This document discusses pit and fissure sealants. It begins by noting that pit and fissure areas are highly susceptible to dental caries, accounting for 50% of caries. It then reviews the caries process in pits and fissures. Several milestones in pit and fissure sealant development are outlined, from early filling techniques to modern resin-based sealants. The document discusses the classification, effectiveness, requirements, case selection criteria, and application technique for pit and fissure sealants. Recent advances including acid-releasing and wet-bonding sealants are also summarized.

1. PIT AND FISSURE
SEALANTS
By
DR.A.SELVA AROCKIAM

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. 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. 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. 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. 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. 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. 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. 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. 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. THANK
U