DENT 2220: WEEK 12

dental floss

Use __________ to check for proximal overhangs after curing sealants

Acid solutions used to prepare a tooth for bonding

What are etchants?

paint w/hydrogen peroxide, wash w/water, sharp instrument tip, prophylaxis w/plain pumice (that has not oil/flouride)

What are other methods used to clean tooth surfaces before placing sealants?

light moisture tolerant, dry field required

What are the 2 types of sealant moisture tolerance?

acrylic resin, glass ionomer, composite

What are the 3 types of material for sealants?

filled, semi filled, (stronger; poor flow, require dent professional for high spot adjustments) unfilled (better flow but weak, high spots adjust to pt bite)

What are the 3 types of sealant filler?

amines, peroxides

What are the activators/initiators of acrylic resin?

(POLYMERS)Acrylic, Glass Ionomer, Composite

What are the materials used for sealants?

light cured (requires mixing, requires longer to polymerize, but cures more completely), self cured (does not require mixing and cures immediately, but may not cure completely)

What are the types of sealant curing?

removes some of the enamel crystals, leaving many small depressions on the tooth surface

What does acid etching do to the tooth surface?

acrylic resin

What is CCRI's choice of sealant material?

leach into tooth surface and used for remineralization

What is the purpose of fluoride in a sealant?

helps spread material in grooves, helps check for attachments, used to explore open margins & surface smoothness

What is the significance of a shepherds hook explorer in a sealant procedure?

wet cotton roll

What is used to remove the air inhibited layer (surface layer) of sealants?

obtain informed consent

What must be done before a sealant can be applied to a pt?

10-50% solution phosphoric acid in water, (we use 37% in clinic)

What percentage of etchants can we use?

give fluoride treatment, provide postoperative directions (no eating, drinking, smoking for 30 min, sealants need to be reapplied periodically)

What should you do after applying a selant?

articulating paper

What should you use to check the occlusion of the sealant?

pits and grooves, tooth restoration interface, over the margin of a fixed orthodontic appliance

Where should sealants be placed?

bcs pits, groove, fissure anatomy can predispose to tooth demineralization and caries development

Why do tooth surfaces need to be sealed?

it can interfere with bonding this technique is no longer recommended because it causes the greatest amount of micro leakage.

Why should oil and fluoride be avoided for sealant placements?

flowable composites

_______ a low viscosity type of composite for sealants

Co polymers

_______ other monomers that cause a change in properties slightly

acrylic resin

________ is the most common sealant material made of BIS GMA MONOMER + CO POLYMERS

composite sealants

________ is the same material as acrylic resin; it is just more heavily filled. - often used to seal the margins of restorations to prevent microleakage - harder to apply but stronger once in place

polymer

________ long chain of many links

polymerization

________ the process of chaining and setting

Sealants

_________ A thin plastic coating materials are used predominantly to prevent disease. - some contain FLOURIDE

resin based sealants fluoride releasing

__________ Conseal f by SDI Innovative Dental Products; Long term fluoride release - Low viscosity allowing for better flow and optimal sealing of margins.

monomers

__________ giant organic molecules that when chained together forms a polymer. - the act of chaining causes the material to set - one link in the chain

glass ionomer sealants

___________ Fuji TRIAGE by GC America Inc; High fluoride releasing - Forms a semi-permeable skin to keep acid attacks and bacteria out while allowing calcium/phosphate ions to pass through

glass ionomer sealants

____________ is a a polymer like acrylic resin. It is different because it has a maleic or tartaric acid catalyst and fluoroaluminosilicate reinforcing particles added. - leaches fluoride into the surrounding area. This helps prevent secondary decay.

Acid etching

______________ Painting the surface with weak acid liquid or gel solution - Acid is usually 37% phosphoric

yup

does etching alone removes debris, breaks down surface molecules and roughens surface?

yes

does glass ionomer leach fluoride naturally?

isolates surface from bacteria/acid, prevent progress of incipient carious lesion, prevent microleakage & 2ndary decay at tooth restorations, leach fluoride & amorphous calcium phosphate into adjacent tooth surfaces

how does sealants prevent tooth decay?

Camphoroquinone

what initiator is used in light cured materials?

Benzoyl peroxide

what initiator is used in self cured materials?

assess and diagnose

what is the 1st step to sealant process?

acid can penetrate the softer interprismatic area and enter the outermost layers of enamel

what is the microstructure of enamel?

sealant placement procedure

Ø Prepare tooth Ø Apply sealant Ø Assess result Ø Provide post-operative directions

Sealants clinical concerns

- Adequate isolation - Ease of placement - Visibility - Retention - Wear - Caries resistance of surrounding tooth structures

Pt assessment criteria

- Caries Risk and activity pattern - Pt has a moderate to high risk for occlusal caries - Depth of pits and fissures - Dietary patterns - Current and past fluoride exposure - Eruption status of tooth - Ability of patient to cooperate - How often patient receives preventive services

Properties of acrylic resin

1. Colorless — but can be tinted 2. Sorbs fluids — absorbs dissolved substances and discolors 2. Wears readily — must be reapplied periodically 4. Poor compressive strength — excess can be cut away with a scaler, curette or bur 5. Good tensile strength — bond holds well

Etchant procedural use

1. Painted or expelled onto tooth 2. Acid enters micropaths between hydroxy 3. apatite crystals and loosens some of them 4. Loosened crystals fall out 6. Result is roughened surface that can be mechanically interlocked with a bonding material

Sealant contradictions

1. Patient has low caries risk 2. Patient cannot cooperate adequately 3. Tooth has any type of carious lesion, determined by utilizing Spectra caries detection device 4. Tooth has not erupted enough to maintain dry surface 5. Primary tooth is expected to be lost shortly

Carious lesion in area to be sealed, Previous restoration in area to be sealed, Gingival tissue on the occlusal surface

A DH can decide a tooth can be sealed only if the tooth DOES NOT HAVE ...??? (otherwise dentist has to do it)

tumbled, strength, cross linking

ACRYLIC RESIN CHAINING

Activators

ACRYLIC RESIN COMPONENTS: _________ (light or another chemical) add energy to material to open molecule bonding

Initiators

ACRYLIC RESIN COMPONENTS: _________ are the chemicals whose bonds are opened and available to react in a new way to begin polymerization

thixotropic, 0.04 microns, dry field, light cured, fluoride releasing

ACRYLIC RESIN SEALANT CHARACTERISTICS

30, 60, white, chalky, retention

APPLICATION OF ETCHANT

Yes

Are acids corrosive?

sealant result evaluation

Check for: - No bubbles - Smooth surface - Secure attachment - Adequate but not excessive extension - Absence of proximal overhangs - No occlusal high spots

gel, solution

Etchants are available as _____/____???

water

Etching action is stopped by flushing area with __________??

do not touch with an instrument

Evidence of an etched enamel is its chalky, white appearance. This indicates unsupported rods are vulnerable. What should you not do to an etched enamel?

Acid safety measures

Keep off soft tissues If spilled, flush away with water If spilled on skin - Wash well with soap and water

hydrophobic

Nearly all sealant material are __________ therefore area must be dry and isolated from moisture

moisture, oil, debris, bite, occlusion habits, polishing, acid fluoride

RETENTION OF SEALANTS

toothbrush, cotton rolls, etch, 30, 30, dry, 1/2mm, 20

SEALANT PROCEDURE

erupted, free, deep pit, groove, fissure

TOOTH ASSESSMENT

removes surface debris and plaque

TOOTH PREPARATION: What does brushing tooth w/ a dry toothbrush do the the teeth for sealants?

enameloplasty sealant technique (EST)

TOOTH PREPARATION: __________ excavates the pits and fissures using a tungsten carbide bur under low speed. This technique decreases microleakage because it enlarges the narrow fissues. - This can be done by a dentist.

fissurotomy technique

TOOTH PREPARATION: ___________ uses a microshort fissured bur to open up the fissures. Causes the same microleakage as conventional technique

Air abrasion w/ acid etching

TOOTH PREPARATION: ___________ uses alumina particles to open the pits and fissures followed by acid etching. This technique reduces microleakage