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