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. 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. 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. 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. 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. 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. 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. 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. Based on filler content:
A. Unfilledbetter flow
more retention
abrade rapidly
B. Filledresistance to wear
need occlusal adjustments
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
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. 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.
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. Chemically inert
Anti-cariogenic
Reduced polymerization
shrinkage
Same thermal conductivity as
tooth
Increased hardness and abrasion
resistance after curing
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. 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. 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. 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. 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
