预防口腔医学临床技术

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
Clinical Techniques of Dental Prevention
Jiang Han
Department of Preventive Dentistry ,School of Stomatology,
Wuhan University
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教学要求
掌握： 一、窝沟封闭 1.概念; 2.窝沟封闭的临床应用: (1) 适应证和非适应证；(2) 操作方法及步骤 二、预防性树脂充填： 1.定义; 2. 适应证；3. 临床操作步骤 三、ART： 1.基本概念; 2.适应证;3.操作方法
A large occlusal restoration is already present 23
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
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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
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
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.
The disease susceptibility of the tooth
In handicapped patients
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Background of Sealants
Polyurethanes ( 氰基丙烯酸脂)
Cyanoacrylates (聚氨基甲酸乙脂)
Bisphenol A –glycidyl methylacrylate (Bis-GMA) (双酚A甲基丙烯酸缩水甘油酯)
❖ 龋病形成早期阶段，点隙裂 沟底部没受到影响，随着龋 病继续发展，沟壁病损逐渐 扩大，最后累及沟底，形成 金字塔形的损害。
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Several agents to deal with
1895: Wilson, dental cement 1929: Bodecker, enameloplasty 1923,1936: Hyatt, Prophylactic
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熟悉： 一、窝沟封闭： 1. 窝沟解剖形态及患龋特点 2. 封闭剂组成、类型及特点 了解： 一、窝沟封闭： 1.酸蚀的作用; 2.临床效果评价 二、ART：由来及发展
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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
❖ 龋病首先发生在窝沟壁，表 现为狭窄处相对的沟壁上牙 釉质龋损的形成。
19Biblioteka Baidu
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