Week 1 PP Flashcards
How Sealants Work
- Bacteria accumulate in the narrow pits and fissues
- Even a single toothbrush bristle is too large to enter and clean pits and fissures
- Enamel at the base of fissure is thinner than the rest of the tooth
- The sealant acts as a physical barrier
Indications for Sealant Placement
- Patient with poor oral hygiene
- High risk of caries
- Lack of exposure to fluoride
- High-sugar diet
- Dentinal defects
- Underlying systemic diseases
- Medications that affect the oral environment
- Fully erupted tooth
Contraindications to Sealant Placement
- Lack of pits and fissures - if they grind alot and create a smooth occlusal surface
- Apparent occlusal decay
- Interproximal decay - unless it is incipient as this can actually be beneficial for it to stop further decay from happening
- Insufficient eruption of a tooth
- Soon-to-be-lost primary teeth
- Poor patient cooperation in the dental chair (ex. small children)
2 Main Types of Sealant Materials
- Composite resin
- Glass Ionomer (Fuji Triage) - this is what we use at SAIT
2 Types of Fillers in Sealant Materials
Filled resins - makes sealant more rigid, able to withstand force from opposing arch - you must always adjust bite if its too high because it will not self adjust due to rigidity
Unfilled resins - easily adjustable in terms of the patients bite (we only adjust the bite on dexter typically) - however, if the bite is slightly too high it will typically self adjust in a few days from biting forces
Method of Polymerization
The major difference among the materials is the method of setting (polymerization)
- Self cured (chemical cured) - about a minute of working time
-base and catalyst, when mixed they harden - Light-cured - no mixing required
General tips on sealant materials..
- Replace caps on syringes and bottles immediately after use
- Do not expose the materials to air or light
- Do not store the materials in proximity to eugenol-containing products
- Most etchant and sealant materials are designed to be used at room temperatures
- The shelf lives of most sealant products at room temperature reange from 18 to 36 months
Procedure Methods - Resin based
- Surface cleaned (pumice) - polish, rinse dry
- Etching of surface
- Isolation
- Sealant placement
- Check integrity of sealant, no voids, no bubbles, adjust bite as needed
Placement Technique for Resin Based
-The surface to be sealaed must first be cleaned with a rubber cup and pumice
-Retention of the sealant is attained by etching the enamel with 37% phosphoric acid
-After etching, rinsing, and drying of the enamel, isolation of the field is VERY important
-The sealant is applied to the pits, fissures, and the surrounding enamel and is cured
-Any moisture on the tooth could result in failure of the sealant to adhere
-Moisture could come from saliva, from an air water syringe that leaks water into the air, or even from the patient’s breath
-if moisture contamination occurs, the sealant could be lost immediately or partially lost at a later date
-Also, leakage could occur around the partially retained sealant, resulting in decay beneath the sealant
Why Glass Ionomer Sealants?
- According to the Journal of the American Dental Association glass ionomer and resin-based sealants are equally effective in preventing tooth decay.
- The material is hydrophilic in nature, which makes it compatible with the challenging environment of the mouth.
- Molars can be difficult to dry especially on an erupting tooth. Since one of the ingredients is water, saliva isn’t an issue setting the seal
Advantages of Glass Ionomer Sealants
-Contains fluoride
-Generally easier to place then resin-based
-Require no etching or bonding agent
-Can be used on a smooth tooth surface because they are less fluid
-Don’t require the area t obe completly dry for placement becase they are not moisture sensitive -Bond directly with enamel
-Doesn’t contain methacrylate or bisphenol A (BPA)
How Glass Ionomer Releases Fluoride
- Fluoride is released continuously for about 2 years
- Allows remineralization of enamel
- The fluoride ions are taken up by the enamel,
which renders the tooth structure less susceptible
to acid challenge through disruption of bacterial
activity. - Ideal for patients with a high caries rate or
xerostomia
Glass Ionomer Sealants
- Glass ionomers offer an option for applying
sealants to newly erupting teeth, where resin based sealants may be contra-indicated. - GC Fuji Triage is a chemical-set glass ionomer
sealant and surface protection material that
allows the dentist to seal a newly emerging
permanent molar when isolation is difficult.
Technique for Glass Ionomer Sealants
-The GC Fuji Triage kit contains glass inomer capsules (in either pink or white), an applier, GC Fuji Cavity Conditioner and GC Fuji Varnish
-Prep tooth (clean, polish)
-Etching
-Isolation
-Place Sealant
-Inspect
Inspection of Sealant Placement
-Inspect sealed surface and occlusion
-Do NOT check with an explorer this will compromise the sealant
-If necessary, re-condition and reapply the material
-at 23C, the material has a working time of 1 min 40 secs from the time of mixing, at higher temps the working time is shorter
-Setting time is 2 minutes and 30 secs (could be as short as 2 mins)
-The material is self-curing
Why choose GC Fuji Triage?
- White shade is for fully erupted teeth; pink shade offers a visual indicator that is ideal for newly erupted molars
- Seals and protects tooth enamel
- Six times more fluoride than any other sealant
- Releases fluroide for up to 24 months to help prevent decay from acid and bacteria
-brush/polish occlusal surface util clean
-rinse thoroughly
-isolate area
-Apply cavity conditioner for 10 seconds
-Rinse thoroughly
-tap or shake capsule to loosen power, depress the plunger and hold for 2 seconds
-mix for 10 seconds in a GF capsule mixer, do not click prior to mixing
-working time is 1 min and 40 seconds from the start of mixing, do not over mix
-insert into GC capsule and click twice to prime the capsure
-isolate further, if necessary
-apply GC fuji triage sealant
-adapt material to tooth surface with finger or microbrush
-material will be completely set 2 mins 30 seconds afer start of mix
Diet recommendation after GC Fuji Triage
-soft food diet recommended for up to 48 hours after sealant (GC Fuji Triage
Resin Sealant (Clin Pro) - Differences from GI
Preparation (Cleaning) - Pumice (no fluoride)
Etch - YES!
Prepation (Material) - Place new tip on syringe
Isolation - Cotton rolls, Garmer, Dri-Angle, dental dam
Polymerization - light cure
Adjustment - round bur
Glass Ionomer GC Fuji Triage (differences from resin)
Preparation (Cleaning) - Toothbrush
Etch - Cavity Conditioner
Prep (material) - Triturate (10 seconds)
Isolation - Cotton Rolls, Garmer, Dri-angle, Dental Dam
Polymerization - Self Cure
Adjustment - Enhance Polishing Point
What to do if too much sealant material is placed?
Use microbrush prior to setting
What to do if sealant blocks interproximal contact area?
Floss interproximal
What to do if sealant has holes/bubbles in surface
There should be no voids if you properly use a wet finger and press down firmly after first application, but if material hasn’t set yet fill voids with extra material that is still in extruder gun and press down firmly again
What to do if Sealant is high interfering in occlusion?
Check occlusion; dentist adjust with bur (Assistant in Alberta can adjust)
