-
Class I
- This is caries affecting the pits and fissures of teeth (just the occlusal surface)
-
Class II
- A carious lesion which involves the interproximal areas of posterior teeth. Often, this is best seen using bitewing radiographs.
-
Class III
- Carious lesion involving the interproximal surfaces of anterior teeth.
-
Class IV
- Carious lesion involving the interproximal surface on anterior teeth AS WELL AS the incisal edge.
-
Class V
- Carious lesion affecting the cervical third of the tooth, both anterior or posterior.
-
Class VI
- lesions involving cusp tips
-
chart:
Class I = Molars and Pre-molars
Class II = Molars and Pre-molars
Class III = Canines / Laterals / Incisors
Class IV = Canines / Laterals / Incisors
Class V = All teeth
Class VI = All teeth
- chart:
- Class I = Molars and Pre-molars
- Class II = Molars and Pre-molars
- Class III = Canines / Laterals / Incisors
- Class IV = Canines / Laterals / Incisors
- Class V = All teeth
- Class VI = All teeth
-
Can you name some preventative programs to combat caries?
- Public water fluoridation
- School fluoride programs
- Fl2 tooth paste
- Fl2 rinse otc
- In-office tx
- Tb – homecare = mechanical removal
- Fl2 = chemical prevention
- DietjQuery112405438231463210261_1517287045017
-
PIT and FISSURE SEALANTS purpose?
- Prevent carious forming bacteria from penetrating into all micropores, cracks, pits, and fissures on the occlusal (biting) surfaces
- Physical barrier
- Deciduous and permanent
- Noncarious
- Material: unfilled or lightly filled resins
- Conservative
- Systemic Fl2 is still greatest benefit
-
Teeth at greatest risk for caries?
Teeth with uncoalesced grooves are at greatest risk for caries
-
Ideal Criteria for PFS Material?
- Prolonged bonding to enamel
- Biocompatibility
- Ease of application
- Low viscosity
- Low solubility
- Low cost
-
Sealant Composite Resin Types:
- Filled
- Un-filled
- Fluoride releasing
-
Sealant Resin component :
(Bis-GMA)= (bisphenol A-glycidyl methylacrylate)
-
Sealant Polymerization method:
-
-
Contraindications for sealants:
- Dry field cannot be maintained
- Radiographic evidence of proximal caries
- Open carious lesions exists on occlusal or other surface of the same tooth: “Enameloplasty ”
- If large occlusal restoration already present
- Teeth that are well coalesced (fused/blended) or shallow, easily cleaned pits and fissures
- fluoride and sealants do not mix
- Patient has allergy to ‘methacrylate’
-
-
Which teeth do you think are at the highest risk for carious lesions? Why?
- lower molars— about 50%
- upper molars— about 35% to 40%
- upper and lower second premolars
- upper laterals and upper first premolars
- upper centrals and lower first premolars
- caries occurs most often in upper and lower molars = 85% to 90% of pit and fissure caries
-
How effective are fissure sealants at preventing caries?
- sealed with resin-based sealant
- 79% to 92% after 12 months
- 71% to 85% at 24 months
- 61% to 80% at 36 months
- 52% at 48 months
- 72% at 54 months
- 39% at 9 years
-
Rational for sealant placement
- Disease susceptibility of the tooth
- 3 - 4 yrs after deciduous teeth have erupted
- 6 -7 yrs first permanent molars have erupted
- 11 – 13 yrs second permanent molars and premolars have eruptedAdults if caries prone – sometimes due to health changes, medications, cancer treatment, etc
- Tooth recently erupted (less than 4 yrs prior)
- Xerostomia or Low saliva flow
- Deep pits and fissures – uncoalesced
- Fluoride treatments are not suspended
- Orthodontic pt.
- Caries
- patients’ age ??
- Can you seal primary teeth?
-
Pre- Instructions for sealants:
-
sealant Post- Op Instructions:
-
Unfilled Sealant:
Resin-based sealant that does not contain filler particles
-
Acid Etch
- Provides mechanical retention with interlocking mechanical ‘tags’
- Phosphoric acid (37% - 50%)
- Purpose provide mechanical retention
- Improves mechanical retention by:
- Cleanses the area
- Increases surface area
- Improves wettability
-
A properly etched tooth appearance is ________?
chalky, frosty, dull
-
If not etched enough, what is done? __________
re-etch
-
Isolation sealant:
- Isolate (for optimum bond):
- Rubber dam
- Cotton rolls
- Triangular pads (Dri Angle or Dri Aid)
- Saliva ejector to reduce saliva
- Check for oil and moisture in h2o line
- Use ‘clean’ air
-
6 main steps for placing sealants:
- Prepare tooth [non-fl2 prophy paste or pumice]
- Isolate and dry
- Acid etch/condition
- Rinse, dry, isolate, dry again
- Apply sealant and cure
- Check occlusion and contacts
-
Polymerization:
- Polymerization \ chemical reaction between monomers / join together to form long-chain, high molecular weight molecules called polymers=polymer-ization
- Chemicals initiating polymerization reaction are: initiators and activators
-
Autopolymerizated
[chemical &/0r self-curing] is two pastes, a base and a catalyst, mixed together. (temporary crown and bridge)
-
Dual cured
[utilize both visible light and chemical reactions ](build-ups, cementation of porcelain restorations)
-
Light Cured
- photopolymerization
- No mixing required, longer working time.
- A special light called a curing light is used. **Damages Retina of the eye**
Operators and patients must use shielding
-
Armamentarium for sealant:
- Flour of pumice or prophy paste without fluoride or air polisher
- Dental dam \ cotton rolls
- Check occlusion with articulating paper and adjust as necessary.
- Check contacts with floss.
-
Chemical cure sealant advantages and disadvantages:
-
light cure sealant advantages and disadvantages:
-
failure retention:
- Debris
- Saliva
- Air inclusion = voids
- Manipulation of self cure
-
glass ionomer sealants:
- can be applied in mouths with some moisture
- protected better against caries [fl2 release]
- technique-sensitivity\operator error
- none lost all their sealant at 6 months with or without tooth preparation
- Loss rate at 2 years
- with tooth preparation was 60%.
- without preparation was 100%
-
Resin-based
- Most used in US
- Resin-based pit-and-fissure sealants lasted longer
- technique-sensitivity\operator error
- none lost all their sealant at 6 months with or without tooth preparation
- Loss rate at 2 years
- with tooth preparation was 32%.
- without preparation was 80 %
-
Risk associated with sealants:
-
Xenoestrogens
- are industrially made chemical compounds which disrupt communication within the bodies’ endocrine/ hormone producing organs.
- These compounds have a negative estrogenic effect that differs chemically from naturally occurring hormones produced by living organisms.
- have a cumulative effect
- Their potential ecological and human health impact is under study and is of great concern to endocrinologists
|
|
