F15. List and discuss the five manipulative factors that can influence
sealant retention and prevention.
Etchant and etching procedure
Water rinse
Air drying
Sealant application
Cure
Etchant and etching procedure.
The acid should be able to reach into the fissures and etch the fissures efficiently. To achieve this goal liquid etchants or low viscous gels are preferred. The acid should ideally be lightly rubbed to secure a complete wetting. Excessive intense rubbing can cause some unnecessary surface loss. The best phosphoric acid concentrations range from 27-37% phosphoric acid.
Water rinse
It is important to rinse the acid carefully. A rinse time of 20 s is needed when phosphoric acid has been used because of the risk that calcium precipitates form during the etching procedure.
Air-drying
It is important to dry the etched enamel surface if a hydrophobic sealant is used. Before the enamel surface is dried, make sure that the compressed air is free from oil contaminations.
Sealant application
The sealant should ideally be placed with a syringe. It can be placed with a brush, but such a placement often increases the risk for air-bubble incorporation. By using low viscosity sealants, it becomes easier to adapt the sealant to the etched surface.
Cure
Remember that the resin at the bottom of the fissure must be well cured. Because of the tooth anatomy and the light protective ability of the enamel surrounding the sealant, it is very easy to undercure the resin. Therefore, make sure that the light tip is as close to the surface as possible without touching the resin and that the recommended cure time is followed.
Rubber dam
By use of rubber dam, it is possible to avoid enamel surface contaminations. This improves the likelihood of improved success with the sealant.