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Pit and Fissure Sealants

By completing this survey, you give Pulpdent Corporation permission to use the information you provide below for quality assurance and compliance purposes.
 
1) How often do you personally place pit and fissure sealants?
2) Which pit and fissure sealant material do you use regularly? (Please select only one for this survey)(Required.)
3) How long have you been using this material? (Required.)
4) What do you like most about this product?
5) Please rate the characteristics of the sealant material you chose(Required.)
Excellent
Good
Fair
Poor
N/A
Marginal Integrity
Flowability
Handling
Setting Time
Retention
Color Match
Durability
Strength
Ion Release
6) For any answer of fair or poor, please explain: 
7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?(Required.)
If yes, please rate the severity of the issue
8) How often have you had to replace or repair a sealant done with this material?
9) If you have had to replace sealants done with this material, how many were replaced within;
10) What are the main reasons you have had to replace or repair sealants done with this material?
Comments: 
Are you a dental healthcare provider?(Required.)
I give Pulpdent consent to follow up in 6 months(Required.)
We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.
Internal use only