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Bonded Sealing: A Great Way to Save Fractured Teeth By Dr. Ed Mapes Bonded sealing is a process used to seal broken teeth or teeth with enamel hypoplasia. These damaged teeth are susceptible to the entry of bacteria that can then travel down the tooth’s interior (the dentin) to set up infection within the root structure. This eventually causes an abscess that erodes the root and then infects the gum. Needless to say, this is a painful process that pets usually endure without our knowledge. This whole scenerio can be prevented by early intervention when a tooth is broken. Application of a bonded sealant closes the broken surface to prevent bacteria from entering the tooth’s dentin. This region of the inner tooth is comprised of many fine tubules that traverse the tooth toward the root. Application of the sealant closes these tubules and thereby prevents further damage to the tooth and adjoining gum surfaces. The process starts with dental digital radiographs to visualize the tooth and ensure that it is healthy. Close examination of the root apex (deepest portion of the root) is important because unseen infection can exist there. Teeth with damage or infection involving the root structures will not respond to bonded sealing, since the damage has already been done. These teeth will require either root canal or extraction procedures at that point. Figure 1: Dental X-ray shows that the root of this canine tooth is healthy With evidence that the root structures are healthy and intact, the technique begins by rounding off any jagged areas of the fractured tooth with a dental burr. The tooth is then ground with a series of polishing discs until the surface is very smooth and even. At this point we etch the surface with a phosphoric acid solution, preparing it for sealing. Two compounds are subsequently applied to the tooth and heat-treated with a dental curing light. This process creates a very hard, impervious surface that permeates the dentinal tubules and seals them against penetration by microbes. We recommend sealing of any fractured teeth, even if the damage is not recent. As long as the tooth is stable in its socket and has no radiographic evidence of root damage or infection, sealing is worth the effort; this process is much less traumatic and more economical than either the root canal or extraction. We always re-radiograph sealed teeth six months after the treatment to ensure that the sealant is still present and the root structures are healthy. The bonded sealant is very effective in protecting fractured teeth or those with damaged enamel surfaces. Patients that insist on chewing rocks and fences can eventually wear the sealant off and require another procedure, but the sealant in the tubules usually persists unless the tooth is fractured again.