Pits and Fissure Pits and Fissure SealantsSealants

What is the rational for pits and What is the rational for pits and fissure sealing?fissure sealing?

Pits and fissure are areas of plaque and Pits and fissure are areas of plaque and debris accumulation debris accumulation and at the same time,and at the same time, they are difficult to clean they are difficult to clean Possibility of Possibility of caries developmentcaries development

Fluoride application Fluoride application is more effectiveis more effective in in preventing proximal caries than occlusal preventing proximal caries than occlusal cariescaries

The concept of sealing pits & fissures with The concept of sealing pits & fissures with resin resin was developed in 1960swas developed in 1960s after the after the introduction of acid etching technique.introduction of acid etching technique.

Who are indicated for pits & Who are indicated for pits & fissure sealing ?fissure sealing ?

Children with special needs; Children with special needs;

1. Medically-compromised 1. Medically-compromised

2. Mentally or physically handicapped2. Mentally or physically handicapped

Children with extensive caries in their Children with extensive caries in their primary teethprimary teeth

<<<<Condition>>>><<<<Condition>>>>The ability to perform perfect isolation and The ability to perform perfect isolation and

moisture control is a must moisture control is a must andandthis requires patient cooperation and fully this requires patient cooperation and fully

erupted molarserupted molars

What teeth are exactly selected What teeth are exactly selected for the treatment ?for the treatment ?

Molars with fissure caries not attacking the Molars with fissure caries not attacking the dentin dentin are indicated for pits &fissures are indicated for pits &fissures sealingsealing

Bite wing X-ray or laser caries-detecting Bite wing X-ray or laser caries-detecting device (Diagnodent) is essential before device (Diagnodent) is essential before

decision makingdecision making

How can we Know the extension of caries ?

Molars with localized occlusal caries confined Molars with localized occlusal caries confined up to the occlusal third of dentin up to the occlusal third of dentin are are indicated for indicated for sealant restorations sealant restorations (i.e. conservative restoration of deep carious area (i.e. conservative restoration of deep carious area followed by sealing of the rest of pits and fissures)followed by sealing of the rest of pits and fissures)

Occlusal caries extending more than the Occlusal caries extending more than the occlusal third of dentin occlusal third of dentin Is indicated for Is indicated for regular restorative techniquesregular restorative techniques

What teeth are exactly selected What teeth are exactly selected for the treatment ?for the treatment ?

Materials for Pits & Fissures Materials for Pits & Fissures sealingsealing

1) Resin-based Sealants1) Resin-based Sealants

Either chemically or visible light-cured resins Either chemically or visible light-cured resins (preferred).(preferred).

Most of them are based on viscous resins such Most of them are based on viscous resins such as as Bis-GMA Bis-GMA and and UDMAUDMA. .

TEGDMA TEGDMA is added to increase the material’s flow is added to increase the material’s flow over the etched enamel surfaces.over the etched enamel surfaces.

Some brands contains Some brands contains inorganic fillersinorganic fillers (silica) (silica) to to

improve the wear resistanceimprove the wear resistance Some new brands contains Some new brands contains fluoride-releasing fluoride-releasing

fillersfillers Others contain Others contain coloring agentscoloring agents to facilitate the to facilitate the

controlled application of the materialcontrolled application of the material

Steps of applicationSteps of application

1.1. Tooth Cleaning Tooth Cleaning using non-fluoride prophylaxis pasteusing non-fluoride prophylaxis paste2.2. Washing with oil-free water sprayWashing with oil-free water spray3.3. Acid etching Acid etching using phosphoric acid for 15-20 susing phosphoric acid for 15-20 s4.4. Washing of acid and drying with airWashing of acid and drying with air5.5. Application of resin sealant Application of resin sealant and light cureand light cure

Materials for Pits & Fissures Materials for Pits & Fissures sealingsealing

2) Glass ionomer-based sealants2) Glass ionomer-based sealants

Low consistency G.I. has been used for sealing Low consistency G.I. has been used for sealing These materials could withstand for 2 years .. These materials could withstand for 2 years .. Low Low WRWR It is recommended when fissure width is more than It is recommended when fissure width is more than 100 µm100 µm

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