fissure sealant an preventive resin restoration Flashcards
what is fissure sealant
a material places in the pits a fissures of teeth in order to prevent development of dental caries
what is a resin restoration
restoration of a carious lesion into dentine where the lesion is limited to areas of the tooth not bearing occlusal loads
what is dental caries
Dental caries is a disease caused by an ecological shift in the composition and activity of the bacterial biofilm when exposed over time to fermentable carbohydrates, leading to a break in the balance between demineralisation and remineralisation
as tooth brush bristles can’t access the fissure system what results
icro-organisms remain within the fissure system undisturbed. The tooth is most susceptible to plaque stagnation during eruption - 12 -18 months
Carious lesions are preventable by averting onset, and managable by implementing interventions, which may halt progression from early stage of the disease to cavitation, characterised by enamel demineralisation to frank cavitation
what is issues form a primary prevention perspective
From a primary prevention perspective, anatomic grooves or pits and fissures on occlusal surfaces of permanent molars trap food debris and promote the presence of bacterial boil, thereby increasing the risk of developing carious lesions.
Effectively penetrating and sealing these surfaces with a dental material - for example - a pit and fissure sealant - can prevent lesions and is part of a comprehensive caries management approach
what is the secondary prevention
sealants can inhibit the progression of non cavitated carious lesions
- part of comprehensive cares management approach
what percentage does pits and fissures account for
12.5%
what percentage of carious lesions are in the pits and fissures
66%
why do we use fissure sealant
- highly effective at preventing dental caries
- caries reduction 60%
- retention rate of 52% up to 4 years
- reduce incidence of occlusal carious lesions in permeant molars by 76% after 2-3 years of follow up
- for a population with caries prevalence;ence of 30%, 207 carious lesions would be prevented out of 100 sealant applications
what is the benefits of fluoride varnish
73% reduction in the incidence of occlusal carious lesions in permanent molars after 2-3 years
who is selected for fissure sealants
- all children at high risk of dental caries
- susceptible sites of permeant teeth
- could include palatal pits on upper lateral incisors
- good practice to FS 2nd primary molars
why are the patients factors and tooth factors on when FS should be used
Patient factors
- caries In primary teeth
- caries in other permanent molars
- patients with underlying medical physical or emotional problems
- risk factors (diet)
Tooth factors
- depth of fissures
- hypomineralisation
- hypoplasia
- inaccessible for cleaning
describe different placement techniques
Placement techniques vary based on sealant type and the manufacturer or brand
JADA 2016 - when assessing retention, GI sealants may have 5 times greater risk of experiencing loss of retention from the tooth compared with resin-based sealants after 2-3 years
The guideline panel suggests that clinicians take into account the likelihood of experience of lack of retention when choosing the type of sealant material most appropriate for a specific patient and clinical scenario
For example, in situations where dry isolation is difficult [eg partially erupted tooth], then a material that is more hydrophilic e.g. GI would be preferable to a hydrophobic resin-based sealant
On the other hand if the tooth can be isolated to ensure dry site, then resin-based sealant may be preferable
How are fissure sealants placed
- clean the pits and fissures
- Isolate the tooth - moisture control
- Ethc ,wash + dry
- Apply bonding agent, cure
- Apply sealant, cure
- Evaluate
