper molars (35-40%)
3rd - U/L 2nd premolars
4th - Upper laterals & 1st premolars
5th - Upper centrals & lower 1st premolars
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12
Q

Why are deep pits and fissures susceptible to decay?

A
  • bristles too large to clean fissures

- collect food debris & bacteria

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13
Q

Examples of teeth that should be sealed

A
  1. Teeth with deep, narrow pits & fissures
  2. Occlusal surfaces of premolars & molars
  3. Buccal grooves & pits on Mandibular 1st & 2nd molars
  4. Lingual grooves & pits on Maxillary 1st & 2nd molars
  5. Lingual pits on upper anterior teeth
  6. Recently erupted, susceptible teeth
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14
Q

Teeth not indicated for sealants

A
  1. Occlusal or proximal caries present (no proximal)
  2. Well coalesced pits and fissures
  3. Teeth caries free for many years
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15
Q

Seal fissures with obvious caries?

A

No, do not seal

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16
Q

8 steps for application of sealants

A
  1. Isolate with rubber dam
  2. Cleanse with pumice and brush
  3. Rinse and dry thoroughly
  4. Apply acid for 20 seconds
  5. Rinse and dry completely. If contaminated, re-etch 15 sec.
  6. Apply sealant with brush or syringe
  7. Cure 20 sec. each area
  8. Check retention, occlusion, and contacts
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17
Q

T or F, Working with an assistant to apply sealants will improve the overall retention rate

A

True

18
Q

4 advantages to rubber dam isolation

A
  1. Maintains dry field
  2. Keeps moisture from breath off etched surfaces
  3. Keeps tongue away
  4. Barrier for infection control
19
Q

4 disadvantages to rubber dam isolation

A
  1. Difficult to clamp partially erupted teeth
  2. May require anesthesia for placement
  3. Patient phobias - suffocation
  4. Allergy to latex
20
Q

T or F, it is ok to use flavored polishing pastes to clean surface of tooth

A

False, Do not use flavored polishing pastes

21
Q

T or F, pumice removes smear layer, biofilm and pellicle

A

True

22
Q

T or F, Rinse well and dry the tooth after pumice

A

True

23
Q

2 approaches to sealants

A
  1. Non-invasive - just seal
    - -> 90% of sealants are performed this way
  2. Invasive - Open fissure & clean out before sealing
24
Q

What two burs can be used to explore suspicious fissures

A

1/4 round bur

132 F Diamond bur

25
Q

How long do you apply the acid etch?

A

20 seconds

26
Q

Which etch is preferred?

A

Gels are better, better control of placement with gel

27
Q

Resin tags create what?

A

Micromechanical retention

28
Q

T or F, use of self-etch is contraindicated for sealants?

A

True, use of bonding agent may enhance retention

29
Q

What does the tooth look like after it has been etched and dried

A

Frosty, etched and clean enamel

30
Q

What happens to the wettability on an etched surface vs an un-ethced surface

A

Etched: low contact angle

Un-etched: High contatact angle

31
Q

What happens if too much sealant is applied?

A

Bite will be high, occlusion will be off

32
Q

What is the minimum for light curing a sealant

A

Minimum is 20 seconds but you can go longer, cannot overcure

33
Q

Why do you rinse teeth or swipe with gauze immediately after light cure?

A
  • To remove oxygen inhibited layer of sealant
  • Remove bad taste
  • Reduce xenoestrogen exposure of BPA
34
Q

What bur is used to adjust contacts after rubber dam is removed?

A 
A football ultrafine diamond
#7404 bur
35
Q

T or F, Do not floss teeth after sealant is placed

A

False, floss teeth to make sure sealant flash has been removed.

36
Q

T or F, Sealants may not be visible over the years but they are still effective

A

True

37
Q

What is the chart entries for sealants?

A
  1. Date
  2. Teeth and surfaces sealed
  3. Diagnosis and rationale for Tx
  4. Isolation and material used
  5. Post Op Instructions
38
Q

How long until failures show up?

A

Most failures occur within the first 3-6 months

- All or part of sealant may come off

39
Q

What is the worst failure in sealants?

A

A sealant that leaks, does not come off, goes undetected & decays underneath

40
Q

What is visible in a leaking sealant

A
  1. Look for discoloration at the margins

2. Dark appearance under the sealant

Operative (7 decks)

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