The presentation is about the preventive resin restoration involving various types of the same.

1. PREVENTIVE RESIN
RESTORATION
DR. PRIYANKA SHARMA
II YEAR M.D.S
DEPARTMENT OF PUBLIC HEALTH DENTISTRY
JSS DENTAL COLLEGE & HOSPITAL

2. WHAT ARE DENTAL CARIES
Progressive irreversible microbial disease of multifactorial nature
affecting the calcified tissues of the teeth, characterized by
demineralization of the inorganic portion and destruction
of the organic portion of the tooth.

3. High prevalence and rapid onset of occlusal caries is related to the:
i) Bacterial and nutrient harboring capacity of pit and fissures.
ii) Close proximity of its base to the DEJ.
iii) Total inaccessibility of this area to any mechanical means of
debridement.

4. PRR
• Are among the newer techniques which show long term
success.
• This treatment of resin restoration has various distinct
advantages over the traditional amalgam restorations.
• But it requires an excellent isolation of moisture and saliva
contamination.

5. PRR
• PRR utilizes the invasive and non invasive treatment of
borderline or questionable caries.
• The resin placed in the carious areas and adjacent caries
susceptible areas, seals them from the oral environment and
provides a valuable treatment alternative to conventional
restorations like amalgam.

6. PRR
It integrates the preventive approach of the sealant therapy for
caries susceptible pits and fissures with the therapeutic
restoration of incipient caries with composite resin that occurs
on the same occlusal table.

7. Deep pit and fissures on tooth surface
Require sealant therapy

8. If caries present in one area or part of the
pits or fissures
That particular caries is restored and remaining pits and
fissures are protected with sealants
PREVENTIVE RESIN RESTORATION

9. TYPES OF PRR
Based on the extent and depth of the carious lesions:
a) Type A - Suspicious pits and fissures where caries removal is limited to
enamel.
b) Type B - Incipient lesion in dentin that is small and confined
c) Type C - Characterized by the need for greater exploratory preparation
in dentin

10. • Simonson (1978) advocated an unfilled sealant --- type A
A diluted composite resin ---- type B
Filled composite resin ---- type C
• Ulvested (1976) adopted the concept of diluted composite resin---- mixture
of filled composite resin and unfilled bonding agent over an unfilled sealant.
• Use of an intermediate unfilled resin layer.

11. • Lebell and Forsten (1980)
• Shapira and Eidelman (1984)
• Houpt et al (1984) demonstrated by using an auto
polymerization filled resin over covered with unfilled sealant in
type b restorations.
• After 4 yrs reported that 76% of placed restorations were
completely retained.

12. TYPE A RESTORATION
• Enamel fissure caries are removed with slow speed round bur.
• Enamel surface is etched
• Completely with sealant.

13. PLACEMENT TECHNIQUE
• TYPE A RESTORATION
1)CLEAN THE SURFACE
2)ISOLATION
3)REMOVE DECALCIFIED PITS AND FISSURE
4)PLACE ACID – ETCHED GEL – 20 TO 60 SEC
5)WASH AND DRY
6)APPLY THE SEALANT
7)POLYMERISE WITH VISIBLE LIGHT – 20 SEC
8)ADJUST THE OCCLUSION, IF NEEDED

14. TYPE B RESTORATION

15. PLACEMENT TECHNIQUE
 Removal of caries
 Application of acid – etching gel
 Bonding agent application
 Injection of filled composite resin
 Condensation and smoothing
 Filled sealant application
 polymerization

16. REMOVAL OF CARIES
1.With a high speed no.330 bur,
followed by a slow speed no.1/2
Round bur.
2.After caries removal Ca(OH)2
liner is placed .

17. Acid etching
Acid etching gel is applied over
the entire occlusal surface for
20 to 60 sec , then washed 20
Sec and dried 10 sec.

18. Bonding agent application
The walls of the preparation
are coated with bonding agent
which act as an intermediate
Resin layer.

19. Composite resin application
Filled composite resin is
injected into the preparation
and placed.

20. Resin condensed and smoothened by plastic
or Teflon instrument
The composite resin is
condensed and smoothed
with a plastic or teflon
Instrument.

21. Sealant application
Filled sealant material is
Applied over the entire
Occlusal surface.

22. Polymerization
All layers are simultaneously
Polymerized with visible light
Produced by the Polymerization
unit.

23. Occlusal adjustment
The occlusion is adjusted,
Where required, with finishing burs.

24. TYPE C RESTORATION
 Repeat all steps listed for type B
 Type C is larger and deeper add additional polymerization time
(30 sec).
 In most cases local anesthesia will also be required.

25. ADVANTAGES
Minimal cavity preparation is required
thus prevents unnecessary removal of healthy tooth
structure for retention.
Seals caries halting the destruction of tooth.
Eg: teeth with pit and fissure

26. Conventional restoration leading
to complete tooth loss

27. PRR with minimal tooth
loss

28. Loss of the restoration and subsequent replacement proves
to be less invasive than that for conventional restoration like
amalgam.

29. PRECAUTIONS
Early loss of PRR similar to pit and fissure
sealants
due to insufficient etching
so, it is very important to maintain excellent isolation
from moisture contamination

31. THANK YOU!