Pit And Fissure Sealants
Question.1. Write a short note on pit and fissure sealant.
Or
Write notes on pit and fissure sealant.
Or
Write in brief on pit and fissure sealants.
Answer:
Pit and fissure sealants are used to seal pit and fissure
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Ideal Requirements:
Pit and fissure sealants should fulfill the following requirements:
- They should achieve sustained bonding to the enamel surface.
- They should be biocompatible to oral tissues.
- They offer a simple application procedure by a dentist and/ or dental hygienist.
- They should be free flowing, low-viscosity material which is capable of entering narrow fissures.
- They should exhibit low solubility in an oral environment.
- They should be easily distinguishable from natural tooth structures during periodic checkups.
Classification of Pit and Fissure Sealants:
They are broadly classified into the following categories:
1. Based on the material used:
- Polyurethanes
- Cyanoacrylates
- Bisphenol A glyceryl methacrylate
- Glass ionomer sealants
- Fluoride containing sealants
2. Based on the curing method:
- Self-cured or autopolymerized or chemically polymerized resin sealants
- Visible light-cure or photopolymerized resin sealants
3. Based on filer content:
- Filled sealants
- Unfiled sealants
4. Based on the color:
- Clear
- Tinted
- Opaque
- Color changing
5. Another classification of sealant’s based on the evolution of First generation sealants:
- Polymerized by using ultraviolet light at wavelength of 350 nm
- Second-generation sealants: Polymerized by using chemical polymerization
- Third-generation sealants: Polymerized when exposed to visible light 430 to 470 nm
- Fourth-generation sealants: Fluoride was added to existing sealants for added benefits of anti carcinogenicity.
Mode of Action:
As pit and fisure sealants are placed as thin film covers and obliterate technological niches, thereby removing the sheltered environment in which caries can develop.
Indications of Pit and Fissure Sealants:
- In newly erupted posterior teeth with deep pits and fissures should be sealed soon after eruption.
- An incipient caries lesion on pit and fisure area.
- In deep lingual pits
- In mentally or physically challenged individuals.
- In children living in non-fluoridated area.
- Patients with xerostomia Margin of Class I amalgam or composite can be sealed with sealant to improve marginal integrity.
- In cases where the contralateral tooth surface becomes carious or previously restored.
Contraindications of Pit and Fissure Sealants:
- In well-coalesced and self-cleansing pits and fissures in molars and premolars.
- When there is radiographic evidence of proximal dental caries in the tooth which has to seal.
- Pit and fissure caries extending in dentin.
- In partially erupted tooth where isolation is not possible.
- In large occlusal restoration.
- In patients with behavioral problems.
- When caries or restoration existing in adjacent fossa extend in a selected area of fissure sealing.
- If pit and fissure remained caries-free for 4 years or more.
The technique of Placement of Pit And Fissure Sealant:
- Polish tooth surface with pumice and prophylactic cup
- Wash pit and fissures with water for 10 seconds
- Isolate operative fild with a rubber dam
- Compressed air should dry the operating field
- Etch pit and fissure with 30 to 50% orthophosphoric acid for 15 seconds.
- The etched surface is rinsed with water for 15–20 seconds.
- Air dry the teeth.
Flow liquid sealant gently in pit and fissures:
- Polymerize sealant in visible light curing unit for 20–40 seconds or as recommended by the manufacturer.
- Examine the sealed surface carefully before removing the isolation.
- If pit and fissures are incompletely covered, or air bubbles are seen re-etch for 10 seconds, dry and apply additional sealant material.
- With articulating paper check the occlusion and remove premature contacts.
- Interproximally pass the dental floss on either side of the sealed tooth.
- Optionally topical fluoride can be applied over the sealed tooth
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