Abstract
Sealant is beneficial to dental caries prevention. To improve sealants' retention and effectiveness in long term, adequate isolation and secure cleaning pits and fissures prior to sealant are the most critical aspects. One example of recommended sequence of isolation and cleaning is as follows; Rubber dam application, removal of plaque and pellicle by rotating brush, ultrasonic irrigation of pit and fissure, scratching by the explorer with sodium hypochlorite solution.
However ideal, this procedure is so complex and demands pretty long chair time that may frequently be challenging particularly in children with poor co-operation. So we tried to establish a new procedure that is simple, short chair time and results in long term stability.
Coolex®( APT) was selected as an isolation system in our procedure. Coolex® has features as follows; able to apply to newly erupted teeth, able to attach in the mouth in less than ten seconds, able to create an ideal environment for adhesive dentistry.
For pit and fissure cleaning, only scratching by the sharpened #3A explorer with10% sodium hypochlorite gel( AD gel, Kuraray) was adopted but the mechanical and ultrasonic steps were skipped.
In order to evaluate this method is effective enough to cleaning prior to sealant, 30lower molars dyed with disclosing solution were examined. Result shows that AD gel dissolved the plaque on the smooth surface in 1 minute and scratching by the #3A explorer with AD gel removed the pit and fissure plaque as well. Etchant and sealant material were selected on their fluidity to be able to flow into the bottom of pit and fissure(Red Activator,Sun Medical, Conseal F, SDI).
Cases of sealant placement with this procedure are shown in this report. They are maintained for over 7 years without breaking, falling and new caries.
