Preventive Resin Restorations D1352

A Preventive Resin Restoration (PRR) is a thin, resin coating applied to the chewing surface of molars, premolars and any deep grooves (called pits and fissures) of teeth. More than 75% of dental decay begins in these deep grooves. Teeth with these conditions are hard to clean and are very susceptible to decay.

Carious lesions appear most frequently in the pits and fissures of molars and premolars. The dental plaque inside pits and fissures cannot be removed through conventional cleaning techniques used in dental offices or through home care. The morphology of the fissure makes it difficult to diagnose the initial lesion, and surface decay may only become evident when the carious lesion has progressed. 

In the past, clinicians used the “extension for prevention” approach to treat caries in pits and fissures. Thanks to new restorative techniques and bioactive materials, we can use minimally invasive approaches for more conservative cavity preparations, such as Preventive Resin Restorations (PRR). PRRs were first described by Simonsen and Stallard in 1977. Now PRRs can be performed with ionic composite resins, which restore the lesions in pits and fissures and help prevent recurrent caries in the rest of the fissure system.

The clinical diagnosis for PRRs has three primary elements:

  1. Assessment of the patient’s caries risk; Document the patient’s medical history and perform testing as necessary to determine caries risk.
  2. Diagnosis of lesion depth; Diagnose enamel lesions and not only cavitated lesions. This is important as the progression of the enamel lesion can be arrested.
  3. Diagnosis of lesion activity; Both the activity of the lesion and the risk of caries are very important for diagnosis and treatment planning.

PRR’s are indicated in both temporary and permanent dentition. A PRR is indicated when the carious lesion in the pits and fissures is small and discrete and confined only to the enamel. A dual-cure bioactive ionic resin (Activa Restorative Pulpdent) is applied and, after completing an initial 20-30 second self-curing phase, is covered with an oxygen inhibitor and light-cured.