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Pit And Fissure Sealants-Subhajit Saha


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Pit And Fissure Sealants-Subhajit Saha

  2. 2. INTRODUCTION  The high susceptibility of pit and fissures to caries presents a major dental problem and provides the rationale for caries control of these areas .  While occlusal surfaces represent approximately 10% of the enamel surface at risk, they account for
  3. 3. CONCEPT Pits and fissures typically result from an incomplete coalescence of enamel and are par ticularly prone to caries. T hese areas can be sealed with low viscosity f luid resin after acid etching. Long ter m clinical studies indicate that pit and fissure sealants provide a safe and ef fective method of preventing caries
  4. 4. PITS AND FISSURES  PIT: a small pinpoint depression located at the junction of developmental grooves or at terminals of those grooves.  FISSURE: It is defined as deep clefts between adjoining cusps. They provide areas for retention of caries producing agents.
  5. 5. Definition:  Material that is introduced into pits and fissures of caries susceptible teeth , thus forming a micromechanically bonded protective layer,cutting access of caries producing bacteria from their sources of nutrients.(SIMONSEN)
  6. 6. ACCORDING TO ADA:  An adhesive material that is applied to pits and fissures of teeth in order to isolate from rest of oral cavity
  7. 7. HISTORY:  IN 1905: application of silver nitrate by Miller.  IN 1923: Hyatt reported a technique named “prophylactic odontomy”.  IN 1929: Bodecker introduced fissure eradication.  IN 1955: Buanocare introduced a method of adhering resin to an acid etched enamel surface.  IN 1965: Bowen and associates developed BIS-GMA resin.  IN 1970 and EARLY 1980’s: UV light with a wavelength of 365nm was used to initiate the setting reaction.
  8. 8. Classification  According to chemical structure of monomers used: 1. MMA-methyl methacrylate 2. TEGDMA-triethylene glycol dimethacrylate 3. BPD-bisphenol dimethacrylate 4. BIS-GMA 5. PMU-propyl methacrylate urethane
  9. 9.  According to generations: 1st generation 2nd generation 3rd generation 4th UV light cured at 356 nm Self cured Examplealphaseal Blue visible light cured at 490 nm Fluoride Examplestephen K.W strang Example- Exampleconcise white sealant,delton
  10. 10.  Based on filler content: A. Unfilledbetter flow  more retention  abrade rapidly B. Filledresistance to wear  need occlusal adjustments
  11. 11. Morphology of pits and fissures: According to Nango 1961: V-shaped fissure: wide at top and narrow at the bottom. I-shaped fissure: quite constricted and may resemble a bottle neck. U-shaped fissure: same width from top to bottom K-shaped fissure: extremely narrow slit with larger space at bottom
  12. 12. Morphology of pits and fissures
  13. 13. Procedure of application of sealants
  14. 14. Clinical Technique. Step 1 : The tooth is isolated by using a rubber dam(or another effective isolation method such as cotton rolls or Isolite) Step 2 : The area is cleaned with a slurry of pumice on a bristle brush Step 3 : The tooth surface is dried and etched with 37% phosphoric acid gel for 15-30 seconds.
  15. 15. Step 4 : The sealant material is then applied with an applicator or small hand instrument. The sealant is gently teased into place to avoid entrapping air, and it should overfill slightly all pits and fissures, But it should not extend onto an etched surface. Step 5 : The sealant is light activated for 15 seconds. Step 6 : The occlusion is evaluated using articulating paper.
  16. 16. Review of sealant application
  17. 17. Evaluation of sealant
  18. 18. REQUIREMENTS OF SEALANT MATERIAL: Adhesion to enamel for extended periods  Simple clinical application  Non-toxic and non -injurious to oral tissues  Low solubility in oral fluids  Less expensive
  19. 19.  Chemically inert  Anti-cariogenic  Reduced polymerization shrinkage  Same thermal conductivity as tooth  Increased hardness and abrasion resistance after curing
  20. 20. AGE RANGES FOR SEALANT APPLICATION  3-4 years of age for primary molar sealant application.  6-7 years of age for the first permanent molar  11-13 years of age for the second permanent molars and the
  21. 21. Indications :  Deep retentive pit and 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
  22. 22. Contraindications:  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.
  23. 23. Sealant will be long lasting if:  The case is selected properly.  The tooth is selected properly.  An appropriate placement technique is followed.  Adequate maintenance is provided.
  24. 24. PARENT EDUCATION  Educating parents and patients on the importance of dental sealants is critical.  Dental sealants are cost effective treatment modalities when placed on the teeth of children at high risk of
  25. 25. THANK YOU