Fissure Sealants Part I - Theory
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Questions and Answers

What is the primary chemical bonding mechanism of glass ionomers?

  • Acid-base reaction (correct)
  • Covalent bonding
  • Polymerisation reaction
  • Ionic bonding

    • Which material is known for having higher tensile strength?

  • Glass ionomer
  • Resin modified glass ionomer
  • Compomer
  • Composite resin (correct)

    • What property is associated with resin modified glass ionomers compared to compomers?

  • Greater retention (correct)
  • Higher viscosity
  • Increased water sensitivity
  • Shorter working time

    • Which type of fissure sealant requires a dry, acid-etched enamel for effective bonding?

    <p>Composite resin</p> Signup and view all the answers

    Which sealant is hydrophilic and does not require etching for bonding?

    <p>Glass ionomer</p> Signup and view all the answers

    What is a notable feature of unfilled resin sealants compared to filled sealants?

    <p>Clear appearance</p> Signup and view all the answers

    What is the primary advantage of acid etching enamel before applying a resin sealant?

    <p>Increases surface area for bonding</p> Signup and view all the answers

    What is a common outcome of applying resin-based sealants to molars?

    <p>Reduction in caries incidence</p> Signup and view all the answers

    Which of the following statements about Bisphenol A (BPA) in dental materials is accurate?

    <p>No evidence of adverse effects has been found</p> Signup and view all the answers

    What must be considered regarding the choice of sealant material?

    <p>Both tooth and patient factors</p> Signup and view all the answers

    What characterizes ICDAS 1 or 2 lesions?

    <p>Demineralization confined to enamel with no breakdown</p> Signup and view all the answers

    What is necessary for fissure sealants to be effective?

    <p>All fissures must be fully covered</p> Signup and view all the answers

    Which of the following actions is recommended during a recall visit?

    <p>Reapply if fissures are carious</p> Signup and view all the answers

    Which statement is NOT true regarding early moderate lesions (ICDAS 3)?

    <p>Demineralization is wholly superficial</p> Signup and view all the answers

    What should be done if a fissure sealant appears worn?

    <p>Revisit caries risk and consider reapplication</p> Signup and view all the answers

    What is an appropriate method to check for sealant integrity?

    <p>Visual inspection and physical probe check</p> Signup and view all the answers

    During a recall visit, which of these actions should NOT be performed?

    <p>Apply sealant without checking the fissure</p> Signup and view all the answers

    Which of the following documents specifically addresses the use of pit-and-fissure sealants?

    <p>Evidence based clinical practice guideline for sealants</p> Signup and view all the answers

    What is the purpose of the Clinical Technique lecture mentioned?

    <p>To cover the practical application of fissure sealants</p> Signup and view all the answers

    What indicates that a fissure sealant needs to be 'topped up'?

    <p>Fissures are noticeable and potentially carious</p> Signup and view all the answers

    What factors must be assessed for patient selection in dental procedures?

    <p>Medical history and co-operation level</p> Signup and view all the answers

    What does the ICDAS II system primarily focus on?

    <p>Standardizing caries detection and assessment</p> Signup and view all the answers

    What is the significance of the ICDAS score 0?

    <p>A sound tooth with no evidence of caries</p> Signup and view all the answers

    Which of the following conditions represents an indication for applying fissure sealants?

    <p>Deep pits and fissures</p> Signup and view all the answers

    In the context of ICDAS, what characterizes score 2?

    <p>Distinct visual change in enamel while wet</p> Signup and view all the answers

    What is a contraindication for applying fissure sealants?

    <p>Shallow self-cleansing pits and fissures</p> Signup and view all the answers

    Which approach is suggested for ensuring patient co-operation, especially in children?

    <p>Tell-show-do method</p> Signup and view all the answers

    How does the ICCMS™ classify dental lesions?

    <p>Into initial, moderate, or extensive categories</p> Signup and view all the answers

    What is the primary function of fissure sealants?

    <p>To act as a physical barrier against food debris and biofilm</p> Signup and view all the answers

    For which scenario is radiographic assessment typically warranted when managing early caries?

    <p>To confirm a clean and dry tooth with pits or fissures</p> Signup and view all the answers

    What does an ICDAS score of 1 indicate?

    <p>First visible change in enamel after drying</p> Signup and view all the answers

    Which of the following areas are the most caries susceptible and would benefit from fissure sealants?

    <p>Occlusal surfaces of posterior teeth</p> Signup and view all the answers

    Which factors must be considered before placing a fissure sealant?

    <p>Both patient and tooth factors</p> Signup and view all the answers

    What are the pits and fissures in relation to caries susceptibility?

    <p>Deep clefts and small depressions prone to plaque retention</p> Signup and view all the answers

    Which type of tooth surface is the least likely to benefit from fissure sealants?

    <p>Smooth surfaces of anterior teeth</p> Signup and view all the answers

    What is a possible indication for the use of fissure sealants?

    <p>High risk of caries in specific tooth surfaces</p> Signup and view all the answers

    What is an important limitation to consider with fissure sealants?

    <p>They are not a substitute for regular dental care and hygiene</p> Signup and view all the answers

    Which condition is NOT an indication for the application of fissure sealants?

    <p>Healthy, caries-free surfaces</p> Signup and view all the answers

    What is one of the key scientific principles underlying the use of fissure sealants?

    <p>They form a physical barrier against decay</p> Signup and view all the answers

    What role do fissures play in relation to dental caries?

    <p>They are areas at risk for plaque retention</p> Signup and view all the answers

    Study Notes

    Fissure Sealants Part I - Theory

    • Fissure sealants are protective coatings applied to caries-prone tooth surfaces
    • Posterior teeth occlusal surfaces are most vulnerable to dental caries
    • Sealants create a physical barrier preventing food debris and biofilms from accumulating, stopping caries development
    • They control and manage some carious lesions in addition to preventing caries
    • Important areas for fissure sealants are fissures, buccal and cingulum pits, dens in dente, dens evaginatus and prominent cusp of Caribelli
    • Fissures are deep clefts between cusps, high risk for plaque accumulation
    • Pits are small depressions in developmental grooves

    GDC Learning Outcomes

    • Describe scientific principles underpinning materials/biomaterials used in dentistry, including limitations and selection processes, with focus on those used in dentistry
    • Advise on and apply a range of preventive materials and treatments

    Intended Learning Outcomes

    • Define fissure sealants
    • Describe different fissure sealant types and their evidence base
    • Explain indications and contraindications for fissure sealants
    • Identify patient and tooth factors to consider before sealant placement

    Associated Reading Material

    • Aetiology of dental caries
    • Histopathology of enamel and dentine caries
    • Tooth morphology
    • Fissure sealants Part II - Clinical Technique lecture
    • Future biomaterials lectures as relevant to the course

    Types of Fissure Sealant

    • Glass ionomer
    • Resin-modified glass ionomer
    • Polyacid-modified resin (compomer)
    • Composite resin

    Ideal Fissure Sealant Properties

    • Retention
    • Dimensionally stable
    • Wear-resistant
    • Low solubility
    • Biocompatible
    • Easy to apply

    Glass Ionomers and Composite Resins

    • Glass Ionomers:
      • Acid-base reaction
      • High acid-base bonding
      • Low shrinkage on setting
      • High fluoride release
      • Low thermal expansion
      • Low tensile strength
      • Susceptible to drying
      • Stiffer
    • Composite resins:
      • Polymerisation reaction
      • Resin-dentine bonding
      • Higher shrinkage on setting
      • Low fluoride release
      • Less expansion
      • High tensile strength
      • Low susceptibility to drying

    Compomers and Resin-Modified Glass Ionomers

    • Compomers:
      • Polyacid-modified resin sealants
      • Combine resin-based material with fluoride and adhesive properties of glass ionomer
      • Poorer retention
    • Resin-modified glass ionomers:
      • Modified glass ionomers with resin components
      • Release fluoride
      • Longer working time
      • Less water sensitivity

    Acid-etch Technique

    • Removes smear layer
    • Creates microporosities
    • Increases surface area
    • Creates micromechanical retention for resin sealant
    • Uses 35-37% phosphoric acid (liquid or gel)

    Resin Sealants

    • Bis GMA (Bisphenol A glycidyl methacrylate) monomer mixed with low weight dimethacrylate
    • Fourth generation sealants contain fluoride
    • Formation of physical barrier against caries
    • Effectiveness depends on longevity of retention
    • Filled sealants - opaque, higher viscosity, greater wear resistance
    • Unfilled sealants - clear, less resistant to wear
    • Require a dry, acid-etched enamel surface for bonding
    • Light-activated

    Bisphenol A (BPA)

    • Dental composites and sealants contain BisGMA derived from BPA
    • Low levels of BPA are present immediately after placement
    • Human exposure to BPA mostly through food and beverages
    • No demonstrable adverse effects
    • Ensure light-curing unit calibration and function
    • Adhere to manufacturer instructions
    • Wash/polish/rinse after placement
    • Rubber dam usage

    Glass Ionomer Sealants

    • Fluoroaluminosilicate powder and polyacrylic acid solution
    • Hydrophilic
    • No etching required
    • Chemical bonding
    • Anticariogenic (fluoride release)
    • Less retentive

    Evidence

    • Resin-based sealants reduce caries in permanent molars by 11-51% two years after application

    Which Type of Sealant to Use

    • Evidence for superiority of one material over another is weak
    • Resin sealants are the material of choice
    • Consider tooth and patient factors

    Indications and Contraindications

    • Patient factors:
      • Caries risk assessment for patient
      • Medical/social history, diet, fluoride use and plaque control
      • Patient level of co-operation is essential
    • Tooth factors: - Tooth morphology (highly fissured, lateral incisors, pits) - Tooth eruption stage (recently erupted, repair of previously sealed) - Isolation possibility - Caries status

    Patient Selection

    • Caries risk
    • Level of co-operation
    • Assessing caries risk (medical, social, dietary habits, plaque control, fluoride use, past caries experience, and clinical presentation)
    • Introduction to dentistry (first experience, procedures, child-friendly language, co-operation)

    Tooth Selection

    • Tooth Morphology (highly fissured/deeply fissured molars, lateral incisors & cingulum pits, recently erupted teeth, repair of previous sealants, isolation possibility)
    • Caries status (radiographs, ICDAS/ICCMS codes)
    • Refer to your tooth morphology and the aetiology of dental caries, histopathology of enamel and dentine caries lectures for more information

    ICDAS II

    • International Caries Detection and Assessment System II
    • Clinical scoring system for diagnosing caries at every stage
    • Used for research/clinical/epidemiological purposes
    • Provides standardized way to detect and assess caries

    ICCMS™

    • International Caries Classification and Management System
    • Classifies lesions into initial, moderate, or extensive stages
    • Focus on lesions prevention/arrest, maintaining tooth structure during treatment

    ICDAS Score 0, 1, 2, 3

    • ICDAS 0: Sound tooth with no caries; no evidence of caries after 5 seconds of air drying
    • ICDAS 1: First visible change in enamel (opacity/discoloration, white or brown lesion not consistent with sound enamel, restricted to pit/fissure entrance)
    • ICDAS 2: Distinct visual change in enamel (wet tooth shows either white spot/brown discolouration- seen both wet and dry, for diagnosis, clinician must consider)
    • ICDAS 3: Localized enamel breakdown (wet tooth shows enamel breakdown, opacity/discoloration, no visual involvement of dentine observed on wet/dry)

    Fissure Sealants - Review and Maintenance

    • Sealants effective only if all fissures covered
    • Monitor each recall visit
    • Visual inspection with probe
    • Reassess caries risk
    • Reapply sealants ('top-up')
    • Re-evaluate developing dentition

    Clinical Technique

    • Fissure sealants Part II - Clinical Technique lecture

    End

    • Fissure sealants Part II – Clinical Technique lecture
    • Formative assessment

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    Fissure Sealants Part 1 Theory PDF

    Description

    This quiz covers the essential theoretical concepts related to fissure sealants in dentistry. It focuses on the protective function of these coatings, particularly on vulnerable posterior teeth surfaces. Participants will learn about the scientific principles behind these materials and their application in preventing dental caries.

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