Pits & fissure sealant l Pediatric dentistry MCQs

Pits & fissure sealant  l Pediatric dentistry & dentistry for children MCQs for dental students

 

Pit and fissure sealant:

• are the organic polymer (Resin) which are applied to pit and fissure of carious susceptible teeth forming a micromechanical retained physically protective layer that acts to prevent the demineralization of enamel by blocking the interaction of cariogenic bacteria and their nutrient substrate, thus eliminating the harmful acidic byproducts.

 

N.B

• On an average these sealant remain in place for 5-7 year.

• Cyanoacrylates bis-GMA (bis phenol glycidyl methaacrylate,

• urethane dimetha-acrylate are the material commonly used as pit and fissure sealant.

• U and V type fissures are usually shallow and wide, tend to be self-cleansable and are caries resistant.

• Patients are asked to report for regular recalls after sealant placement. if the sealant is lost completely or partially, it should be replaced. Clear and tooth colored sealants are esthetic but are difficult to detect on recall examinations. Typically. resin adhesion to etched enamel requires a clean, dry enamel surface. Resins used as sealants are typically not moisture tolerant.

• In general, caries on occlusal and buccal / palatal surfaces account For almost 90% of caries experienced in children and adolescents. the reason for this high rate of caries relates specifically to the pit and fissure morphology of occlusal and buccal/palatal surfaces that are not affected by the caries preventive effects of systemic and topical fluorides.

• Isolation of field and access to the pits and fissures contribute to sealant success. Teeth should therefore be fully erupted into the oral cavity before attempting the placement of a resin sealant.

 

Sealant are indicated in:

• the pit and fissure of non carious primary and permanent teeth. Recently erupted teeth with deep and pit are the ideal indication.

 

Pit and fissure sealant are contraindicated in:

1. carious teeth.
2. In teeth with well coalesced or blended pit and fissure,
3. teeth with shallow open groove.
4. already restored teeth.

 Technique:

1. clean teeth
2. isolate teeth with cotton rolls or rubber dam.
3. acid etch tooth surfaces apply 15% to 40% phosphoric acid for 15 to 60 seconds
4. rinse for 30 second
5. dry for l0 seconds, dry with compressed air for 15 seconds .
6. Apply sealant.
7. check occlusion.

 

Classification:

 

1. Depending on the type of curing agent

First generation sealants:

• Polymerized with UV light at a wavelength of 356 nm

Second generation sealants (auto polymerization):

• are mostly unfilled resin and have better retention than the first generation

Third generation sealants:

• are light cured by visible (blue) light at a wavelength of 430 nm and 490 nm. It may be unfilled or filled

 

Fourth generation sealants are fluoride containing sealants

 

2. According to color

• Transparent—clear, pink, amber
• Opaque— tooth colored, white
• Tinted

 

3. According to fluoride content

• Fluoridated
• Non flouridated

 

4. According to filler content :

• Unfilled.
• Filled
• Semifilled

 

5. According to method of polymerization :

• Autopolymerized
• Light cured.
• Laser cured

PRR (preventive resin restoration) : 

• if there are carious areas on the occlusal surface you drill those areas slightly place flowable or packable composite and fissure sealants on the rest of the fissures

 

PRR ( preventive resin restoration) TYPES:

Type A :

•  caries are confined to the enamel

Type B :

•  caries are small but extend to the dentine

Type C :

•  caries are deeper into the dentine