The document discusses pit and fissure sealants, which are materials applied to the depressions and grooves of teeth to prevent dental caries. It details types of sealants based on chemical structure, generation, filler content, color, and curing method, along with indications and contraindications for their use. The application procedure for sealants is also outlined, emphasizing the importance of timely intervention after tooth eruption for effective prevention.

1. Pit and Fissure Sealants
ASHUTOSH KUMAR GUPTA
Manipal College of Dental Sciences,
Mangalore.

2. What is Pit and Fissure ?
• Pit - It is defined as small pinpoint depression located at a
junction of developmental grooves.
• Fissure : Fissure is defined as deep clefts
between adjoining cusps.

3. MORPHOLOGY OF PITS AND
FISSURES
• Although only 12.5% of all tooth surfaces are occlusal these
surfaces develop more than 75% of total caries of children..
• The fissure contains organic plug composed of -
- Reduced enamel epithelium,
- Microorganism forming dental plaque and
- OAral debris.

4. • The increased susceptibility of occlusal surface to caries is
due to the fact that fissure provides a protected niche for
plaque accumulation.
• Recently erupted teeth have a porous enamel lining !
• Now this porous zone of enamel bordering the fissures offers
three-dimensional honeycombed structure
into which fissure sealants could be locked.

5. •Therefore, any procedure must be carried out at
the earliest possible time after eruption to make
effective preventive use of fissure sealants.

6. • There are five types of pits and fissures - :
• 1. V – type (34%)
• 2. U – type (14%)
• 3. I – type (19%)
• 4. IK – type (26%)
• 5. Inverted Y – type

7. (34%)
(14%) (19%)
(26%) (7%).
V – type

8. What is Pit & Fissure sealant ?
• It is a material that is placed in
the pits and fissures of teeth in order to prevent or arrest the
development of dental caries .

9. TYPES OF

10. 1. According
to chemical
structures
of monomers use
d
• Methyl methacrylate (MMA)
• Triethylene glycol dimethacrylate
(TEGDM)
• Bis phenol dimethacrylate (BPD)
• ESPE monomer

11. 2. Based on generations
• First generation sealants:
• Polymerized with UV light with wavelength of 356 μm .
• Had excessive absorption and incomplete polymerization
• of sealant at its depth
• e.g. - Nuva-lite (Caulk/Dentsply).

12. • Second generation sealants:
• Self cure or chemical cure resins
• Based on accelerator catalyst system
• Eg. - Concise White (3M)
• Third generation sealants:
• Light cured with visible (blue) light of 430–490 μm
• e.g. - Helioseal
• Fourth generation:
• – Fluoride releasing sealants . E.g. - Seal right (Pulpdent).

13. 3. Based on filler content:
• Unfilled: Advantages include better flow and more
retention but, abrade rapidly
• Filled: Advantages include resistance to wear but, may
need occlusal adjustments.

14. 4. Based on color :
• Clear:
• Esthetic
• Difficult to detect in recall visit
• e.g. Helioseal
• Tinted/opaque:
• Can be identified
• For example, Delton
• Colored:
• Based on color change technology
• Easy to see during placement and recall
• eg. Clinpro pink

15. 5. Based on curing:
• Autopolymerizing
• Light cure.

16. Indications of
Pit and
Fissure
Sealant
Deep, retentive pits and fissures, which may
cause wedging of an explorer
Stained pits and fissures with minimum appearance
of decalcification
No radiographic or clinical evidence of proximal
caries
Caries free pit and fissures
Caries pattern indicative of more than one lesion per
year
Routine dental care with active preventive
dentistry program
Community-based sealant program.

17. REQUISITES
• Viscosity allowing penetration into deep and narrow fissures even in maxillary teeth.
• Adequate working time
• Rapid cure
• Good and prolonged adhesion to enamel .
• Resistance to wear
•Minimum irritation to tissues .
• Cariostatic action.

18. Contraindications for Sealant Usage
• Well-coalesced, self-cleansing pits and fissures
• Radiographic or clinical evidence of interproximal caries
• Tooth not fully erupted
• Isolation not possible
• Life expectancy of tooth is limited
• Dentinal caries
• Lack of preventive practices.

19. Factors affecting Sealant retention
• Type of Sealants – Studies have shown that the second generation
sealants provide better retention than first generation sealants.
• Posiition of tooth in the mouth -
Anterior > Posterior
Mandibular > Maxillary
• Age of the child
• Eruption status of teeth – In molars which are early in eruption
placement of sealants will far more likely require replacement within 3
years

20. Procedure of
Sealant
Appplication

21. Step 1: Tray Set-up
• Prior to the start of the procedure, a tray with all necessary
instruments, supplies, and equipment should be prepared.
• The items included in the sample tray set-up aremouth
mirror, slow speed handpiece, explorer (No. 5),toothbrush,
cotton pliers, material, isolation device, saliva ejector, curing
light, syringe tip, articulating tape.

22. Step 2: Isolation
of Tooth
• The tooth should be
isolated from salivary
contamination by use of
rubber dam or by cotton
rolls and suctioning .

23. Step 3: Tooth Preparation
• There are different methods of enamel surface preparation
prior to etching and sealant application -
• Air abrasion with aluminum oxide particles
• Use of sodium bicarbonate
• Air polishing system
• Enameloplasty

24. Step 4: Acid Etching Tooth Surface
• Apply the etching agent to the tooth surface- 37 percent phosphoric
acid using a fine
• Brush gently rub the etchant applicator over tooth surface including 2
to 3 mm of cuspal inclines and reaching into any buccal or lingual pits
and grooves that are present.
• Etching time: -
Step Primary tooth Permanent tooth
Acid etch 30 seconds 20 seconds
Wash 30 seconds 30 seconds
Dry 15 seconds 15 seconds

25. ZONES OF ETCHING

26. Etched tooth surface

27. Step 5: Rinse and Dry Etched
Tooth Surface
• Rinse the etched tooth surface with air water spray for 30 seconds.
• This removes the etching agent and reaction products
from etched enamel surface.
• Dry the tooth for 15 seconds with uncontaminated compressed air.
• The dried etched enamel should have a frosted white appearance

28. Step 6:
Application of
Bonding Agent
Application of halogenated bonding agent
after etching displaces saliva from enamel
thereby improving sealant wetting of surface
and increases the bond strength
Most of the sealants today are provided with
single step etching and bonding agents
combined into one -
e.g. Xeno Bond.

29. Step 7: Application of Sealant
• The sealant material can be applied to the tooth in a
variety of methods.
• In mandibular teeth, apply the sealant distally and allow it to
flow mesially with the inverse being true for the maxillary
teeth.

30. Step 8: Cure the Sealant
• Cure according to the manufacturer’s recommended time for
curing
• For light cured sealants, polymerization should be initiated
quickly after the sealant is placed on the etched surface to
help minimize potential contamination.

31. Step 9 :
Explore the
Sealed Tooth
Surface
and Evaluate
Occlusion
• Explore the entire tooth surface
for pits and voids that may have not
been sealed.
• Evaluate occlusion of sealed tooth
surface with articulating paper to
determine if any excessive sealant is
present and needs to be removed.

32. Step 10: Recall and Re-evaluation
• Recall and check the patient at subsequent visits.
• It is necessary to re-evaluate sealed tooth surface for loss of
material, exposure of voids and caries development,
especially in the first 6 month of placement.

33. And the teeth is protected ..

34. Current Sealants Used -
• Fluoride Releasing Sealants
• Hydrophilic Fluorescent BPA
free Pit and Fissure Sealant
• Moist Bonding Pit and Fissure Sealant
• Pit and Fissure Sealant with ACP

35. Points to Ponder !
• In deep fissures if caries is present in part of pits and fissures
it is restored and remaining pits and fissures are protected
with sealants ..
• This process is termed as ?

36. Preventive Resin Restorations
or
Conservative Adhesive resin
restoration

37. Thank You !
Stay Safe !