Week 4 - Pit and Fissure Sealants + Restoring Caries Flashcards
What are pit and fissure sealants
low viscosity, plastic material that can flow into, conform and occlude the put and fissure system of a tooth as a preventive measure against the development or progression of dental caries
Why do pit and fissure caries occur
- Plaque and cariogenic microbiota accumulate in narrow pits and fissures
- Even a single bristle of a toothbrush is too large to reach or clean it - it contains inaccessible plaque
What are the functions of P/F sealants (4)
- Physical barrier
Occlude the pit and fissures, stopping food and bacteria being stuck in there
- Eliminate Environment
Forming a barrier to the substrate that is needed for caries process to streptococcus mutants/ cariogenic bacteria
- Cleansibility
Providing an easily accessible area for natural cleansing by saliva flow and the chewing action and during toothbrushing
- Chemically realeasing fluoride
For GICs they can also act as a fluoride reservoir
What are the types of PF sealants based on method of polymerisation
- self curing/auto curing/ chemically curing
- Light curing
What are the different compositions of PF sealants
- composite resin (with or without fluoride)
- GIC
- Can be clear/opaque/coloured
What are the properties of resin sealants
- many are available with fluoride releasing properties
- Able to flow and adhere better than GIC
- Can withstand shearing masticatory forces better when in thin layer than GIC
- Normally opaque sealant is used because its easier to see when being placed and when reviewing sealants
- Clear is used to detect recurrent caries underneath the sealant (not really used)
What are the properties of GIC based sealants
- combined with fluoride
- can adhere under moist conditions
- lower retention rate in comparison to composite resins
- Should be considered in case where moisture control is not possible such as partially erupted molars
What is penetration coefficient
property to be able to flow into narrow pits and fissures.
The sealant material will adapt more closely to the enamel surface if it has a high coefficient of penetration, high surface tension and low viscosity
When do you use P/F sealants
- in any tooth with a non self cleansable pit or fissure
- Primary molars only if they have deep fissures
- 1 permanent molars, especially if they have deep fissures
- If there’s history of caries - premolars and 2nd permanent molars as well
- Permanent upper incisors with lingual pits
What are the benefits of sealants
- non sealed teeth are 7.5 times more likely to develop caries
- Children treated with P/F sealants are less likely to require permanent restorations
- there is a longer period between the placement of the sealants and the placing of permanent restorations and that these restorations were less extensive
What is the procedure for sealants
- Prep
- Acid etch clean enamel surface
- Avoid saliva contamination
- Pit and fissure preparation not needed
- Complete seal is important
- less is more
Explain tooth prep for sealants
- Remove the pellicle of plaque
Can be done through:
- Pumice water and a bristle brush
- Prophylaxis paste and bristle brush
- Dry bristle brush and probe
- Tooth brushing, wet or dry
- Air polishing using Prophy Jet
Explain step 1 acid etch
- Etch with 35% phosphoric acid and leave for 15 sec before rinsing
- Fluorosed and deciduous teeth need needs 30 sec
Explain step 2 - avoid saliva contamination
- Field isolation for moisture control
- Use cotton wool rolls/ absorbent cheek pads
- Use of high and slow speed suction
Explain step 3 - pit and fissure preparation not needed
not necessary to open the fissures up with a bur as long as a complete occlusion of the fissure system is achieved
