PREVENTIVE RESIN RESTORATIONS

:
Preventive resin restoration (PRR) is a thin, resin coating applied to the chewing surface of molars, premolars and any deep grooves of the teeth.
• They are a natural extension of the use of occlusal sealants.
• It consists of an enamel sealant with a resin filling.
• If caries is present in one area or parts of pits and fissures, that particular area of caries is restored and fissures are protected with sealants.
• It integrates the preventive approach of the sealant therapy for caries susceptible pit & fissure with therapeutic restoration incipient caries with composite resin that occur on the same occlusal surface.
• They are the conservative answer to conventional extension for prevention” philosophy of Class I amalgam cavity preparation.

Preventive resin restoration(PRR) consists of a thin, resin coating applied to the occlusal surface of molars, premolars and deep grooves.
Most decays begin in the deep grooves. Thus, teeth with this condition are difficult to clean and becomes more susceptible to caries.
PRR protects the tooth by sealing the deep grooves and creating a smooth, easy to clean surface.
By this way, the teeth is protected from decay for several years, provided they are checked for thinning and wear at regular dental check-ups.

  • Dental caries is due to the imbalance between loss & gain of
  • minerals from a tooth surface.
  • The loss of minerals from our teeth occurs from the bacteria from the foods and producing acids, whereas the tooth gains minerals from our saliva and fluoride that is present within our mouth which over a period of time becomes a tooth decay.
  • Fissure sealants are a preventive treatment that is part of the minimal intervention dentistry approach to dental care.
  • This approach facilitates prevention and early intervention, in order to prevent or stop the dental caries process before it reaches the ends stage of the disease.

CLASSIFICATION:

There are three types of preventive resin restoration based on the extent & depth of carious lesion as determined by exploratory preparation.

Simonsen (1978) has classified them:

TYPE A:

• Suspicious pits & fissures where caries removal is limited to enamel
• Local anesthesia is not required.
• A slow speed 4 or 2 round burs. used to remove decalcified enamel
• Sealant is placed

TYPE B:

• Incipient lesion in dentin that is small & confined.
• No local anesthesia is needed.
• An appropriate base is placed in areas of dentin exposure, composite resin is placed & the remaining pit & fissure are covered with a sealant.

TYPE C:
• More extensive dentinal involvement & requires restorations with posterior composite material
• Appropriate base is placed over the dentin.
• Pits & fissures are covered with sealant.
• Local anesthesia is required.

PROCEDURE:

CONCLUSION:
• Regular maintenance and sealant addition when necessary is important in long-term caries protection after sealant placement.
• Much better effectiveness data will result if sealants are used on teeth with a true predilection to caries.
• Better materials and better use of bonding agents with sealants will improve overall effectiveness on all teeth,particularly on those teeth now thought of as difficult to seal.
• Use of sealants has proved to have good results.
• For prevention of dental caries in pit and fissure, sealants were introduced.
• There is evidence suggesting effectiveness of sealants.
• Sealants prevent bacteria growth which causes caries.
• Biomaterials to seal pit and fissure should present with the simple application method, biocompatibility, low viscosity and good surface retention and low solubility.
• To improve this biomaterial, more laboratory should be developed.

REFERENCES:

  • Essentials of Public Health Dentistry, Soben Peter (6th Edition).
  • FENESTRA 2002-18, Dr. Bruno Jacquot(Bruno.Jacqout@odonto.u-nancy.fr)

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