preventive resin restoration

PREVENTIVE RESIN RESTORATION

PREPARED BY: GROUP C

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GROUP MEMBER

• Nurul Amidah• Nur Awanis• Norliza• Nor Afiqah• Nur Fahira• Nur Nadiah• Nurul Syahidah• Siti Sarah• Suraya• Zaidah

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OUTLINE

• Introduction• Indication• Contraindication• Advantages• Disadvantages• Classification• Procedures

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INTRODUCTION• A preventive resin restoration is a

conservative treatment that involves limited excavation to remove carious tissue, restoration of the excavated area with a composite resin, and application of a sealant over the surface of the restoration and remaining, sound, contiguous pits and fissures (Ripa et al,1992)

• This technique is employed after caries has formed and the caries is judged to be deeper into dentin (Anusavice, 1989) .

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• Treatment philosophy•Painless•Prevention•Preservations

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• Indication•For small pit or fissure cavities in posterior teeth in nonstress-bearing areas.• Deep pits and fissures in primary and permanent teeth that contain questionable caries areas.• Implicit carious lesions.• Well confined carious lesions. •Enamel defects.

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• Contraindication•For stress-bearing posterior restorations•When moisture control is poor• . Large single-or multi-surf ace carious lesions

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Advantages

• Esthetic• Direct material (one appointment

placement)• Easy to repair• Bonded resin may enhance tooth strength• Conservative preparation technique results

in minimal loss of healthy tooth structure.• Less tooth structure is removed, leaving a

much stronger tooth than when extension for prevention is necessary.

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Disadvantages

• No self-sealing quality like amalgam or fluoride release like glass ionomers; once the bond is broken between the adhesive and tooth, leakage occurs with a high rate of secondary caries

• Excessive wear under stress• Low fracture strength• High technique sensitivity• Harder to manipulate for dentist in site 2

preparations• Generation and subsequent inhalation of dust

during finishing procedures represent potential hazard for the patient and especially for dental staff.

INVESTIGATIONS• Radiographic• Radiographs are insufficient for the detection of occlusal lesions, presumably because many lesions are too small to create a radiographic image• Show no evidence of proximal caries that would mandate a more extensive restoration

• Visual• the affected area will appear a matte white in contrast to the gloss of normal enamel.

• Tactile assessment• The pits and fissures of the occlusal surface are carefully probed with a sharp explorer to determine if the explorer tip "catches‘• (Ripa et

al,1992)10

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TYPE OF PRR

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Type A

• Deep pits and fissures

• caries is limited to enamel

• A slow speed round bur is used to remove any decalcified enamel

Type B

• comprises of incipient carious lesion extending into dentin that is small and confined.

Type C

• presence of deep caries and need for greater exploratory preparation in dentin

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• L.A and R.D• surface is cleaned• decalcified pits and fissure are removed with a slow

speed round bur• acid etching gel is placed over the entire occlusal

surface for 60 sec.• surface is then washed for 20 sec. , and dried for 10

sec.• sealant is applied carefully , avoiding air entrapment

in the preparation site• polymerization done with visible light for 20 sec.• occlusion is adjusted ,if needed with finishing bur

TYPE A

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• L.A and R.D• thorough prophylaxis of the surface• caries from pit and fissures removed with slow speed

round bur• etching gel placed over the entire occlusal surface for 60

sec.• wash for 20 sec . and dry for 10 sec.• coat of bonding agent applied on the walls of preparation• preparation then filled with composite material• filled sealant material is applied over the entire occlusal

surface• all layers are simultaneously cured• occlusion is adjusted• surface is finished and polished

TYPE B

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• L.A and R.D• thorough prophylaxis of the surface• caries from pit and fissures removed with slow speed round

bur . In case of pain , anesthesia may be given• cavo surface margins are beveled• base of fast setting Ca hydroxide is given to cover the

exposed dentin surface• etching gel placed over the entire occlusal surface for 60

sec.• wash for 20 sec . and dry for 10 sec.• coat of bonding agent applied on the walls of preparation• preparation then filled with composite material• filled sealant material is applied over the entire occlusal

surface• all layers are simultaneously cured• occlusion is adjusted• surface is finished and polished

TYPE C

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• Restoration is intact and covering all involved and/or susceptible pits and fissures.

• Normal occlusal relationship is maintained• No evidence of caries development

beneath or around the margins of the restoration

OUTCOME ASSESSMENT

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References

• Book• Richard R. Welbury, Monty S. Duggal: Paediatric Dentistry, Oxford Medical Publication, 2005.

• Journal• Richard J. Simonsen, D.D.S:Preventive resin restorations (I); Dental Science and Research,1978,1(1).• http://jalandhardentalcare.com/services/pediatric-dentistry.php• http://multimedia.3m.com/mws/mediawebservermwsId

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