pits and fissure sealants dental material

1. Pits and FissurePits and Fissure
SealantsSealants

2. What is the rational for pits andWhat is the rational for pits and
fissure sealing?fissure sealing?
 Pits and fissure are areas of plaque andPits and fissure are areas of plaque and
debris accumulationdebris accumulation and at the same time,and at the same time,
they are difficult to cleanthey are difficult to clean  Possibility ofPossibility of
caries developmentcaries development
 Fluoride applicationFluoride application is more effectiveis more effective inin
preventing proximal caries than occlusalpreventing proximal caries than occlusal
cariescaries
 The concept of sealing pits & fissures withThe concept of sealing pits & fissures with
resinresin was developed in 1960swas developed in 1960s after theafter the
introduction of acid etching technique.introduction of acid etching technique.

3. Who are indicated for pits & fissureWho are indicated for pits & fissure
sealing ?sealing ?
 Children with special needs;Children with special needs;
1. Medically-compromised1. Medically-compromised
2. Mentally or physically handicapped2. Mentally or physically handicapped
 Children with extensive caries in theirChildren with extensive caries in their
primary teethprimary teeth
<<<<Condition>>>><<<<Condition>>>>
The ability to perform perfect isolation andThe ability to perform perfect isolation and
moisture control is a mustmoisture control is a must andand
this requires patient cooperation and fullythis requires patient cooperation and fully
erupted molarserupted molars

4. What teeth are exactly selected forWhat teeth are exactly selected for
the treatment ?the treatment ?
 Molars with fissure caries not attacking theMolars with fissure caries not attacking the
dentindentin  are indicated for pits &fissuresare indicated for pits &fissures
sealingsealing
Bite wing X-ray or laser caries-detectingBite wing X-ray or laser caries-detecting
device (Diagnodent) is essential beforedevice (Diagnodent) is essential before
decision makingdecision making
How can we Know the extension of caries ?

5.  Molars with localized occlusal caries confinedMolars with localized occlusal caries confined
up to the occlusal third of dentinup to the occlusal third of dentin  areare
indicated forindicated for sealant restorationssealant 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 theOcclusal caries extending more than the
occlusal third of dentinocclusal third of dentin  Is indicated forIs indicated for
regular restorative techniquesregular restorative techniques
What teeth are exactly selected forWhat teeth are exactly selected for
the treatment ?the treatment ?

6. Materials for Pits & Fissures sealingMaterials for Pits & Fissures sealing
1) Resin-based Sealants1) Resin-based Sealants
 Either chemically or visible light-cured resinsEither chemically or visible light-cured resins
(preferred).(preferred).
 Most of them are based on viscous resins such asMost of them are based on viscous resins such as
Bis-GMABis-GMA andand UDMAUDMA..
 TEGDMATEGDMA is added to increase the material’s flowis added to increase the material’s flow
over the etched enamel surfaces.over the etched enamel surfaces.
 Some brands containsSome brands contains inorganic fillersinorganic fillers (silica)(silica) toto
improve the wear resistanceimprove the wear resistance
 Some new brands containsSome new brands contains fluoride-releasing fillersfluoride-releasing fillers
 Others containOthers contain coloring agentscoloring agents to facilitate theto facilitate the
controlled application of the materialcontrolled application of the material

7. Steps of applicationSteps of application
1.1. Tooth CleaningTooth Cleaning using non-fluoride prophylaxis pasteusing non-fluoride prophylaxis paste
2.2. Washing with oil-free water sprayWashing with oil-free water spray
3.3. Acid etchingAcid etching using phosphoric acid for 15-20 susing phosphoric acid for 15-20 s
4.4. Washing of acid and drying with airWashing of acid and drying with air
5.5. Application of resin sealantApplication of resin sealant and light cureand light cure
Materials for Pits & Fissures sealingMaterials for Pits & Fissures sealing
2) Glass ionomer-based sealants2) Glass ionomer-based sealants
 Low consistency G.I. has been used for sealingLow consistency G.I. has been used for sealing
 These materials could withstand for 2 years ..These materials could withstand for 2 years .. Low WRLow WR
 It is recommended when fissure width is more thanIt is recommended when fissure width is more than 100 µm100 µm

8. Thank YouThank You