Sim Manual

Question 1

Mechanical options for fissure sealing include

Answer 1

• Resin fissure sealing

- Glass ionomer fissure sealing

Question 2

When do you use resin fissure sealing?

Answer 2

• Minimally stained susceptible fissure system
• Optimal moisture control achievable
• Some benefit associated with temporarily retained sealant that releases fluoride

Question 3

When do you use glass ionomer fissure sealing?

Answer 3

• Optimal moisture control difficult to achieve

Question 4

Indications for resin fissure sealing

Answer 4

• Usually within 2-4 years of eruption
• Minimal evidence of staining in depth of fissure
• Good moisture control possible
• Caries susceptible fissure e.g. deep complex fissure pattern, caries in fissures in other teeth, patient with moderate to high caries rate

Question 5

Contra-indications for resin-fissure sealing

Answer 5

• Evidence of caries: clinical or radiographic
• Unable to isolate with rubber dam
• Low caries risk

Question 6

Procedure of resin-fissure sealing

Answer 6

• Obtain BW radiographs to confirm non-carious lesions
• Check occlusal contacts
• Clean tooth with pumice and slurry and bristle brush + wash
• Isolate tooth with rubber dam (single tooth isolation)
• Etch 30 sec; Wash 20 sec; Dry 10 sec (dessicate enamel)
• Seal - apply small amount of FS resin with tip of perio probe
• Allow resin to flow into fissures with gravity to avoid air entrapment
• Cure 40 seconds
• Remove rubber dam and check and adjust occlusion

Question 7

Indications of glass ionomer fissure sealing

Answer 7

• Caries susceptible fissures
• Achievement of optimal moisture control is either difficult or not possible e.g. tooth is partly erupted
• Radiograph unobtainable (e.g. ortho band in place)

Question 8

Contra-indications of glass ionomer fissure sealing

Answer 8

Tooth is suitable for resin fissure sealing

Question 9

Examples of glass ionomer fissure sealing

Answer 9

• Fuji VII or Fuji III LC

Question 10

Glass ionomer fissure sealing procedure

Answer 10

• Obtain BW radiographs to confirm non-carious lesions
• Check occlusal contacts
• Clean tooth with pumice slurry and bristle brush + wash
• Isolate tooth with cotton rolls/ Garmer’s Clamp
• Dentine condition 20 sec
• Wash 10-15 sec
• Dry but do not dessicate. Remove when its just enough
• Activate and mix Fuji VII capsule or mix Fuji III
• Seal - extrude a small amount of sealant along fissure pattern - use ball burnisher (large end) to adapt and remove gross excess
• Cure 40 seconds
• Place a thin layer of a protective coating (e.g. Bonding agent, duraphat, G-coat) over GI fissure seal to protect from moisture contamination during the first 24 hours
• Remove excess (using a large spoon excavator or carving instrument
• Check occlusion
• Reapply protective coating