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Pit and Fissure Sealants in Preventive Dentistry Pit and Fissure Sealants.

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Presentation on theme: "Pit and Fissure Sealants in Preventive Dentistry Pit and Fissure Sealants."— Presentation transcript:

1 Pit and Fissure Sealants in Preventive Dentistry Pit and Fissure Sealants

2 The focus of this presentation is on the role that dental sealants play in preventive dentistry, and two types of placement techniques: the traditional method and a no-rinse technique. Pit and Fissure Sealants

3 Role of dental sealants in preventive dentistry: Used in combination with patient education, effective personal oral hygiene, and the use of fluorides, sealants are major factors in the prevention of dental caries. Pit and Fissure Sealants

4 Dental Sealants Sealants are plastic coverings for pits and fissures in teeth that provide mechanical barrier against cariogenic bacteria The procedure is esthetic, non-invasive, and cost- effective for dental patients Sealants are applied by dental professionals, including: Dentists Registered Dental Hygienists Registered Dental Assistants with Certification Pit and Fissure Sealants

5 How to determine who should have a dental sealant placed: Assess the caries risk of the patient and their individual teeth Caries risk factors include: Accumulations of plaque Cariogenic diet History of caries in the patient or the patients family Low fluoride intake Pit and fissure anatomy Pit and Fissure Sealants

6 Other Considerations: Teeth can be sealed if pits and fissures are caries free Teeth with deep grooves and pits will benefit from sealants being placed as soon as possible after eruption If interproximal caries are present via radiographs a sealant should not be placed Frank pit or fissure caries should not be sealed Pit and Fissure Sealants

7 Situations where sealants would not be recommended: Inability to isolate and maintain a dry field Primary teeth close to exfoliation Presence of decay Any known allergies to the sealant material Pit and Fissure Sealants

8 Glass ionomer vs.resin-based sealants: Fluoride releasing glass ionomer sealants are a good choice for teeth that are: Partially erupted Difficult to isolate Glass ionomer sealants are moisture tolerant Excellent as a transitional sealant Pit and Fissure Sealants

9 Glass ionomer vs. resin-based sealants (cont.) Once the tooth is totally erupted, a resin-based sealant should be placed Resin-based sealants provide higher bond strengths and longer retention than glass ionomer sealants Pit and Fissure Sealants

10 Are sealants recommended for both children and adults? Susceptibility to decay can exist in any tooth with pits and fissures This includes the primary teeth of children, and the permanent teeth of children and adults The caries risk status of an individual can change over a period of time during both adolescence and adulthood Therefore - sealants really arent just for kids. Pit and Fissure Sealants

11 Long-term Success of Sealant Therapy Dependent on vigilant recall and repair if necessary Even partial loss of a sealant can lead to a surface with a risk for caries similar to one never sealed Studies that incorporated routine recall and maintenance report >80% success after a decade or more Pit and Fissure Sealants

12 Sealant Placement Techniques Using a Resin-Based Material Traditional Technique No-rinse Technique Pit and Fissure Sealants

13 Traditional Sealant Placement Procedure Pit and Fissure Sealants

14 Select teeth to be sealed and isolate Pit and Fissure Sealants

15 Clean the tooth surfaces with an air polisher or prophy paste using a rubber prophy cup or brush Pit and Fissure Sealants

16 Enamel cleaned of debris Pit and Fissure Sealants

17 Etch the enamel (minimum of 15 seconds). Pit and Fissure Sealants

18 Rinse and dry etched enamel Pit and Fissure Sealants

19 Gently rinse etchant and look for a frosty white appearance Pit and Fissure Sealants

20 Apply sealant material Pit and Fissure Sealants

21 Light cure for time period recommended via product instructions. Colored sealant material turns from pink to tooth colored after light-curing. Pit and Fissure Sealants

22 Check sealant coverage using articulating paper. Arrows indicate the points of contact. Pit and Fissure Sealants

23 No-Rinse Sealant Placement Technique Pit and Fissure Sealants

24 No-Rinse Sealant Placement Technique: 3M ESPE Adper Prompt Self-Etch Adhesive and 3M ESPE Clinpro Sealant: This technique uses a self-etching dental adhesive to bond the sealant to the tooth Pit and Fissure Sealants

25 Adper Prompt Self-Etch Adhesive Indications For Use: Bonding light-cured composite and compomer materials to dentin and enamel Desensitization of exposed root surfaces Bonding of light-cure resin based pit and fissure sealants Unidose L-Pop delivery system Two-vial delivery system Pit and Fissure Sealants

26 Self-etch Adhesive Clinical Technique Thoroughly clean the teeth to remove plaque and debris from the enamel surfaces and fissures Do not use any cleaning medium that may contain fluoride or oils as it may affect the adhesion value Rinse thoroughly with water and dry Isolate the tooth (e.g. with cotton rolls, rubber dam) Dry the surface to be sealed Activate the L-Pop Pit and Fissure Sealants

27 Self-Etch Adhesive: L-Pop Activation Squeeze the material from the red reservoir into the yellow (middle) reservoir The middle reservoir will expand indicating proper transfer of fluid Pit and Fissure Sealants

28 Fold back the red reservoir until it meets the flat face of the yellow reservoir Keep the red reservoir tightly squeezed while bending the package to prevent the material from flowing back Squeeze the liquid from the yellow reservoir into the blue reservoir Pit and Fissure Sealants

29 Apply a churning or spinning motion to the applicator for five seconds to mix the adhesive and fully coat the applicator tip Pit and Fissure Sealants

30 A lightly yellow-tinted applicator tip indicates proper activation. If a yellow color is not obtained unfold the L-Pop, reactivate, and apply a spinning motion to the applicator for 5 seconds to mix the adhesive. Pit and Fissure Sealants

31 Clear tip indicates improper activation Tip must be yellow indicating proper activation Adper Prompt Self-Etch Adhesive Pit and Fissure Sealants

32 Apply adhesive onto the surface to be sealed; scrub for 15 second applying moderate finger pressure. Do not shorten this time. Proper bonding will not occur if the solution is simply applied and dispersed. Pit and Fissure Sealants

33 Use a gentle stream of air to thoroughly dry the adhesive to a thin film (approximately 10 seconds) If the stream of air is too forceful, the adhesive will be blown off the tooth The surface will appear glossy, but not moist The tooth surface will not appear frosty as in the traditional technique Pit and Fissure Sealants

34 Apply a light-cured sealant Pit and Fissure Sealants

35 Light-cure the sealant and adhesive together with a halogen, LED or plasma light for the amount of time specified to cure the sealant Pit and Fissure Sealants

36 Check sealant coverage, occlusion, and wipe the surface of the sealant material clean using a wet cotton-tipped applicator; this removes the smear layer or tackiness of the material used. Pit and Fissure Sealants

37 Adper Prompt Self-Etch Adhesive and Clinpro Sealant - Key Technique Tips: Activated L-Pop must be a deep golden yellow The L-Pop can be activated up to 10 minutes before the procedure Saves time to activate before bringing patient back to operatory Adhesive must be scrubbed on the surface for a minimum of 15 seconds Pit and Fissure Sealants

38 Key Technique Tips (continued) Gentle, but thorough, drying step is critical Purpose: evaporate the solvent (water) Dry an inch or so away from the tooth surface Adhesive will have a waving motion the first 10 seconds of drying When the wave stops... water is evaporated Tooth will not have a frosty appearance Co-cure adhesive and sealant together for 20 seconds Pit and Fissure Sealants

39 Benefits of Technique: No rinsing involved (means no bitter taste, which can increase salivary flow and affect isolation) Adper Prompts are simple to use and will etch any uncut enamel surface Sealant is actually being bonded to the tooth (same concept as bonding a composite) Less micro-leakage compared to the traditional technique: Means less chance of recurrent decay/better retention Decreased challenge of patient management Saves time compared to the traditional technique Pit and Fissure Sealants

40 Conclusions about the use of dental sealants: One of the best preventive measures we can offer patients Cost effective, simple and fast When properly placed and maintained: Sealants have proven longevity Will aid in the prevention of caries Patients appreciate the preventive efforts Pit and Fissure Sealants

41 Acknowledgements: The instructional staff wish to gratefully acknowledge the following for their contributions to this project – 3M-ESPE Vicki L. Svoboda – 3M Dental Division Columbia Dentoform The California Association of Dental Assisting Teachers, Inc. © 3M-ESPE/CADAT 2010

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