DHE132 Lecture 2

  1. Class I
    • This is caries affecting the pits and fissures of teeth (just the occlusal surface)
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  2. Class II
    • A carious lesion which involves the interproximal areas of posterior teeth. Often, this is best seen using bitewing radiographs.
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  3. Class III
    • Carious lesion involving the interproximal surfaces of anterior teeth.
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  4. Class IV
    • Carious lesion involving the interproximal surface on anterior teeth AS WELL AS the incisal edge.
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  5. Class V
    • Carious lesion affecting the cervical third of the tooth, both anterior or posterior.
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  6. Class VI
    • lesions involving cusp tips
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  7. 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
  8. 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
  9. 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
  10. Teeth at greatest risk for caries?
    Teeth with uncoalesced grooves are at greatest risk for caries
  11. Ideal Criteria for PFS Material?
    • Prolonged bonding to enamel
    • Biocompatibility
    • Ease of application
    • Low viscosity
    • Low solubility
    • Low cost
  12. Sealant Composite Resin Types:
    • Filled
    • Un-filled
    • Fluoride releasing
  13. Sealant Resin component :
    (Bis-GMA)= (bisphenol A-glycidyl methylacrylate)
  14. Sealant Polymerization method:
    • Light /
    • Chemical
    • Dual
  15. Indications for sealant:
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  16. 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’
  17. Enameloplasty
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  18. 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
  19. 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
  20. 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?
  21. Pre- Instructions for sealants:
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  22. sealant Post- Op Instructions:
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  23. Unfilled Sealant:
    Resin-based sealant that does not contain filler particles
  24. 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
  25. A properly etched tooth appearance is ________?
    chalky, frosty, dull
  26. If not etched enough, what is done? __________
    re-etch
  27. 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
  28. 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
  29. 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
  30. Autopolymerizated
    [chemical &/0r self-curing] is two pastes, a base and a catalyst, mixed together. (temporary crown and bridge)
  31. Dual cured
    [utilize both visible light and chemical reactions ](build-ups, cementation of porcelain restorations)
  32. 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
  33. 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.
  34. Chemical cure sealant advantages and disadvantages:
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  35. light cure sealant advantages and disadvantages:
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  36. failure retention:
    • Debris
    • Saliva
    • Air inclusion = voids
    • Manipulation of self cure
  37. 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%
  38. 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 %
  39. Risk associated with sealants:
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  40. Xenoestrogens
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    • 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
Author
dentalhygiene
ID
337661
Card Set
DHE132 Lecture 2
Description
DHE132 Lecture2
Updated