3.4 Caries control and prevention

Reference material:

  → Use of preventive resin restoration:

   The preventive resin restoration is an alternative procedure for restoring young permanent teeth that require only minimal tooth preparation for caries removal but also have adjacent susceptible fissures. 

    A gel or liquid form of 37% phosphoric acid is commonly used for 20 seconds. Surface preparation with aluminum oxide air abrasion or a laser system approved for hard tissue may not substitute for acid-etching. If these cleaning methods are used, etchant must still be applied to provide adequate resin-bonding enamel. The lingual grooves of maxillary molars and the buccal grooves of mandibular molars are also commonly etched and sealed. The tooth is thoroughly washed for approximately 30 to 40 seconds andcompletely dried.

    A thin layer of bonding agent is applied to the cavity. A stream of air must be used to thin the bonding agent and to prevent pooling of bonding agent in the cavity. The cavities are filled with a light-curing composite or resin-modified glassionomer, which may be cured at this time. A light-curing sealant is placed over there maining susceptible areas and brushed into the pits and grooves. The materials are polymerized with visible light in accordance with the manufacturer’s instructions. The occlusal contacts are checked. A small-particle diamond rotary instrument canbe used to remove excess sealant and ensure centric stops on the enamel.

   There is no single perfect conservative restoration. Each dentist must decide, on an individual basis, the appropriate type of procedure. The restoration described can bevery effective in carefully selected cases.