Pit And Fissure Sealants
Pit and fissure sealants are used to seal pit and fissure
Read And Learn More: Dental Materials Question And Answers
Ideal Requirements:
Pit and fissure sealants should fulfill the following requirements:
- Pit and fissure sealants should achieve sustained bonding to the enamel surface.
- Pit and fissure sealants should be biocompatible to oral tissues.
- Pit and fissure sealants offer a simple application procedure by a dentist and/ or dental hygienist.
- Pit and fissure sealants should be free flowing, low-viscosity material which is capable of entering narrow fissures.
- Pit and fissure sealants should exhibit low solubility in an oral environment.
- Pit and fissure sealants should be easily distinguishable from natural tooth structures during periodic checkups.
Classification of Pit and Fissure Sealants
Pit and fissure sealants 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
Leave a Reply