Pit and fissure sealents

RECENT ADVANCEMENTS IN PIT
AND FISSURE SEALENTS
Dr.Tinet Mary Augustine. BDS,MDS
Pediatric Dentist
Dr.Tinet’s Pedorayz, Pediatric And Early Age Orthodontic Dental
Clinic
DR.TINET MARY AUGUSTINE.MDS1

 INTRODUCTION
 PRINCIPLE
 DEFINITION
 HISTORY
 CLASSIFICATION
 RATIONALE
 INDICATION
 CONTRAINDICATION
DR.TINET MARY AUGUSTINE.MDS
2

 REQUIREMENTS OF AN IDEAL SEALENT
 CONVENTIONAL METHOD OF PIT AND FISSURE
APPLICATION
 LIMITATIONS OF THE CONVENTIONAL SEALENTS
 RECENT ADVANCEMNETS
 REMINERALIZING PROPERTY
 FLOURIDE INCORPORATED
 ACP INCORPORATED
 NOVAMIN
 RESIN BASEED
3

 SEALENTS WITH OPTIC PROPERTIES
 CLEAR
 COLOURED
 FLOURESCENT
 HYDROPHILIC BOND SEALENTS
 BIOLOGICAL SEALENTS-BPA FREE SEALENTS
 SEALENTS WITH NANOPARTICLES
 COMPARATIVE EVALUATION /CRITICAL EVALUATION
OF DIFFERENT SEALENTS
 RECENT RECOMMENDATION OF AAPD
 CONCLUSION
4

INTRODUCTION
The prevalence of caries has decreased in
the past two decades and contributing to
this decline are water fluoridation,
dentifrices, improved oral hygiene, changes
in diet and awareness.
Pit and fissure sealants are major
cornerstone of modern preventive dentistry
in prevention of caries in susceptible teeth.
5

PRINCIPLE
 Any procedure must be carried out at the
earliest possible time after eruption to
make effective preventive use of fissure
sealants
GREWAL 2008
6

DEFINITION
Pit (Ash, 1993):
A small pinpoint depression located at the
junction of developmental grooves or at
terminals of those grooves.
 Fissures (Orbans, 1954):
Deep clefts between the adjoining cusps.
They provide areas for retention of caries
producing agents.
7

 A material that is introduced into the
occlusal pit and fissure of caries
susceptible teeth, thus forming a micro-
mechanically bonded, protective layer
cutting access of caries producing
bacteria from their source of nutrients‖
(Simonsen RJ, 1978)
8

 Fissure sealants are materials designed to
prevent pit and fissure caries when they
are applied to the occlusal surfaces of
teeth in order to obliterate occlusal
fissures and remove the sheltered
environment in which caries may thrive.‖
(Gordon-1962)
9

It is a material that is placed in the pits and
fissures of teeth in order to prevent or arrest
the development of dental caries
R Welbury, M Raadal, N Lygidaks, EAPD
Policy Document, 2003
10

According toADA
 An adhesive material that is applied to
pits & fissures of teeth in order to isolate
from rest of the oral cavity.
11

HISTORY
12

13

Classification of pit and fissure
sealent
Nagano, 1961
1. V – type (34%)
2. U – type (14%)
3. I – type (19%)
4. IK – type (26%)
5. Inverted Y – type (7%).
14

Classification of pit and fissure
sealants (Mitchell and Gordon
1990)
15

16

Indication (Ekstrand and
Christiansen, 2005 )
 active fissure caries has been diagnosed.
 a high risk had been established.
 fissures are deep and the patient or
parent either cannot, or will not remove
plaque effectively.
17

Rationale (British society of
pediatric dentistry 2000)
 Very high proportion of dental decay
occurs in pits and fissures. Recent data
shows that relative proportion of pit and
fissure lesions has increased to 84% of total
new caries experience.
 Pits and fissures remain at risk of caries for
long periods of time, not just within the first
few years of eruption.
18

 Fluoride has limited effect in preventing
pit and fissure caries.
 Fissure sealants are effective at
preventing pit and fissure caries and are
best used as a part of overall preventive
program.
19

Advantages
• It is a non-invasive technique.
• Sealing of pits & fissures prevents tooth
decay.
• Fluoride release from fluoridated sealants
can confer protection to adjoining areas.
• Sealants can be used at the community
level for prevention of caries.
20

Limitations (Hallstrom, 1993)
Adverse reaction- allergy to resin
Caries susceptibility of etched enamel.
Economic feasibility.
Inadvertent placement over carious sites
Detection of lost sealant.
21

REQUIREMENTS OF MATERIALS USED
AS SEALANTS (Brauer 1978, HienNGO 2012)
 A viscosity allowing penetration into deep
and narrow fissures.
 Adequate working time.
 Rapid cure
 Good and prolonged adhesion/bonding
to enamel
22

 Low sorption and solubility.
 Resistance to wear.
 Be compatible with oral tissues.
 Cariostatic action
23

Patient selection
Simonsen 1983.
 Group 1 – Caries free patients judged at
no risk to decay.
 Group 2 – Patients judged to be at
moderate risk to decay.
 Group 3 – Patients with rampant caries at
a high risk to decay.
24

 3-4yrs : Primary molar sealant
application.
 6-7yrs : First permanent molar .
 11-13yrs : Second permanent molars
and the premolar.
25

WF Waggoner and M Siegal. Pit and fissure sealant application: An updating technique. J Am Dent Assoc, 1996; 127: 351-361.

27

34
28

SALIVA CONTAMINATION
 Silverstone 1984- glycoprotein reduce
bond strength
 I sec saliva contamination wont clear
even after 30 seconds of copious irrigation
29

 Hitt, 1992 and Fiegal, 2002 postulated that applying
halogenated bonding agent after etching can
increase bond strength in saliva contaminated
enamel (0.0005 to 17.8 Mpa) and in
uncontaminated enamel (16.7 to 20.5 Mpa)
because bonding agent displaces saliva from
enamel, improving sealant wetting of surface.
30

TOOTH PREPARATION
 Brockleherst, 1992 suggested that air
abrasion with aluminum oxide particles is
the best method of cleaning as it results in
an improved surface for resin wetting,
more number of resin tag formation and
more depth of sealant penetration.
31

 Sol et al. 2000 found out that use of
sodium bicarbonate air polishing system
resulted in higher retention of cement.
32

 Garcia Godoy et al. (1994) and Zervou et
al. (2000) recommended enameloplasty
as it increases the surface area and
decreases microleakage
33

FISSUROTOMY BUR
 It cuts a smooth, minimally invasive
groove in suspicious fissures to allow for
explorer access
34

ETCHING TIME
 Buonocore (1955) Observed that, after
treatment of the enamel with
concentrated phosphoric acid
solution, attachment of acrylic resin to
tooth surfaces was greatly increased.
35

 Duggal et al. (1997) have used different
etching timing of 15, 30, 45 and 60
seconds and concluded that there is no
difference is retention of sealant using
different etching time.
36

 Tandon S et al. (1989) have proposed an
etching time of 15 sec to be sufficient for
primary teeth
 Etching of 2mm on either side of exposed
groove
37

Application times (IADR sealant
symposium in 1991).
38

ZONES OF ETCHING
(SILVERSTONE 1976)
39

CURING
 Chosak and Eidelman found that the longer sealants were
allowed to sit on the etched surface before being
polymerized, the more the sealant penetrated the
microporosities, creating longer resin tags, which are
critical for micromechanical retention.
 Hicks et al. (2000) found that argon laser curing of sealant
material may enhance caries resistance.
40

RETENSION-
Wintrobe 1989
41

The sealant effectiveness
canbe assessed by
CCC sealant evaluation
system
 The sealant effectiveness can
be assessed by CCC sealant evaluation
system
C – Colour: validity of sealant
identificationa nd caries diagnosis.
C – Coverage: effectiveness of the sealant.
C – caries: caries status on the surface.
42

Codes for evaluation of sealant-
Ana Luiza Falavinha VieiraI et al 2006
43

TYPES OF SEALENTS
1. Glass ionomer cement sealants
2. Sealants with bonding agents
3. Self-etching light cured sealants
4. Fluoride releasing sealants
5. Moisture-resistant sealants
6. Colored versus clear sealants
44

RECENT ADVANCEMNETS
 REMINERALIZING SEALENTS
 FLOURIDE INCORPORATED
 ACP INCORPORATED
 NOVAMIN
 RESIN BASED
 SEALENTS WITH OPTIC PROPERTIES
 CLEAR
 COLOURED
 FLOURESCENT
 HYDROPHILIC BOND SEALENTS
 BIOLOGICAL SEALENTS-BPA FREE SEALENTS
 SEALENTS WITH NANOPARTICLES
45

TRADE NAMES
 Fluoride releasing sealants—Seal-Rite® (Pulpdent),
FluoroShield® (Dentsply), Conceal F® (SDI)
 Clear pit and fissure sealant—Helioseal®
 Colored pit and fissure sealant—Clinpro®
 Fluorescing pit and fissure sealant—Delton
Seal-N-Glo®
46

 Moist bonding pit and fissure sealant—
Embrace WetBond®
 Pit and fissure sealant with acp—Aegis
Pit® and fissure sealant
 Hydrophilic fluorescent BPA free Pit and
fissure sealant—UltraSeal XT® hydro.
47

FLOURIDE RELEASING SEALENT
(Seal-Rite® (Pulpdent), FluoroShield® (Dentsply),
Conceal F® (SDI).
FLOURIDE RELEASE:2-3 MICROGRAMS/ML/DAY
48

Evolution
 fluoride-releasing sealants were introduced by
SWARTZ in 1976
 The sealants developed by Dr. H. Ralph Rawls
of the Louisiana State University School of
Dentistry, research associate Barbara
Zimmerman, and dental by ion exchange.
This process leaves the sealant structure intact
while providing a long-term, steady rate of
release
 Zimmerman, B.F.; Rawls, H.R.; and Bassett, R.G., Jr. Fluoride release
and physical properties of an experimental resin-filled sealant. J
Dent Res 63:295, abstract no. 1116, 1984.
49

 Current commercial fluoride-releasing
sealants contain either a soluble fluoride
salt such as sodium fluoride (NaF) or
fluoride-releasing glass filler or both
50

 Garcia Godoy (1997) found out that all
the fluoridated sealant had the greatest
amount of fluoride release by 24 hours
after mixing and the fluoride release
declined sharply thereafter.
51

Dr. Harald Loe 1986
52

PRINCIPLE
 The long-term capability of resin sealants and glass
ionomer cements to release fluoride to the sealed
enamel and the adjacent unsealed pit and fissure
associated to a reduction in pit and fissure caries
experience for children (CHESTNUTT 1994)
 Act as rechargeable fluoride release devices
(FOSTEN 1991)
 Contact to adjacent teeth prevent
demineralization (DONLY KJ 1999)
53

 Cooley et al. (1990) and Hicks et al.
(1992) conducted lab studies on a
fluoride releasing sealant material
composed of a modified urethane Bis-
GMAresin.
 They concluded that fluoride release dips
considerably as the days go by. But, they
showed that 60 percent reduction in
secondary caries and enhanced degree
of caries resistance was seen.
54

LEVEL OF FLOURIDE RELEASE
This benefit of fluoride release and
subsequent adsorption is found not only in
enamel immediately adjacent to
restorations, but also in areas up to 3 mm
away from the restoration margins and may
even protect the entire tooth
 ARNADA M 1994
55

RECHARGE OF FLOURINE
 The higher fluoride release from glass
ionomer cements during the first days is
named ―burst effect‖ (ATTAR N 2003)
 Sealent materials with higher initial fluoride
release have higher recharge capability
(XU X 2003)
 Regular use of fluoride toothpastes
(WEIGAND A2007)
56

57

NO F
58

Fissurit FX/Voco showed significantly higher fluoride release than
Grandio Seal/Voco till day 49The application of fluoride varnish
Profluorid Varnish enhanced the fluoride release for all sealants than
highly fluoridated fluoridated CPP-ACP toothpaste
59

 Refluoridation of flouridated sealants supported by:
 Takahashi K, Emilson C G, Birkhed D. Fluoride release
in vitro from various glass ionomer cements and resin
composites after exposure to NaF solutions. Dent
Mater. 1993;9:350-4.
 Attar N, Turgut MD. Fluoride release and uptake
capacities of fluoride-releasing restorative materials.
Oper Dent. 2003;28:395-402.
60

61

CLEAR PIT AND FISSURE
SEALENT
 Helioseal®: Changes from green to white
62

OPAQUE PIT AND FISSURE
SEALENST
63

Concern
 Inappropriate application of sealants and
subsequent micro-leakage might lead to
the progression of caries .Therefore,
periodic recall visits should be arranged to
assure their effectiveness.
 Wells MH. Pit and fissure sealant: scientific and clinical rationale. In:
Cassamassimo PS, Field HW, Mctigue DJ, Nowak AJ, editors. Pediatric
dentistry: Infancy through adolescence. 5th ed. St Louis: Saunders Elsvier; 2013.
pp. 467–489.
64

Evaluation
 Visual evaluation
 A possible method to achieve this goal is
to employ Laser flourescence by
DIAGNOdent
LF Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of
occlusal caries in children.Anttonen V, Seppä L, Hausen H Caries Res. 2003 Jan-Feb;
37(1):17-23.
Effect of sealants on laser fluorescence caries detection in primary teeth.Askaroglou E,
Kavvadia K, Lagouvardos P, Papagiannoulis LLasers Med Sci. 2011 Jan; 26(1):29-34.
65

Advanatge of clear sealents
 As clear sealants allow visual examination
of carious lesions beneath the sound
enamel, they seem to be the best option
to clinically detect the caries
 The influence of pit and fissure sealants on infrared fluorescence measurements.Diniz
MB, Rodrigues JA, Hug I, Cordeiro RC, Lussi A Caries Res. 2008; 42(5):328-33.
66

Opaque sealers
 The most common opacifying filler in
sealants is TiO2. This filler facilitates the
application of sealant and its visual
assessment in recall visits
67

Ti02
 As TiO2 content increases, fluorescence
transmission is weakened thus it might
interfere with the fluorescence transmitted
from caries or laser devices.
 Delton opaque sealants contain 1.5%
TiO2, and also SiO2 .
 Helioseal opaque sealant, contained 2%
TiO2. Effect of sealants on laser fluorescence caries detection in primary
teeth.Askaroglou E, Kavvadia K, Lagouvardos P, Papagiannoulis L Lasers Med
Sci. 2011 Jan; 26(1):29-34.
68

Reading on recalls
 intrinsic fluorescence of clear and
opaque sealants significantly affects LF
readings
 Therefore, it might lead to increased false
positive results and therefore caries
overestimation.
 An in vitro evaluation of the effect of sealant characteristics on laser
fluorescence for caries detection.Gostanian HV, Shey Z, Kasinathan C,
Caceda J, Janal MNPediatr Dent. 2006 Sep-Oct; 28(5):445-50.
69

Controversy
 Deery et al.(2006) and Sonmenz et
al.(2011) have concluded that
fluorescence measurements was
significantly decreased after applying
clear sealants
storing media was 1% aqueous thymol
solution
70

Thin sealer thickness-0.5-1mm
71

 The ability of LF in detecting caries beneath the filled
and unfilled clear sealants as well as the sealants
containing titanium dioxide was evaluated.
 Clear sealants (not containing opacifying agents)
weakened LF signals, considering the fact that filled
sealants decreased LF values more profoundly than
unfilled sealants (p< 0.001). Also, as the concentration of
titanium dioxide reaches 0.5%, the transmission of
fluorescence signals was significantly decreased
 Gostanian HV, Shey Z, Kasinathan C, Caceda J, Janal MN Pediatr Dent. 2006 Sep-Oct; 28(5):445-
50.
72

 In an in vitro study by Diniz et al., the influence of
Delton clear, Delton opaque and Helioseal clear pit
and fissure sealants was evaluated on infrared
fluorescence measurements. By using conventional LF
and an LF pen device for measurements, no
statistically significant changes were observed after
the application of the clear sealant, while values
tended to decrease when using Delton and Helioseal
opaque sealants
 Diniz MB, Rodrigues JA, Hug I, Cordeiro RC, Lussi A Caries Res. 2008; 42(5):328-33.
73

74

COLORED PIT AND FISSURE
SEALENT
 Clinpro®—changes to pink on setting.
75

DENTEX SEAL
- Available in yellow , white n pink in
color
76

CLINPRO SEALANT
Colour changes technology to visualize
placement
Low viscosity to flow easily into pit and
fissures
77

3M ESPE KETAC MOLAR PIT
ANDFISSURE SEALANT
Light cure
Low viscosity
Colour change technology to visualize
placement.
78

COMPOMER PIT AND FISSURE
SEALANT
Tooth coloured
Opaque fissure sealant
Releases fluoride
Contains bactericidal zinc ions
79

FLOURESCING PIT AND FISSURE
SEALENT
 Delton Seal-N-Glo (Dentsply).
80

Advanatge of flouresecent
sealers
 Eliminates the guess works involved in the
placing of sealents and confirming
placement during recall appointments
 Use of UV pen light. Seal-N-Glo Fluoresces
a blue/white color.
 Thus easiest way to verify retension and
inspect margins
81

82

83

SELF ETCHING SEALENTS
- Self etching
- Light cure
- Release fluoride
- Natural white
According, to the company, Enamel Loc
is:
“The First Self-Etching Light-Cured Pit &
Fissure Sealant. “
84

 Beauti Fill sealant
 Fluoride releasing / recharging
 Tooth colored
 Free of Bis –phenol A
 Hydroxyethylene methacrylate (HEMA)
85

86

87

In a study to Compare effectiveness of traditional acid
etching and of the self-etching agent in sealant
retention,the results showed that there was No significant
difference was seen in the retention of fissure sealants
placed on occlusal surfaces following the use of an
traditional acid etching technique and Self Etching
bonding agent, after 6 months.
88
Mohammed IP, Jaleel BF, Hiremath SS, Manjunath C, Amarah U, Krishnamoorthy
A. Comparison of effectiveness of traditional acid etching and of the self-etching agent in sealant retention: A randomized
controlled trial. J Indian Assoc Public Health Dent 2016;14:4-9

89

90

Pit and Fissure Sealant with
Amorphous Calcium Phosphate)-
Aegis® Pit and fissure sealant.
91

Advantage
 It is a light-cured sealant
 contains the ―smart material‖ amorphous
calcium phosphate (ACP) that is more resilient
and flexible, creating a stronger, longer lasting
sealant.
 Also it releases calcium and phosphate ions
when the pH drops to 5.9. Once the calcium
phosphate is released, it will act to neutralize the
acid and buffer the pH. ACP acts as
reinforcement to the tooth’s natural defense
system only when it is needed.
92

 It has a controlled flowability that keeps
the sealant on the tooth structure while
completely filling occlusal surfaces and it forms a
chemical and thermal barrier protecting the tooth
enamel on the occlusal surface from carious
attacks.
93

ACP-Amorphous calcium phosphate
sealant )
Eg: Bosworth Aegis pit & fissure sealants
Zawaideh FI, Owais AI, Kawaja W. Ability of pit and fissure sealant-containing
amorphous calcium phosphate to inhibit enamel demineralization. Int J Clin
94

95

96

97

98

Saliva contamination
99

Moisture tolerant pit & fissure sealants.
Eg: Embrace WetBond™ (Pulpdent
Corporation).
Akurathi Ratnaditya et al. Clinical Evaluation of Retention in Hydrophobic
and Hydrophillic Pit and Fissure Sealants-A Two Year Follow-Up Study .
Journal of Young Pharmacists 2015 ;7( 3);171-179
100

Embrace WetBond™
(Pulpdent Corporation).
 Hydrophilc.
 Embrace is activated by moisture.
 Embrace WetBond contains no bis-
GMA and no bisphenolA.
 It contains fillers (aluminum powder, carbon
fiber, graphite, calcium carbonate, silica,
clay)
101

ENAMEL WETBOND
Resin cement medium viscosity Brand
names
1.EMCA
2.EMCAR
3.EMCAR2
4.EMCM
5.EMCMR
6.EMCMR2
102

DELTON FS +
Direct delivery system
Fluoride releasing
Low viscosity
Retention rate – 30.4%
High wetting ability
103

 When placed in the presence of moisture, the
sealant spreads over the enamel surface (A
traditional sealant does not spread over a moist
tooth surface because of its hydrophobic nature).
 Because of its unique chemistry, Embrace
WetBond is miscible with water and flows into
moisture-containing etched enamel and
combines with it.
104

Sealing ability
 It forms a unique resin acid-
integrating network (RAIN) that
improves penetration into pits and fissures
and provides superior sealing of the
margins.
105

Bonding It bonds chemically and micromechanically to
the moist tooth, integrating with the tooth
structure to create a strong, margin-free bond
that virtually eliminates microleakage.
106

Advantage
 Wet bonding,
 Tooth integrating,
 no marginal chipping,
 no need of bonding agent
 contains no Bisphenol A Bis-GMA or Bis-
DMA.
107

CONCERN
 Feigal came up with the novel concept
that hydrophilic bonding materials that
contain water, may, when applied under
a sealant, minimize the bond strength
normally lost when a sealant is applied in
a moist environment.
108

109

110

111

112

113
• The Hydrophillic sealant (79.6) showed significantly more retention
than Hydrophobic sealants(73.4).
Akurathi Ratnaditya et al. Clinical Evaluation of Retention in Hydrophobic
and Hydrophillic Pit and Fissure Sealants-A Two Year Follow-Up Study .
Journal of Young Pharmacists 2015 ;7( 3);171-179

114

HYDROPHILLIC FLOURESCENT BPA
FREE PIT AND FISSURE
SEALENTUltraSeal XT® hydro.
115

Advantage
 Hydrophilic chemistry,
 Advanced adhesive technology,
 Fluorescent properties,
 Thixotrophic viscosity,
 Bpa-free formula.
116

117

 Thus not only can it be used in wet
environment but also is easy to place
owing to thixotrophic viscosity and is easy
to follow up due to fluorescence.
 To prevent nay estrogenicity issues the
manufacturer has kept it BPA free.
118

119

Pen type handling of sealants.
 Eg: Ecuseal
(Ecu-PEN is autoclavable up to 130 °C. It will
withstand 100 autoclave cycles.)
120

Nano composites as sealants.
 Eg: Transeal (Deep penetration and
excellent flow rate)
121

123

125

126

Advances in curing of sealants
1. U.V light cure (320-395nm)
2. LED CURING LIGHT (440-490nm)
3. Tungsten halogen curing light (400-500nm)
4. PlasmaArc (400-500nm)
5. LSAER (LightAmplification by Stimulated
Emission Radiation)
Eg: Co2 laser improved retention of sealant
(10600nm).
Argon laser improved mechanical retention of
sealant (488, 514nm).
127

128

 Compared sealed and unsealed teeth in
the same mouth.
 Teeth which were initially sound had
caries rate 13% at 5 years when unsealed
and
129

Studies on Sealant
130
•Huda Nazar et al (2013) conducted a study on
Effectiveness of Fissure Sealant Retention and Caries Prevention
with and without Primer and Bond. Results showed that There
was no difference between teeth sealed with primer and bond and
teeth sealed without primer and bond retained sealant.
Huda Nazar et al. Effectiveness of Fissure Sealant Retention and Caries
Prevention with and without Primer and Bond. Med Princ Pract
2013;22:12–17 DR.TINET MARY AUGUSTINE.MDS

131
Priscilla Santana Pinto Goncalves et al(2016)
Conducted a study with Pit and Fissure Sealants
with Different Materials: Resin Based vs Glass
Ionomer Cement. Both the sealants, Fluroshield
(Dentsply) and Clinpro TM Varnish® XT(GIC) were
effective in preventing caries lesion within 6
months, although Fluroshield sealant showed
better clinical retention.
Ref: Priscilla Santana Pinto Goncalves et al. Pit and Fissure Sealants
with Different Materials: Resin Based x Glass Ionomer Cement – Results
after Six Months .Brazilian Research in Pediatric Dentistry and Integrated
Clinic 2016, 16(1):15-23

 Comparison 1.
Sealants versus nonuse of sealants. The
results of 9 studies (3,542 participants).
Participants who received sealants reduced
their risk of developing new carious lesions
by 76% compared with participants who did
not receive sealants.
132

 Comparison 2.
Sealants versus fluoride varnishes. The results
of 3 studies (1,715 participants) Participants
who received sealants had a 73% reduction
in the risk of developing new carious lesions
compared with participants who received
fluoride varnishes.
133

134

Priscilla Santana Pinto Goncalves et
al(2016) conducted a study Pit and Fissure
Sealants with Different Materials: Resin Based vs
Glass Ionomer Cement. Both the sealants,
Fluroshield (Dentsply) and Clinpro TM Varnish®
XT(GIC) were effective in preventing caries
lesion within 6 months, although Fluroshield
sealant showed better clinical retention
Priscilla Santana Pinto Goncalves et al. Pit and Fissure Sealants with
Different Materials: Resin Based x Glass Ionomer Cement – Results
after Six Months .Brazilian Research in Pediatric Dentistry and
Integrated Clinic 2016, 16(1):15-23
135

136

 Huda Nazar et al (2013) conducted a
study on Effectiveness of Fissure Sealant
Retention and Caries Prevention with and
without Primer and Bond. Results showed
that There was no difference between
teeth sealed with primer and bond and
teeth sealed without primer and bond
retained sealant.
Huda Nazar et al. Effectiveness of Fissure Sealant Retention and Caries Prevention
with and without Primer and Bond. Med Princ Pract 2013;22:12–17
137

 Imran Pasha Mohammed et al (2016) conducted a
study on Comparison of effectiveness of traditional
acid etching and of the self-etching agent in sealant
retention: A randomized controlled trial. The study
results showed that there was No significant
difference was seen in the retention of fissure
sealants placed on occlusal surfaces following the
use of an traditional PAE technique and SE bonding
agent, after 6 months.
Mohammed IP, Jaleel BF, Hiremath SS, Manjunath C, Amarah U,
Krishnamoorthy A. Comparison of effectiveness of traditional acid
etching and of the self-etching agent in sealant retention: A
randomized controlled trial. J Indian Assoc Public Health Dent
2016;14:4-9
138

SOME REVIEW STUDIES
139

140

141

DIFFERENT OPTIONS
142

143

144

145

146

AAPD GUIDELINES
147

EVALUATED
 Resin-based sealants,
 Glass ionomer (GI) cements, GI sealants,
 Polyacid-modified resin sealants,
 Resin-modified GI sealants.
148

Resin-based sealants
 Resin-based sealants are urethane dimethacrylate,
―UDMA,‖ or bisphenol A-glycidyl methacrylate (also
known as ―bis- GMA‖) monomers polymerized by
either a chemical acti- vator and initiator or light of a
specific avelength and intensity.
 Resin-based sealants come as unfilled, colorless, or
tinted transparent materials or as filled, opaque,
tooth- colored, or white materials.
149

GI sealants
 GI sealants are cements that were
developed and are used for their
fluoride-release properties, stemming from
the acid- base reaction between a
fluoroaluminosilicate glass powder and
an aqueous-based polyacrylic acid
solution.
150

Polyacid-modified resin
sealants
 Polyacid-modified resin sealants, also
referred to as compo- mers, combine
resin-based material found in traditional
resin-based sealants with the fluoride-
releasing and adhesive properties of GI
sealants.
151

Resin-modified GI sealants
 Resin-modified GI sealants are essentially
GI sealants with resin components. This
type of sealant has similar fluoride- release
properties as GI, but it has a longer
working time and less water sensitivity
than do traditional GI sealants.
152

153

154

Conclusion
 To make significant gain in decreasing
caries in children, it is necessary for dental
professionals to educate and inform the
general public, parents and physicians
about cost effectiveness and caries
preventive benefits of sealants.
155

THANK YOU
156

Pit and fissure sealents

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