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PIT AND FISSURE
SEALANTS
By
DR.A.SELVA AROCKIAM
INTRODUCTION:
⋇ High caries susceptibility of pit & fissure is a major dental
problem and provides the rationale for carie...
MILESTONES OF PIT AND FISSURE:
⋇ HYATT – Prophylactic odontotomy – fissures filled with silver
or copper oxy phosphate cem...
PIT & FISSURE:
 PIT: Small pin point depression located at the junction of developmental
grooves.
 FISSURE: Deep clefts ...
PIT & FISSURE SEALANTS
CLASSIFICATION: (MITCHELL & GORDON - 1990)
polymerization method filled / unfilled clear / tinted r...
REQUISITES OF AN EFFICIENT SEALANT:
 Viscous enough to penetrate into deep pit & fissures
 Adequate working time
 Rapid...
INDICATIONS
 Newly erupted 1⁰ M & permanent PM & M – with
complete recession of pericoronal operculum & with
open / stick...
TECHNIQUE OF APPLICATION
1) CLEANING:
 With slurry of pumice & water.
 Fluoride containing paste not used – interferes
w...
4) WASHING & DRYING
 Wash with water – 30 sec & air dried
 If contaminated re-etch for 10 sec
5) APPLICATION OF RESIN:
...
RECENT ADVANCES
ACP releasing Enamel LocTM
sealant
Embrace TM WetbondTM
 1step application
 F- releasing
 natural white...
THANK
U
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Pit and fissure

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Pit and fissure

  1. 1. PIT AND FISSURE SEALANTS By DR.A.SELVA AROCKIAM
  2. 2. INTRODUCTION: ⋇ High caries susceptibility of pit & fissure is a major dental problem and provides the rationale for caries control of these areas. ⋇ It accounts for 50% of caries in human dentition. CARIES OF PIT & FISSURE: ⋇ Caries process particularly in 1st & 2nd molar starts as soon as it erupts. Pit and fissure is an important factor in determining the presence of caries. ⋇ According to BLACK - P&F don’t cause caries instead provide a sanctuary to caries causing agents. ⋇ P&F caries follows the direction of the enamel rods & forms a shaped lesion with its apex at the outer surface and its base towards DEJ. ⋇ It produces greater cavitations than proximal caries.
  3. 3. MILESTONES OF PIT AND FISSURE: ⋇ HYATT – Prophylactic odontotomy – fissures filled with silver or copper oxy phosphate cement . (1923) ⋇ BODECKER – Fissure eradication – deep retentive fissure into self cleansable one.(1929) ⋇ BUNOCORE - Acid etching – phosphoric acid for 30 seconds. (1955) ⋇ BOWEN – BISGMA – base resin for sealants.(1965)
  4. 4. PIT & FISSURE:  PIT: Small pin point depression located at the junction of developmental grooves.  FISSURE: Deep clefts between adjoining cusps. MORPHOLOGY OF FISSURES: (NANGO - 1960) V – type U – type I – type K - type shallow & self cleansable deep , narrow & retentive (non invasive technique) (invasive technique)
  5. 5. PIT & FISSURE SEALANTS CLASSIFICATION: (MITCHELL & GORDON - 1990) polymerization method filled / unfilled clear / tinted resin system Self activation Light activation Urethane BIS-GMA acrylate I generation II generation III generation IV generation UV light self cure visible light fluoride releasing EFFECTIVENESS OF SEALANTS: ⦿ Technique of application. ⦿ Type of sealant used. ⦿ Morphology of tooth surface to which it is applied.
  6. 6. REQUISITES OF AN EFFICIENT SEALANT:  Viscous enough to penetrate into deep pit & fissures  Adequate working time  Rapid cure  Good & prolonged adhesion to enamel  Low sorption & solubility  Resistance to wear  Minimum irritation to tissues  Cariostatic action CASE SELECTION:  AGE RANGE: 3-4 yrs for primary molar, 6-7yrs for I permanent molar, 11-13yrs for II permanent molar.  GROUP 2: Moderate caries risk patients.  CLINICAL JUGDEMENT CRITERIA:  Age  Oral hygiene  Dietary habits  Tooth type & morphology  Familial & individual history of dental caries  Fluoride environment & history
  7. 7. INDICATIONS  Newly erupted 1⁰ M & permanent PM & M – with complete recession of pericoronal operculum & with open / sticky P&F.  Stained P&F with minimum decalcification / opacification & no softness at the base of the fissure.  Tooth in ? – erupted less than 4 yrs CONTRAINDICATIONS  No previous caries experience , coalesced P&F.  Proximal caries – clinically & radiographically  Wide & self cleansable P&F  Partially erupted tooth / that which cant be isolated.  P&F caries free for > 4 yrs.
  8. 8. TECHNIQUE OF APPLICATION 1) CLEANING:  With slurry of pumice & water.  Fluoride containing paste not used – interferes with acid etching. 2) ISOLATE THE TOOTH:  Using rubber dam  Cotton rolls 3) ACID ETCHING:  30-50% phosphoric acid liquid / gel - 30 sec  Microscopic porosities in the enamel
  9. 9. 4) WASHING & DRYING  Wash with water – 30 sec & air dried  If contaminated re-etch for 10 sec 5) APPLICATION OF RESIN:  Apply the material. Avoid incorporation of air bubble 6) CURING:  Done according to the manufacturer. Examine – all P&F covered, excessive material removed, check occlusion 7) RECALL VISIT:  Check loss of material If needed sealant may be added
  10. 10. RECENT ADVANCES ACP releasing Enamel LocTM sealant Embrace TM WetbondTM  1step application  F- releasing  natural white colour Low viscosity Filled resin  Bonds to moist tooth  Easy to dispense  Snip off the tip & squeeze  Cost efficient Avoids cross contamination  Neutral / high pH remains in its original form.  pH < 5.8, ACP → HAP  Replaces the HAP lost by the acid  Non reliant on patient compliance.  Long life – not washed away  Neutralize acid & buffer pH
  11. 11. THANK U

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