Aquacut Sealant Technique

By Dr. Jeffrey P. Heilig, D.M.D.
The Aquacut Quattro:                                                                                                            
As a Pediatric Dentist, I have the opportunity of providing my young patients with preventive care that can help them achieve a goal of being cavity-free. Unfortunately, I know that regardless of how well teeth are cared for, it is often difficult to prevent cavities from developing in the deep pits and fissures often found on the chewing surfaces of newly erupted permanent molars. That is why I am a strong proponent of dental Sealants. When Sealants are properly applied to these teeth, they are effective in preventing the initiation of caries as well as the progression of early non-cavitated lesions (JADA 2008;139(3):257-68).
As with all dental treatment, each step in the Sealant procedure is critical for its success. I have been using Air Abrasion as part of my Sealant technique since 1995 and found that it improved the success/retention of my Sealants. In 2005, I upgraded my use of Air Abrasion by using the Aquacut, which enhanced the procedure by now providing the benefits of Hydro-Air Abrasion. 
For me, one of the biggest advantages of using the Aquacut for my Sealant technique is in
1) Diagnosis and 2) Tooth preparation prior to the bonding phase of the treatment.
During a patient’s dental exam, certain teeth may have presented with pits and fissures that appeared potentially suspicious for a possible beginning cavity. By using the Aquacut, I can effectively remove plaque and accumulations from the tooth by "pressure cleaning" the pits and fissures. The teeth are then re-examined to verify that there is no decay. If there is no caries, I will proceed with the Sealant procedure. However, if a cavitated lesion becomes apparent, then the treatment plan will change and a Filling will need to be done. Instead of having to now use my dental hand piece and attach a bur, I just continue using the Aquacut to remove any additional caries. 
The Sealant Technique: 
  • Isolation from soft tissues and prevention of contamination from saliva is accomplished by using cotton roll holders for mandiublar teeth and NeoDrys (Microcopy) which are applied to the cheeks for maxillary teeth.
  • The Aquacut is used to effectively remove plaque and accumulations from the pits and fissures.
  • The tooth is rinsed with water and visually examined. If needed, the AquaCut is used again.
  • Consepsis (Chlorhexidine Antibacterial Solution- Ultradnet) with a Blue Mini Dento-Infusor Tip is used to scrub the pits and fissure.
  • The tooth is then re-examined for caries.
  • Adper-Prompt(3M) is used as a bonding agent and light cured.
  • Gradia-Flo (GC America) is used as an initial Sealant layer and a small ball burnisher is used to adapt the flowable composite into the pits and fissures and light cured.
  • UltraSeal White (Ultradent) is applied using a micro tip (3M) as a second layer and light cured.
  • Check the occlusion.
 Other tips:
For Maxillary teeth I use a disposable mirror (Union Broach).
Jeffrey P. Heilig, D.M.D.

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