Introduction Definition Morphology of Pits and fissures Types of Pit and fissure sealants Materials used as sealants Requirements of sealants Diagnosis of Pit and Fissure caries Procedure of application of sealants Indications Contra-indications Factors affecting sealant retention in mouth Summary

1. Pit And Fissure
Sealants
PUBLIC HEALTH DENTISTRY
Submitted by:
ANKUSHA ARORA
(SARASWATI DENTAL
COLLEGE, LUCKNOW)

2. • Introduction
• Definition
• Morphology of Pits and fissures
• Types of Pit and fissure sealants
• Materials used as sealants
• Requirements of sealants
• Diagnosis of Pit and Fissure caries
• Procedure of application of sealants
• Indications
• Contra-indications
• Factors affecting sealant retention in mouth
• Summary
CONTENTS

3. • Caries potential is directly related to shape & depth of the
pit and fissures.
• The cariostatic properties of sealants are attributed to the
physical obstruction of the pit and grooves.
• Sealants are the effective caries protective agents to the
extent they remain bond safe & their effectiveness should
justify their routine use as a preventive measure.
INTRODUCTION

4. • According to simonsen: Material
that is introduced into the pits and
fissures of caries susceptible teeth,
thus forming micromechanically
Bonded protective layer cutting
access of caries producing bacteria
from their source of nutrients.
DEFINITION

5. • Pits and fissures are enamel faults.
• Pitsare small pin point depressions located at the
junction of developmental grooves or at terminals
of those grooves whereas Fisuresare long clefts
between cusps or ridges.
MORPHOLOGY OF PITS AND FISSURES

6. 1. ‘V’ Type & ‘U’ Type
• Are shallow and wide and tend
to be self cleansing.
2. ‘I’ Type
• is deep, narrow and quite
constricted, resembling a bottle
neck.
• Are caries susceptible.
3. Combination types
TYPES OF FISSURES

7. TYPES OF PIT AND FISSURE
SEALANTS
1.Based on curing method:

8. 2. Based on filler
content:
 UNFILLED
Better flow
More retention
Abrade rapidly
 FILLED
Resistance to wear
Need occlusal adjustments.

9. 3. Based on colour:
• Tooth Color
 esthetic but difficult to detect in
recall visits.
• White tinted/opaque
 for easy identification, contain
opaquing agent titanium dioxide.
• Colored
 easy to see during placement
and recall.
eg: Helioseal{ white color
changes to green}

12. Reduced water absorption and solubility.
Increased hardness and abrasion resistance after curing.
Good flow.
Suitable short setting time.
Same thermal conductivity as tooth.
Good bond strength with enamel.
Chemically inert.
Anti- cariogenic.
Reduced polymerization shrinkages.
REQUIREMENTS OF
SEALANTS

14. •When the explorer catches or resists
removal after insertion into a pit and
fissure with moderate to firm
pressure.
• softens at the base of area
•Opacity adjacent to the pit & fissure as
evidence of demineralization.
•Softened enamel adjacent to the pit &
fissure that can be scraped away with
the explorer.

15. PROCEDURE OF APPLICATION OF
SEALANTS

16. • CLEAN THE TOOTH SURFACE:
Remove plaque & debris from enamel and pits
&fissures of the tooth.
Debris interfere with proper etching process
Simply use a toothbrush prophylaxis with
toothpaste or pumice followed by copious water
rinsing.
If sodium bicarbonate slurry has been used, it is
necessary to neutralize the retained slurry with
phosphoric acid for 5-10 sec.

17. •ISOLATE & DRY THE TOOTH SURFACE:
Rubber dam provides best isolation.
Cotton roll isolation with adequate suctioning is
also preferred method of isolation for many
practitioners.

18. •ETCH THE TOOTH SURFACE:
•Etch with 37% conc. Of
orthophosphoric acid for 15-30
sec. for primary teeth and 15 sec.
for permanent teeth.
•Gently rub etchant applicator
over a tooth surface including 2-
3 mm of the cuspal inclines.
•Periodically add fresh etching
agent.
•Do not allow the etchant to come
into contact with the soft tissue.

19. • APPLY BONDING AGENT:
Apply a hydrophilic bonding agent , prior to
sealant application may improve retention
with teeth that cannot be isolated properly.
Then cure it.

21. •MATERIAL APPLICATION:
Sealant material is then applied to the tooth according to
manufacturer direction.
Be careful not to corporate air bubbles in the material.
 With mandibular teeth apply the sealant at the distal
aspect and allow it to flow mesially and with maxillary
teeth vice versa.
After the sealant has set, the operator should wipe the
sealant surface with a wet cotton pellet.
With autopolymerising sealants working time varies from
1-2 min & with photoactive sealants,10-20 sec. for
complete setting.

22. •EVALUATE THE SEALANT:
Sealant should be evaluated visually and tactically.
Take the explorer & attempt to dislodge it.
Remove the rubber dam and cotton rolls.

23. •CHECK OCCLUSION:
If occlusal high points are present,
correct them.
Occlusion checked and adjusted if
needed.

24. •RETENTION AND PERIODIC MAINTAINENCE:
Re-evaluate the sealant at recall visits.
See for any exposure in the voids in the material and
caries development.
Re-application is highest during six months after
placement.

25. REVIEW OF SEALANT
APPLICATION

26. FAILING SEALANT

27. Deep retentive pit & fissures.
No radiographic/ clinical evidence of proximal caries.
Patient with high risk of caries.
patient suffering from xerostomia.
Patient undergoing orthodontic treatment.
Stained pit and fissure with numerous appearance of
decalcification.
INDICATIONS

28. Well-coalesced , self cleansing pit and fissures.
Radiographic/clinical evidence of proximal caries.
Tooth not fully erupted.
Isolation not possible.
Life expectancy of tooth is limited.
Dental caries.
CONTRA-INDICATIONS

29. Type of sealant.
Position of teeth in mouth.
Clinical skill of the operator.
Age of child.
Eruption status of teeth.
Better sealant retention reported more for the anterior and
in mandibular than maxillary arch.
Retention compromised in children due to difficulty in
maintaining a dry field, resulting from the behavior
problems and depending on the eruption status of the
teeth.
FACTORS AFFECTING SEALANT RETENTION IN
MOUTH

30. • Sealant will be adopted as a standard of
care for prevention of pit and fissure caries.
To make significant gains in caries reduction
in child and adult population is necessary
for the dental profession to educate and
inform the general public.
SUMMARY