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Friday, March 1, 2013

Re: [ACEsthetics] sealant retention

I don't do many 'sealants' per se, but the microbur is often used to open up pits & fissures that are stained, many of which are decayed, & I ozone them ALL at full strength, 1/4 lpm, for a solid minute. I really wonder if bond strength is increased? I wish we knew more about all the intricacies of ozone use.  All I DO know, is that post op sensitivity is almost nil, less teeth are undergoing pulpal necrosis, exposure or not, & I feel much better about the 'toiletry'' of my patients teeth!!
Ray

Sent from my iPhone

On Mar 1, 2013, at 9:53 AM, "William Domb" <wmdomb@verizon.net> wrote:

Ozone does NOT just stop active decay.
 
It changes the constituents of the biofilm by killing the bugs AND removing their happy home crap.
 
THAT means it takes months for the bad stuff to recongregate.  Hypochlorite, for instance, kills bugs but doesn't adequately remove their nest, so they're back in weeks with a vengeance.
 
In the months following ozone application you have a window of time to
a) remin the attacked surfaces and
 
b) make a different type of non-acidogenic biofilm.
 
Dontcha remember all those NMR pictures from your course...?
 
In fact, Julian Holmes emphasized similar stuff at the most recent IAOHD meeting.
 
regards
bill domb
 
From: Rick Coker
Sent: Friday, March 01, 2013 5:40 AM
Subject: Re: [ACEsthetics] sealant retention
 
What effect would ozone and remineralizing have on pits and fissures on kids' teeth? Does Ozone only stop decay through bacterial effects, or does it have some prophylactic function? Ozone and glass ionomer?
 
Hmmmm, thinking public health here, mass inoculation types of events, instead of pain relief events, why not pain prevention events? Cost effective services, you know?
 
Rick


On Thu, Feb 28, 2013 at 10:05 AM, William Domb <wmdomb@verizon.net> wrote:
Subject: sealant retention
This is worth looking at. SeLECT Defense sealants delivers an anti-microbial in the form of a selenium resin based compound. You can be rest assured that there is no trapping undetected decay, as biolfilms cannot live under them. In a split mouth, double blind clinical trial completed in September of 2011, 120 patients showed a 96% retention rate on fully erupted molars versus another big player with a marginal 81% retention. Not only that, we showed ZERO plaque growth whereas the other brand showed 12%. Please message me personally if you would like a copy of the study.   ashley@e34tech.com
Ashley Richter|(512) 569-2691


On Wed, Feb 27, 2013 at 9:46 PM, Jane Gillette wrote:
Has any one seen a recent study that reported a 44% retention rate for glass ionomer sealants and a 40% retention rate for resin on newly erupted molars after one year?

Jane Gillette, DDS
 
 
Ongoing public health group discussion on sealants.
 
If the stuff's so strong, how cytotoxic is it elsewhere in the kid?   Other effects like the xenoestrogenics?
 
In any event, my contention's always been that sealant 'retention' is not relevant.  First of all, they often LOOK like they're there but leak like a sieve, and second of all, the important thing is preventing tooth decay and loss WITHOUT, in the process, damaging the teeth's owners.
 
More commentary below.
 
Finally, in terms of oralsystemics, AAOSH needs to start paying attention to the effects of the compounds dentists are using on their patients and not just to diseases of the mouth affecting the rest of the body. 
 
regards
bill domb
 
In 2005, I did a study due to the 2002 Compendium article by Dr Christensen on sealant failure. I was able to follow 245 sealed teeth over fourteen years. The results were 24% of the sealed teeth needed restorative service. 55% of the sealants were still intact in 2005.
My conclusions were:
1. Dr Christensen's conclusion on sealants were not borne out.
2.Sealant success and retention was the most dramatic in the healthy dentition or multple carious lesions in the primary dentition dramatically lessened sealant success and retention.
3. I suggested we look at resin/glass ionomer material as sealants.
This was an internal study and not meant for use outside of the clinic..I forget who asked me to do the study.
 
Paul Dirkes DDS
Alabama
 

Pertinent to Dr. Macintyre's comments, a recent article in JADA (Antonson SA et al, JADA 143(2): 115-122) addresses some of these issues. The 24 month study looks at retention, marginal staining and cariostatic properties of both GI sealant and Resin-based sealants. While retention rates were both similar at 44% and 40% respectively, more important was the caries development. No GI sealants showed demineralization with sealant loss, whereas resin-based did show demineralization where sealants were lost.

 

This study highlights the value of early intervention with glass ionomer sealant on the partially erupted permanent first molars in high risk children. The retention problems will always be with us given the added difficulty of treating these teeth with limited access and saliva control. It does suggest that the two-stage treatment of these teeth is highly likely for most of them; however, the treatment outcomes in terms of loss of tooth structure due to caries and restoration when we simply wait for full eruption and access make this treatment approach worthy for consideration in at risk children.

Ian McConnachie

 

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Dr. Rick Coker, DDS, FACE
Director, Academy of Comprehensive Esthetics
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