Clinical Techniques of Dental Prevention

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Clinical Techniques of Dental Prevention

• Jiang Han
• 
  Department of Preventive Dentistry ,School of
  Stomatology, Wuhan University

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Introduction

• ? Fluorides Smooth surfaces ( 10),
• Occlusal pits and fissures ( 90)
• Occlusal surfaces
• The pits and fissures are approximately
• eight times as vulnerable as the
• smooth surfaces.

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Dental Caries

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Several agents to deal with

• ? 1895 Wilson, dental cement
• ? 1929 Bodecker, enameloplasty
• ? 1923,1936 Hyatt, Prophylactic odontotomy
• ? Do nothing wait and watch
• ? 1960s pit-and-fissure sealants

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Concept

• Pits and fissure sealants are materials which are
  designed to prevent pit and fissure caries. They
  are applied mainly to the occlusal surfaces of
  the teeth in order to obliterate the occlusal
  fissures, and remove the sheltered environment in
  which caries may thrive.

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Concept

• With this option, a liquid plastic is flowed
  over the occlusal surface of the tooth where it
  penetrates the deep fissure to fill areas that
  cannot be cleaned with the toothbrush. The
  hardened sealant present a barrier between the
  tooth and the hostile oral environment.

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Indication of Sealants

• ? A deep occlusal fissure, fucal or lingual pit
  is present
• ? An intact occlusal surface is present where
  the contralateral tooth surface is carious or
  restored
• ? An incipient lesion exists

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Indication of Sealants

• ? 3-4 years deciduous molars
• ? 6-7 years the first permanent molars
  
• ? 11-13 years the second

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Contraindication of Sealants

• ? Patients behaviour does not permit use of
  adequate dry-field techniques throughout the
  procedure
• ? An open occlusal carious lesion exits
• ? Caries exist on other surfaces of the same
  tooth
• ? A large occlusal restoration is already present

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Other consideration in tooth selection

• ? Used in fluoride areas as well as in
  nonfluoride areas
• ? Placed on the teeth of adults drug- or
  radiation-induced xerostomia
• ? The disease susceptibility of the tooth
• ? In handicapped patients

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Background of Sealants

• ? Polyurethanes ( ??????)
• ? Cyanoacrylates (???????)
• ? Bisphenol A glycidyl methylacrylate
• (Bis-GMA)
• (??A??????????)

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Accepted by ADA

• ? Concise Brand White Sealant (3M
• Company)
• ? Visio-Seal (ESPS)
• ? Delton
• ? Nuva-Seal
• ? Oralin Pit and Fissure Sealant

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Composition of sealants

• ? Resin(????) Gis-GMA
• ? Monomer(??????) the liquid plastic
• ? Catalyst(???) benzoyl peroxide

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Glass Ionomer Sealants

• ? Fluoride release
• ? Cariostatic effect
• ? Poor retention (6-12 months)

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Fluoride-releasing Sealants

• ? Add fluoride to sealants ( 20 years)
• ? Increase the enamel resistance to caries,
  antibacterial properties
• ? Reduce the incidence and severity of secondary
  caries

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Polymerization of Sealants

• ? Monomer catalyst ----- Polymer
• ? Light curing ultraviolet, visible blue light
• ? Self-curing autopolymerization, cold cure

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Self-curing Sealants

• ? Do not require light source
• ? The time allowed for sealant manipulation and
  placement must not be exceeded

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Light-curing Sealants

• ? Operator can initiate polymerization at any
  time
• ? Polymerization is shorter than self-curing
• ? Require a light source
• ? Equal in retention

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Question 1
Which of the following statement, if any, are
correct?

1. In an area with fluoridated water, a lower
   incidence of caries can be expected, along with a
   lower proportion of occlusal to smooth surface
   lesions
2. Sealants should never be lowed over incipient
   caries
3. Sealants are contraindicated for adults

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Question 2
Which of the following statement, if any, are
correct?

• 1. Bis-GMA are the initials used to specify the
  chemical family of plastics containing bisphenol
  A-glycidyl methylacrylate
• 2. A monomer can polymerize, but a polymer
  cannot monomerize