what is a p r r

What is a Preventive Resin Restoration?

This section discusses the definition of preventive resin restoration (PRR) and how it differs from traditional extension for prevention in restorations necessitated by minimal occlusal caries.

Definition of PRR

• A PRR is a restoration that maximizes the benefits of conservative adhesive dentistry.

• The PR are limits preparation to pits and fissures that are curious once the lesion is eliminated no further preparation is performed so only the lesion is removed without extending the preparation for prevention.

• Simonson was the first to describe the combination of a composite restoration and a sealant he called this preventive resin restoration prr an enormous advantage of the concept was that hard tissue was preserved especially when compared with traditional amalgam preparations where every fissure in an occlusal surface was cut and restored following Black's principle of extension for prevention.

Indications for PRR

• A PRR is indicated when some areas of the Fischer system of a tooth are associated with Carius dentin and others are not.

• Typically, these restorations are limited in size and depth so no pulp or protection is needed but a prr is indicated even with a deep caries lesion when areas of the fissure system are not curious.

• Regardless of the depth of the lesion we always restrict the preparation to the lesion and we always seal unaffected pits and fissures if there was a previous restoration.

Clinical Study on Composite Resin Sealant Restoration

This section discusses a nine-year clinical study on composite resin sealant restoration which uses sealing for prevention of fissure carries rather than cavity extension for prevention.

Clinical Study

• The study was performed to examine the nine-year success of the composite resin sealant restoration which uses sealing for prevention of fissure carries rather than cavity extension for prevention.

• Exposed dentin was covered with dike L and the cavity was restored with radio-opaque adaptiq an older material which was then covered with Delta and fissure sealant.

• The ADA's definition of a PR are conservative restoration of an active lesion in a pitter fissure that does not extend into dentin includes play some of a sealant in any radiating non Carius fissures or pits.

Conclusion

This section discusses how the definition of PRR has evolved over time and how it is currently defined by the ADA.

Evolution of Definition

• The definition of PRR has evolved over time, from being limited to enamel lesions only to including lesions that extend into dentin.

• Currently, according to the ADA, a PR are is defined as a conservative restoration of an active lesion in a pit or fissure that does not extend into dentin and includes placement of a sealant in any radiating non-Carious fissures or pits.

Introduction

The lack of a CDT code for PRRs and the potential consequences of this.

• Prior to this time, there was no code for PRR.

• 52% believed that not having a CDT code could cause dentists to perform more invasive dentistry to comply with billing requirements.

• Class one restorations are commonly treatment planned for deep pits and fissures with questionable decay not entering the dentin.

Pediatric Dentists and ABA Restrictions

How pediatric dentists hijacked a code in an effort to get paid, but by this time, the ABA had already placed restrictions on one surface posterior composites that they had to be in dentin.

• Pediatric dentists hijacked this code in an effort to get paid for slightly opening a pit or fissure.

• By this time, the ABA had already placed restrictions on one surface posterior composites that they had to be in dentin.

Sealing Restorations

The importance of sealing restorations and how it applies to lesions in dentin.

• Sealing of restorations can serve sound structure protects the margins of restorations and prevents recurrent caries.

• Amalgam preparations must extend into dentin; otherwise, the amalgam falls out.

• Textbooks released at the end of 2013 mention preventive amalgam restorations. This means that authors must be saying that this procedure applies to lesions in dentin.

Preventive Resin Restoration (PRR)

Two conflicting definitions of PRR exist between textbooks and ADA/pediatric dentists.

• There are two conflicting definitions of a PRR: textbooks say one thing, while ADA/pediatric dentists say something else.