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   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 material
o   placement technique
o   retention of sealant
o   cooperation of patient
o   follow-up time
o   the content of fluoride in the drinking water
o   dietary, oral hygiene
o    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 sealant
application are the first and second
permanent 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 first
permanent molar.

Seal the remaining sound first permanent molars.

2. Occlusal caries affecting one or more first
permanent molars

Need to seal the second permanent molar as soon as
they 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 of
caries or its treatment could put the child’s general
  health at risk, sealing primary molar teeth should
be 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 or
partially lost sealant are not at higher risk of
developing caries than teeth that were never seal
in order to reduce the possibility of formerly
sealed teeth returning to their original risk status,
sealants need to be maintained.

answer be yes just if :
 This is particularly
true for children who have sealants applied to
teeth with demineralised enamel or suspicious
lesions.
 as soon as the tooth is sufficiently
erupted to be isolated.
 Time of eruption:
 first permanent molars :
o 6.0–6.3 years for girls
o 6.3–6.5 years for boys
 second permanent molars:
o 11.5–12.3 years for girls
o 11.8–12.4 for boys
patients are not at risk of exposure to BPA from
the use of dental sealants, but recommended
precautionary measures to reduce potential exposure
to BPA from dental sealants which include:

rinsing the surface of the cured material for 30
seconds with water while using effective suction;
getting the patient to rinse for 30 seconds and
spit out after the procedure; removing the
surfaceresidual monomer layer with pumice on a
cotton 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 remember
Isolate the tooth to be sealed with either a
dental dam or cotton wool rolls/isolation
shields combined with effective aspiration
   (1) age
   (2) dmft
   (3) no fluoride
   (4) operator
Application
Technique
Video   
   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.
Pit and fissure sealant

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Pit and fissure sealant

  • 1. Supervisor: Dr. Rana Darwish Done by : Ahlam Taweel 20911199 Sajidah Sarahnah
  • 2.
  • 3. 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
  • 4. 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
  • 5. 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.
  • 6.  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.
  • 7.
  • 8.
  • 9. 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.
  • 10. o type of sealant material o placement technique o retention of sealant o cooperation of patient o follow-up time o the content of fluoride in the drinking water o dietary, oral hygiene o the socioeconomic factors
  • 11.
  • 12. 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
  • 13. 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.
  • 14. 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
  • 15.
  • 16. the most important teeth for sealant application are the first and second permanent 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.
  • 17. 1. Child with occlusal caries on one of the first permanent molar. Seal the remaining sound first permanent molars. 2. Occlusal caries affecting one or more first permanent molars Need to seal the second permanent molar as soon as they have erupted sufficiently. 3. Tooth should be sealed within 2 years of eruption.
  • 18.  for some children, such as those with medical or other conditions where the development of caries or its treatment could put the child’s general health at risk, sealing primary molar teeth should be considered as part of a comprehensive caries- preventive program .
  • 19.
  • 20.  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.
  • 21.
  • 22. The results indicated that teeth with fully or partially lost sealant are not at higher risk of developing caries than teeth that were never seal in order to reduce the possibility of formerly sealed teeth returning to their original risk status, sealants need to be maintained. answer be yes just if : This is particularly true for children who have sealants applied to teeth with demineralised enamel or suspicious lesions.
  • 23.
  • 24.  as soon as the tooth is sufficiently erupted to be isolated.  Time of eruption:  first permanent molars : o 6.0–6.3 years for girls o 6.3–6.5 years for boys  second permanent molars: o 11.5–12.3 years for girls o 11.8–12.4 for boys
  • 25.
  • 26. patients are not at risk of exposure to BPA from the use of dental sealants, but recommended precautionary measures to reduce potential exposure to BPA from dental sealants which include: rinsing the surface of the cured material for 30 seconds with water while using effective suction; getting the patient to rinse for 30 seconds and spit out after the procedure; removing the surfaceresidual monomer layer with pumice on a cotton pellet or a prophy cup.
  • 27.
  • 28. 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.
  • 29.
  • 30.
  • 31.
  • 32. 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.
  • 33.
  • 34.  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.
  • 35.
  • 36. by isolation of the teeth.  application of bonding agents ((use of flowable resin, following phosphoric acid gels))
  • 37.
  • 38. 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 remember Isolate the tooth to be sealed with either a dental dam or cotton wool rolls/isolation shields combined with effective aspiration
  • 39.
  • 40. (1) age  (2) dmft  (3) no fluoride  (4) operator
  • 41.
  • 43. Video
  • 44.
  • 45.
  • 46.
  • 47. 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.

Editor's Notes

  1. 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
  2. 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
  3. the impact of fissure sealants alone onreducing caries is likely to be less for primary teeth than for permanent teeth.
  4. 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.