Resin-based sealants are basedon acrylic (methacrylate), may or may not contain filler particles or fluoride, and the setting reactioncan be automatic (auto-polymerised) or light activated (light-polymerised). Low-viscosity resin-basedrestorative materials (flowable composites) have also been used as fissure sealants.Glassionomer sealants have evolved from glass ionomer cements, which can adhere directly to toothsubstance.15 Glass ionomer materials release fluoride over time and have the advantage of being lesssensitive to moisture contamination than resin-based materials, making them a potential alternative toresin-based sealants when moisture control is an issue
Glassionomer sealants have evolved from glass ionomer cements, which can adhere directly to toothsubstance.15 Glass ionomer materials release fluoride over time and have the advantage of being lesssensitive to moisture contamination than resin-based materials, making them a potential alternative toresin-based sealants when moisture control is an issue
the impact of fissure sealants alone onreducing caries is likely to be less for primary teeth than for permanent teeth.
careful visual assessment of the tooth was appropriate for assessingthe need for sealants, and also that existing radiographs, if recent, should be consulted before sealantapplication. Additional caries detection tools should only be considered when there is concern thatcaries might extend into dentine.
Pit and fissure sealant
Supervisor: Dr. Rana DarwishDone by : Ahlam Taweel 20911199 Sajidah Sarahnah
A thin plastic coating placed in the pit and fissures of the teeth to act as a physical barrier to decay. As a way to prevent caries and protect the tooth . strategy based on assessment of caries risk include application of fluoride varnish, education, nutritional counselling and regular clinical review
The molar teeth have many fissures and pits, which can be very difficult to keep clean. These are the sites most susceptible to developing decay
resin-based sealants :o May or may not contain filler particles or fluoride.o The setting reaction can be automatic(auto- polymerised) or light activated (light- polymerised). .o Low viscosity resin-based RM (flowable composite) have also been used as fissure sealant.o retention rates 2%–80% better than the GIC sealants.
glass ionomer sealants :o can adhere directly to tooth substance.o release fluoride over time.o Less sensitive to moisture contamination than resin-based materials.o Retention is a major problem with GIC sealants, but if this concern can be resolved, there maybe advantages to the GIC sealants through the release of fluoride.
Sealants are able to:o prevent pit and fissure caries initiation .o arrest caries progression by providing a physical barrier that inhibits micro-organisms and food particles from collecting in pits and fissures. the effectiveness of sealants decreased over time and was higher in populations exposed to fluoridated water.
o type of sealant materialo placement techniqueo retention of sealanto cooperation of patiento follow-up timeo the content of fluoride in the drinking watero dietary, oral hygieneo the socioeconomic factors
all permanent molar teeth without cavitation (i.e., free of caries or incipient caries). early (non- cavitated) carious lesions in children, adolescents and young adults to reduce the percentage of lesions that progress (Griffin et al. 2008). teeth that have deep and narrow pit and fissure morphology (the caries risk is increased because of difficulties to clean the tooth). teeth with stained grooves
on the primary molars of children who are susceptible to caries (i.e., high caries risk). Sealants should be placed on first and second permanent molar teeth within 4 years after eruption.
Sealants should not be placed on partially erupted (i.e., once there is gingival tissue on the crown) Teeth with cavitation or caries of the dentin
the most important teeth for sealantapplication are the first and secondpermanent molar teeth. Other teeth, such as premolars, third molars or the palatal surfaces of incisor teeth, may be considered for sealant application, based on:o caries risk status.o and assessment of the tooth surface.
1. Child with occlusal caries on one of the firstpermanent molar.Seal the remaining sound first permanent molars.2. Occlusal caries affecting one or more firstpermanent molarsNeed to seal the second permanent molar as soon asthey have erupted sufficiently.3. Tooth should be sealed within 2 years of eruption.
for some children, such as those with medical or other conditions where the development ofcaries or its treatment could put the child’s general health at risk, sealing primary molar teeth shouldbe considered as part of a comprehensive caries- preventive program .
Teeth should be clean, dry and well-illuminated for visual assessment. A probe should not be used to explore pits or fissures((Forceful use of a probe can damage tooth surfaces)) Radiographs should not be taken for the sole purpose of placing sealants. Other diagnostic technologies are not necessary for the sole purpose of placing sealants.
The results indicated that teeth with fully orpartially lost sealant are not at higher risk ofdeveloping caries than teeth that were never sealin order to reduce the possibility of formerlysealed teeth returning to their original risk status,sealants need to be maintained.answer be yes just if : This is particularlytrue for children who have sealants applied toteeth with demineralised enamel or suspiciouslesions.
as soon as the tooth is sufficientlyerupted to be isolated. Time of eruption: first permanent molars :o 6.0–6.3 years for girlso 6.3–6.5 years for boys second permanent molars:o 11.5–12.3 years for girlso 11.8–12.4 for boys
patients are not at risk of exposure to BPA fromthe use of dental sealants, but recommendedprecautionary measures to reduce potential exposureto BPA from dental sealants which include:rinsing the surface of the cured material for 30seconds with water while using effective suction;getting the patient to rinse for 30 seconds andspit out after the procedure; removing thesurfaceresidual monomer layer with pumice on acotton pellet or a prophy cup.
the placement of sealants should be on permanent molar teeth as both cost-effective and efficacious in the prevention of caries. the supporting evidence of the placement of sealants on primary molars is more limited.
the recall interval for high caries risk children should not exceed 12 months. if isolation has been difficult to achieve or the sealant has been applied over a suspicious lesion, recall within 6 months.
In a randomized trial (Bravo et al. 2005), after nine years, caries reduction was: 65.4% (SE=8.5%) for sealants 27.3% (SE=10.2%) for varnish Furthermore, the varnish programe was not effective during the discontinuation period.
by isolation of the teeth. application of bonding agents ((use of flowable resin, following phosphoric acid gels))
it is very important to adequately isolate the teeth because the salivary contamination is the major cause of loss of sealants in the first year. Just rememberIsolate the tooth to be sealed with either adental dam or cotton wool rolls/isolationshields combined with effective aspiration
Sealant retention should be checked with a probe after polymerisation to ensure that all fissures are completely sealed. If any material is dislodged, the sealant should be reapplied after re-cleaning (if necessary.