1 / 36

Fissure sealants DCP1 S2 Lecture 8 - part 1 By Dr A. Eldarrat & A. Uni

Fissure sealants DCP1 S2 Lecture 8 - part 1 By Dr A. Eldarrat & A. Uni. Objectives. To understand the following: Role of fissure sealants in preventive dentistry. Indications/contraindications; advantages and disadvantages of fissure sealants.

osborn
Download Presentation

Fissure sealants DCP1 S2 Lecture 8 - part 1 By Dr A. Eldarrat & A. Uni

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Fissure sealants DCP1 S2 Lecture 8 - part 1By Dr A. Eldarrat & A. Uni

  2. Objectives To understand the following: • Role of fissure sealants in preventive dentistry. • Indications/contraindications; advantages and disadvantages of fissure sealants. • Different types of materials used as fissure sealants and their advantages and disadvantages.

  3. Objectives • Acid etch technique and the mechanism of bonding of resin based sealants. • To be able to apply fissure sealants (Composite resin sealants and Glass ionomer sealants) on natural teeth in the laboratory situation. • To be able to critically evaluate the quality of composite resin fissure sealants after placement.

  4. FISSURE CARIES

  5. Early caries in fissure confined to enamel only [Incipient Caries]

  6. Early caries in fissure Enamel spread [Incipient Caries]

  7. Caries in fissure Spread to DEJ and involves dentine

  8. Caries in fissure Dentine involvement – note: no cavitation

  9. Why do pits and fissures decay? • Morphology of the pits (buccal/palatal) and fissures

  10. Why do pits and fissures decay? • Two main types of pits and fissures: 1. Shallow, wide, V-shaped fissure

  11. Why do pits and fissures decay? 2. Deep, narrow I-shaped or bottle neck shaped fissures • Plaque retention • Mechanical plaque removal is difficult • Depth of fissure is in close proximity to the DEJ

  12. Diagnosis of pit/fissure caries Diagnosis of pit/fissure caries - can be very difficult 3 Possibilities • No caries • Definite caries • Questionable caries

  13. Are these fissures carious or just stained ?

  14. Are these fissures carious or just stained ?

  15. Management of Questionable pit/fissure early caries • Monitor tooth surface over period of time in conjunction with other caries preventive measures. • Mechanically open up fissures with a bur/air abrasion and check if carious (invasive?) • Fissure seal with fissure sealant.

  16. What is a Fissure sealant? Definition: A low viscosity material which is flowedinto pretreated pit or fissure on (occlusal, buccal, palatal surfaces) which fills the pits/fissures. • The Material polymerizes into a hard material. • Acts as a physical barrier between the sealed area of the tooth and the bacteria in the oral cavity. • Sealants are used as preventive and therapeutic treatment.

  17. How does a Fissure sealantprevent caries? 1. Physical barrier in the pit/fissure of the tooth. 2. Eliminate the environment conducive to s.mutans. 3. Make pit/fissures easier to clean by tooth brushing and mastication

  18. Indications for fissure sealing for children and adults • Caries risk status. • Tooth morphology. • Age of patient.

  19. Contraindications to fissure sealing • Shallow, self cleansing pits/fissures. • Patient with low or negligible caries risk (eg. no new lesions or past restorations). • Partially erupted teeth in which all pits/fissures not exposed to oral cavity.

  20. Cont. • If can not obtain excellent moisture control (for composite resin FS). • Occlusal caries has progressed into the dentine. • Tooth has proximal caries. • Uncooperative child/patient.

  21. Sealing over early occlusal caries?[Advantages and disadvantages] Caries can be in-activated if • use a CR sealant that is well bonded. • use GIC Fuji 7 sealant. (Chemical adhesion & high Fluoride release) Caries can progress • If place a CR sealant which is poorly bonded or partially lost. (Use your own clinical judgement and assess each case carefully)

  22. Partially erupted teethSeal or wait until fully erupted? For Composite Resin • If seal whilst partially erupted - Risk of sealant failure • Risk of caries development For Glass Ionomer Fissure sealant-Fuji 7 only • can be placed in situations where tooth can be partially erupted because of its ability to be placed in conditions where moisture control can not be optimally maintained. • More appropriate material to use in this clinical situation.

  23. What type of sealant materials are available? 1. Composite resin (CR) 2. Glass ionomer (GI)

  24. Composite resin sealants • BIS-GMA (Bowen’s resin) • low viscosity unfilled or partially filled resins. • Polymerised. 2 bottles (base and catalyst which are mixed together)

  25. Composite resin sealants a. Self-cured sealant. (also known as auto-cured or chemically-cured). b. Light-cured sealant. [white light (wavelength 420-490nm) equipped with a blue filter]. Kidd and Smith 1996

  26. Composite resin sealants • Advantages/Disadvantages • Clear/Opaque sealants

  27. Composite resin fissure sealant - light cured opaque type

  28. Glass ionomer sealants • Chemical bond to enamel. • Fluoride release. • New GIC material- Fuji 7 • high fluoride release (6 x more) than other restorative GICs. • has good flow properties and flow well into pits/fissures. • moisture tolerant. • has a strong fused layer which is acid resistant & continues to offer protection to occlusal surface even when it appears “visually” lost due to wear. • Restorative GICstend not to be suitedas fissure sealants as are thicker and do not flow well into narrow/deep pits & fissures

  29. Fuji 7 GIC

  30. Restorative Glass ionomer fissure sealant Mount & Hume, 2005

  31. Summary • Effective primary preventive measure against pit and fissure caries. - prevent plaque accumulation - hence prevent pit & fissure caries. • arrest very early pit/fissure caries. • Can be used as part of patients’ overall caries prevention/management plan.

  32. Summary • Conservative(Minimal Intervention). – non invasive • Relatively Painless.

  33. Summary • Benefitschildren and adults- if at risk pit/fissures sealed. • Commonly used fissure sealants are light cured resin sealants but the new Fuji 7 GIC material gives us more options • Cost effective – if careful case selection.

  34. Thank you

More Related