pits and fissure sealants Exam Questions And Answers

Why Pit and Fissure Sealants? - ANS 1.Preventative sealants •Prevention of dental caries 2.Therapeutic sealants •Attempt to stop the caries process in incipient lesions (caries limited to the enamel surface) what is pit and fissure sealant - ANS •Thin plastic coating (resin) •Placed in the pits and fissures of teeth as a physical barrier - keeps caries producing bacteria from colonizing •Mechanical retention what are the indications for sealants - ANS •Deep plaque-retentive pits and fissures •Incipient caries (check clinically and radiographically) •Xerostomia •Ortho appliances/bands •Radiation therapy (head and neck) •High caries experience •Newly erupted posterior teeth •Heavy plaque (poor plaque control) •High risk eating patterns Difficulties of brushing into fissures - ANS Sometimes, the fissure is shaped in an "I" formation that is very narrow but has a bulbous base. The formation is too narrow to accommodate toothbrush bristles. what are the contraindications for sealants - ANS •Radiographic evidence of proximal dental caries •Assessment of the pits and fissures indentifies that they are self cleansing what are the guidelines for sealant placement decision making - ANS no deep pit and fissure present - no high caries risk - don't seal no deep pit and fissure present - high caries risk - seal deep pit and fissure present - no evidence of proximal or occlusal dentinal caries - seal deep pit and fissure present - evidence of proximal or occlusal dentinal caries - restore deep pit and fissure present - no evidence of incipient occlusal caries - seal deep pit and fissure present - evidence of incipient occlusal caries - seal what cause sealant failure - ANS most often from salivary contamination during placement types of sealants - ANS 1.Self-curing or autopolymerized sealants -Once the monomer and catalyst are mixed together they begin to harden (might be useful in a community health setting where no equipment is available) 2.Photopolymerized or visible light-cured sealants 3.Filled sealants -Higher bond strength; increase flow (viscosity); 2x as wear resistant as unfilled; should be checked with articulating paper to make sure the occlusal is ok 4.Unfilled sealants -Because they do not contain particles they are not as wear resistant and can wear away over long periods of time 5.Fluoride-releasing sealants (glass ionomer sealants) -Can be useful with incipient lesions although they have high rates of occlusal wear what is UltraSeal XT - ANS •Thixotropic, resin sealant •58% filled for optimum strength •radiopaque step 1 of pit and fissure sealant - ANS Pumice and ETCH •Pumice •rinse •Isolate teeth •Apply the etch material -15 - 20 seconds -Rinse with full air and water spray (30 seconds) -Dry -Change saturated cotton rolls step 2 of pit and fissure sealant - ANS Dry •Dry by gently blowing area with moisture-free and oil-free air (DON'T RINSE) step 3 of pit and fissure sealant - ANS seal •Express a small drop of sealant and spread it through the pits and fissures step 4 of pit and fissure sealant - ANS cure •Cure sealant material for 20 seconds (light cure = 20s) •Check with explorer and adjust if needed how does pit and fissure sealant work - ANS Pit and fissure sealant material will literally flow into the deep pit and fissured areas on occlusal surfaces and seal them from bacterial activity armamentarium for placing sealants - ANS mirror, explorer, cotton pliers, sealant resin, etchant, gauze, low-speed handpiece, curing light with shield, air/water syringe tip, no. 6 or 8 round bur or a green or white stone, triangular saliva absorbers or rubber dam setup, air/water syringe tip, saliva ejector, high speed suction, articulating paper, floss, pumice, cotton rolls and garmer holder, posterior scaler 2 ways to isolate for applying sealants - ANS 1.Garmer/isolators 2.Rubber dam summar for sealant placement - ANS 1.Pumice 2.Isolate the teeth 3.Apply the etch: 15-20 seconds 4.Rinse off the etch: 30 seconds 5.Dry completely 6.Apply the sealant and spread through pits and fissures 7.Cure: 20 seconds