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Pedo > Pit and Fissure Caries > Flashcards

Pit and Fissure Caries Flashcards

1
Q

Which patients should have fissure sealants placed?

A
  1. Extensive caries in primary teeth => seal permanent molars when erupt
  2. Special needs (e.g medically compromised, physically/dentally disables, learning difficulties)
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2
Q

Where should FS be placed for patients of various caries risk levels?

A
  • High: primary molars + permanent posterior teeth
  • Medium: permanent molars
  • Low: only teeth w very deep retentive fissures
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3
Q

Which teeth should have fissure sealants placed?

A
  1. Sound teeth with deep fissures that are difficult to clean
  2. Occlusal caries in one permanent 6:
    - Seal fissures of other 6s
    - Assess need to seal 7s when they erupt sufficiently
  3. Dental anomalies (e.g dens evaginatus, dens invaginatus, cusp of Carabelli, hypomineralisation, double tooth)
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4
Q

What is the presentation of deep fissures and what is the treatment?

A
  • Stained P&F
  • No radiographic evidence of P&F caries
  • Tx: FS
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5
Q

What is the presentation of enamel caries and what is the treatment?

A
  • Chalky looking P&F, rough surface
  • No radiographic evidence of P&F caries
  • Tx: FS
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6
Q

What is the presentation of dentinal caries and what is the treatment?

A
  • Discoloured P&F
  • Exposed dentine
  • Radiographic signs of P&F caries
  • Tx: restoration
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7
Q

What is the presentation of an undermining lesion beneath enamel and what is the treatment?

A

Brown-grey discolouration radiating peripherally from pit
Tx: restoration

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8
Q

What are the advantages and disadvantages of filled vs unfilled CR FS?

A

Filled: greater strength, more viscous
Unfilled: lower strength, less viscous => penetrate deeper into fissure system => higher retention rate

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9
Q

What are the advantages and disadvantages of clear vs opaque CR FS?

A

Clear: Able to monitor fissures sealed underneath
Opaque (e.g ClinPro)
- Easier to see during placement & checking at recall
- Prevent subsequent dentist from removing sealant (e,g think caries active when already arrested)

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10
Q

What GIC is used as a FS?

A

Fuji VII is a flowable GIC – contains higher acid content => more watery. Available in white and pink

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11
Q

When are GIC sealants indicated?

A

Poor moisture control, GIC has poor retention rate

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12
Q

What is the long term mx of FS?

A
  • Monitor at appropriate intervals (x-rays where appropriate)
  • Defective sealants should be investigated & repaired/replaced
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13
Q

What is a preventive resin restoration?

A
  • Removing isolated carious lesions within P&F
  • Restore w CR
  • Seal remaining fissures
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14
Q

What are the indications for PRRs?

A

1.P&F caries into dentine:
- High risk P&F remaining
- No pulpal involvement
*extension for prevention: when one groove carious other grooves also prone to caries

  1. Prophylactic tx of dens evaginatus
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15
Q

What is a fissure sealant?

A

Substance placed in P&F to prevent plaque, bacteria and fermentable foods like sugars, starches from entering fissures & causing caries

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16
Q

Describe the procedure for placing a FS

A
  1. Clinical examination
  2. BW radiograph – check for dentinal caries (occlusal & proximal)
  3. Isolate tooth
    - Ideally LA + RDI
    - Cotton roll isolation + salivary ejector
  4. Clean surface
    - Run probe through fissures
    - Use intra-coronal brush + pumice-water slurry
  5. Dry surface
  6. Etch with 30-50% phosphoric acid for 15-20s then wash for 20s and dry – observe for frosted surface
  7. Apply sealant – 2mm up cuspal inclines, include buccal pits/palatal grooves; then cure for 20s
17
Q

Where would cotton rolls be placed in maxillary and mandibular teeth for cotton roll isolation?

A
  • Max tooth: buccal
  • Mand tooth: upper buccal + lower lingual
18
Q

What are the components to check after placing a FS?

A
  1. Retention: try to flick off as hard as possible using sharp probe
  2. Extension: max palatal pit, mand buccal pit
  3. Check for voids: run sharp probe along FS (tactile sensation)
    - If big voids – add FS
    - If small voids – drill out and redo
  4. Occlusion
    - use articulating paper and white stone
19
Q

How can FS be placed on partially erupted teeth?

A

Partially erupted – poor moisture control
1. Use GIC FS
2. Use bonding system + resin FS

Pedo (15 decks)

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