AMRITA SCHOOL OF DENTISTRY

1. PIT AND FISSURE
SEALANTS
17-08-2022

2. CONTENTS
• Introduction
• Definition
• History
• Types
• Indications
• Contraindications
• Procedure for sealant application
• Preventive resin restoration
• References
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3. INTRODUCTION
• Fluorides are highly effective in reducing the number of carious lesions
occurring on the smooth surfaces of enamel and cementum.
• Unfortunately, fluorides are not equally effective in protecting the occlusal
pits and fissures, where 95% of all carious lesions occurs.
• Considering the fact that the occlusal surfaces constitute only 12% of total
number of tooth surfaces, it means that pits and fissures are approximately
8 times as vulnerable as the smooth surfaces.
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4. What are Pits and Fissures?
• Pits and fissures are enamel faults; narrow
shafts or cracks at some length whose blind
ends are directed more or less towards the
DEJ.
• Pits are small pinpoint depressions located
at the junction of developmental grooves
or at terminals of those grooves.
• Fissures are long clefts between cusps or
ridges.
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5. Types of
Fissures
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6. DEFINITION
A fissure sealant is a material that is placed in the pits and fissures of teeth in
order to prevent or arrest the development of dental caries.
-European Academy of Pediatric Dentistry
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7. HISTORY
Wilson reported the
placement of DENTAL
CEMENT in pit and fissures to
prevent caries.
1895
Application of silver nitrate by
miller
1905
again in 1936
•Hyatt advocated the early
insertion of small restorations
in deep pit and fissures before
carious lesion had the
opportunity to develop.
•He termed this procedure
prophylactic odontotomy.
1923
Bodecker suggested widening
the fissures mechanically so
that they would be less
retentive to food particles and
called it as ‘fissure eradication’
1929
Buonocore introduced a
method of adhering resin to
an acid-etched enamel
surface
1955
Bowen and associates
developed the Bis-GMA resin
which is the chemical reaction
product of Bisphenol A &
Glycidyl methacrylate
1962
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8. TYPES OF
PIT AND
FISSURE
SEALANTS
• First generation
• Second generation
• Third generation
• Fourth generation
Based on curing
• Tinted
• Clear
• Opaque
• Pink
Based on color
• Unfilled
• Semi filled
Based on fillers
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9. MATERIALS
USED AS
SEALANTS
Resins
Compomers
Glass Ionomer
Cements
Flouride
containing
sealants
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10. INDICATIONS
• A deep occlusal fissure, fossa or lingual pit.
• A sealant is probably indicated if:
• The fossa selected for sealant placement is well isolated from another
fossa with a restoration.
• An intact occlusal surface is present where the contralateral tooth
surface is carious or restored; this is because teeth on opposite sides of
the mouth are usually equally prone to caries.
• An incipient lesion exists in the pit and fissure.
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11. CONTRAINDICATIONS
• Patient behavior does not permit the use of adequate dry-field technique
through out the procedure.
• An open occlusal carious lesion exists.
• Caries exist on other surfaces of the same tooth.
• A large occlusal restoration is already present.
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12. PROCEDURE
OF SEALANT
APPLICATION
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13. REQUISITES FOR SEALANT RETENTION
There are four commandments for successful sealant placement, and they
cannot be violated
• Should have a maximum surface area.
• Should have deep, irregular pits and fissures.
• Should be clean.
• Should be absolutely dry at the time of sealant placement and
uncontaminated with saliva.
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14. PREVENTIVE RESIN RESTORATIONS(PRR)
• Is a natural extension of the use of occlusal sealants.
• Integrates the preventive approach of the sealant therapy for caries
susceptible pit and fissure with therapeutic restoration of incipient
caries with composite resin that occur on the same occlusal surface.
• They are the conservative answer to conventional “ extension for
prevention” philosophy of class 1 amalgam cavity preparation.
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15. TYPES OF PRR (SIMONSEN- 1978)
• Type A -Suspicious pit and fissures where caries removal is limited to
enamel.
• Type B –Incipient lesion in dentin that is small and confined. Appropriate
base is placed in areas of dentin exposure, composite resin is placed and
remaining area is covered with sealants.
• Type C –More extensive dentinal involvement and requires restorations
with posterior composite material. Local anesthesia is required
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16. TYPES OF PRR
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17. REFERENCES
• Essentials of preventive and
community dentistry - Soben peter
(fifth edition).
• Textbook of public health dentistry-
SS.Hiremath (third edition).
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