Transcript Chapter 59 Dental Sealants Copyright 2003, Elsevier Science (USA). All rights reserved. No part of this product may be reproduced or transmitted in.

Chapter 59
Dental Sealants
Copyright 2003, Elsevier Science (USA).
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Produced in the United States of America
ISBN 0-7216-9770-4
Introduction
Dental sealants are highly effective in
preventing dental caries in the pit and fissure
areas of the teeth.
Dental sealants are made of a resin material, and
are applied to the pits and fissures of teeth to
prevent dental caries.
A dental sealant is successful only if it firmly
adheres to the enamel surface, and protects the
pits and fissures from the oral environment.
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Introduction to Dental Sealants- cont’d
 Pits and fissures are the fossa and grooves that
failed to fuse during development.
 Bacteria accumulate in the narrow pits and fissures.
 Even a single toothbrush bristle is too large to enter
and clean pits and fissures.
 The sealant acts as a physical barrier.
 Dental sealants are a noninvasive technique that
preserves the tooth structure and at the same time
prevents dental decay.
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Fig. 59-1 Micrograph showing toothbrush bristle in a groove.
Fig. 59-1
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Fig. 59-2 Molar with a properly placed sealant.
Fig. 59-2
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Sealants and Existing Caries
 During sealant placement, some bacteria will be
trapped beneath the sealants.
 Some teeth with very small initial carious lesions
may be inadvertently sealed.
 Numerous studies have shown that neither of
these will increase the chance of caries
development or caries growing beneath the
sealant.
 Several studies have shown that the number of
bacteria in small, existing carious lesions that had
been sealed decreased dramatically with time.
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Indications for Dental Sealants
 Pit and fissure sealants are especially useful for
selected patients through the caries-active period
(ages 6 to 15 years).
 Sealants are indicated for teeth with
• Deep pits and fissures
• Preferably in recently erupted teeth (less than 4
years)
 Sealants should be used as part of a preventive
program that includes the use of fluorides, dietary
considerations, plaque control, and regular dental
examinations.
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Types of Sealant Materials
 There is a wide variety of sealant material on
the market from which to chose.
 The dental assistant should have a thorough
understanding of the types and characteristics
of the various sealant products available.
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Fig. 59-3 Sealants should be used as part of a comprehensive preventive
program.
Fig. 59-3
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Method of Polymerization
 The major difference among the materials is the
method of polymerization. Both types are
comparable in bond strengths and rates of
retention.
• Self-cured materials are supplied as a twopart system (base and catalyst). When these
pastes are mixed together, they quickly
polymerize (harden).
• Light-cured sealants do not require mixing.
After the material has been placed, it hardens
during exposure to a curing light.
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Color of Sealant Material
 Sealants may be clear, tinted, or opaque (white).
 Tinted or opaque sealants are more popular
because they are easier to see than clear
sealants when applying, and when checking for
sealant retention on subsequent office visits.
 Some brands have a tint that is visible during
the application, but the sealant turns clear after
polymerization.
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Fillers
 Sealant materials are available as filled or unfilled resins.
 The purpose of filler material in the sealant is to reduce



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the occlusal wear.
Filled and unfilled sealants penetrate the fissures equally
well and there is no difference in microleakage.
Some dentists believe a filled sealant is better because of
a lower wear rate on occlusal surfaces.
Other dentists believe that because sealants flow deep
into the pits and fissures to form a barrier that the
occlusal wear is insignificant.
Sealants should not be placed on the cuspal slopes.
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Fluoride Release
 Some types of sealants release fluoride after
polymerization, and others do not.
 The theory is that the fluoride released from the
sealant may create a fluoride-rich layer at the base of
the sealed groove.
 Clinical studies are still underway comparing the
effectiveness of these two types of sealants.
 Topical fluoride should not be applied to the enamel
surface immediately before a sealant procedure but
may be applied immediately after sealant application.
 Always follow the sealant manufacturer’s instructions.
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Storage and Use
 The following are some general tips on sealant materials
• Replace caps on syringes and bottles immediately after
use.
• Do not expose materials to elevated temperatures.
• Do not store materials in proximity to eugenolcontaining products.
• Most etchant and sealant materials are designed to be
used at room temperatures of approximately 21˚ to 24˚
C or 70˚ to 75˚ F.
• Check the manufacturer’s recommendations.
• Shelf-life of most sealant products at room temperature
range from 18 to 36 months.
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Etching Precautions for Patients and
Dental Personnel
 Etching agents contain phosphoric acid.
 Patients and dental personnel should wear
protective eyewear when using etchants.
 Avoid contact with oral soft tissue, eyes, and skin.
 In case of accidental contact, flush immediately
with large amounts of water.
 If eye contact is involved, immediately rinse with
plenty of water and seek medical attention.
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Sealant Material Precautions for
Patients and Dental Personnel
 Do not use sealants on patients with known acrylate
allergies.
 To reduce the risk of an allergic response, minimize the
exposure to these materials.
 Use protective gloves and a no-touch technique.
 If skin contact occurs, wash skin with soap and water.
Acrylates may penetrate gloves.
 If the sealant contacts the gloves, remove and discard the
glove, wash hands immediately with soap and water, and
then re-glove.
 If accidental eye contact or prolonged contact with oral
soft tissue should occur, flush with large amounts of water.
If irritation persists, contact a physician.
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Protective Eyewear
 Protective eyewear should be used by
operators when using either the ultraviolet or
visible light cured resins.
 Protective eyewear should also be provided for
the patient during sealant procedures.
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Factors in Sealant Retention
 Moisture contamination is the primary cause of
failure of sealant retention.
 Inadequate etching is also a factor in loss of
sealant retention.
 Dental sealants should be examined at each
recall visit to be certain that the sealant material
is not partially or totally lost.
 When dental sealants are properly placed, it is
not uncommon for them to last from 5 to 10
years.
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Important Information
 Always read and carefully follow the
manufacturer’s instructions when applying
dental sealants.
 The application technique and etching times
may vary between manufacturers.
 For example, some manufacturers recommend
against using a polishing paste that contains
fluoride. Other manufacturers do not consider
fluoride polishing pastes to be contraindicated.
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Fig. 59-4 Setup for placement of dental sealants.
Fig. 59-4
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Fig. 59-5 Isolate and dry the tooth.
Fig. 59-5
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Fig. 59-6 Etch the enamel.
Fig. 59-6
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Fig. 59-7 Throughly dry the etched surface.
Fig. 59-7
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Fig. 59-8 After sealant placement, cure the enamel.
Fig. 59-8
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Fig. 59-9 Evaluate the sealant.
Fig. 59-9
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