PIT AND FISSURE SEALANTS

AMRITA SCHOOL OF DENTISTRY

1. PIT AND FISSURE SEALANTS 17-08-2022

2. CONTENTS Introduction Definition History Types Indications Contraindications Procedure for sealant application Preventive resin restoration References 2

3. INTRODUCTION Fluorides are highly effective in reducing the number of carious lesions occurring on the smooth surfaces of enamel and cementum. Unfortunately, fluorides are not equally effective in protecting the occlusal pits and fissures, where 95% of all carious lesions occurs. Considering the fact that the occlusal surfaces constitute only 12% of total number of tooth surfaces, it means that pits and fissures are approximately 8 times as vulnerable as the smooth surfaces. 3

4. What are Pits and Fissures? Pits and fissures are enamel faults; narrow shafts or cracks at some length whose blind ends are directed more or less towards the DEJ. Pits are small pinpoint depressions located at the junction of developmental grooves or at terminals of those grooves. Fissures are long clefts between cusps or ridges. 4

5. Types of Fissures 5

6. DEFINITION A fissure sealant is a material that is placed in the pits and fissures of teeth in order to prevent or arrest the development of dental caries. -European Academy of Pediatric Dentistry 6

7. HISTORY 7

8. TYPES OF PIT AND FISSURE SEALANTS 8

9. MATERIALS USED AS SEALANTS 9

10. INDICATIONS A deep occlusal fissure, fossa or lingual pit. A sealant is probably indicated if: The fossa selected for sealant placement is well isolated from another fossa with a restoration. An intact occlusal surface is present where the contralateral tooth surface is carious or restored; this is because teeth on opposite sides of the mouth are usually equally prone to caries. An incipient lesion exists in the pit and fissure. 10

11. CONTRAINDICATIONS Patient behavior does not permit the use of adequate dry-field technique through out the procedure. An open occlusal carious lesion exists. Caries exist on other surfaces of the same tooth. A large occlusal restoration is already present. 11

12. PROCEDURE OF SEALANT APPLICATION 12

13. REQUISITES FOR SEALANT RETENTION There are four commandments for successful sealant placement, and they cannot be violated Should have a maximum surface area. Should have deep, irregular pits and fissures. Should be clean. Should be absolutely dry at the time of sealant placement and uncontaminated with saliva. 13

14. PREVENTIVE RESIN RESTORATIONS(PRR) Is a natural extension of the use of occlusal sealants. Integrates the preventive approach of the sealant therapy for caries susceptible pit and fissure with therapeutic restoration of incipient caries with composite resin that occur on the same occlusal surface. They are the conservative answer to conventional “ extension for prevention” philosophy of class 1 amalgam cavity preparation. 14

15. TYPES OF PRR (SIMONSEN- 1978) Type A -Suspicious pit and fissures where caries removal is limited to enamel. Type B –Incipient lesion in dentin that is small and confined. Appropriate base is placed in areas of dentin exposure, composite resin is placed and remaining area is covered with sealants. Type C –More extensive dentinal involvement and requires restorations with posterior composite material. Local anesthesia is required 15

16. TYPES OF PRR 16

17. REFERENCES Essentials of preventive and community dentistry - Soben peter (fifth edition). Textbook of public health dentistry- SS.Hiremath (third edition ) . 17

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