Pit and fissure sealents

PIT AND FISSURE SEALENT

1. RECENT ADVANCEMENTS IN PIT
AND FISSURE SEALENTS
Dr.Tinet Mary Augustine. BDS,MDS
Pediatric Dentist
Dr.Tinet’s Pedorayz, Pediatric And Early Age Orthodontic Dental
Clinic


DR.TINET MARY AUGUSTINE.MDS 1

2. INTRODUCTION
PRINCIPLE
DEFINITION
HISTORY
CLASSIFICATION
RATIONALE
INDICATION
CONTRAINDICATION

DR.TINET MARY AUGUSTINE.MDS
2

3. REQUIREMENTS OF AN IDEAL SEALENT
CONVENTIONAL METHOD OF PIT AND FISSURE
APPLICATION
LIMITATIONS OF THE CONVENTIONAL SEALENTS
RECENT ADVANCEMNETS
REMINERALIZING PROPERTY
FLOURIDE INCORPORATED
ACP INCORPORATED
NOVAMIN
RESIN BASEED
DR.TINET MARY AUGUSTINE.MDS
3

4. SEALENTS WITH OPTIC PROPERTIES
CLEAR
COLOURED
FLOURESCENT
HYDROPHILIC BOND SEALENTS
BIOLOGICAL SEALENTS-BPA FREE SEALENTS
SEALENTS WITH NANOPARTICLES
COMPARATIVE EVALUATION /CRITICAL EVALUATION
OF DIFFERENT SEALENTS
RECENT RECOMMENDATION OF AAPD
CONCLUSION



DR.TINET MARY AUGUSTINE.MDS
4

5. INTRODUCTION
The prevalence of caries has decreased in
the past two decades and contributing to
this decline are water fluoridation,
dentifrices, improved oral hygiene, changes
in diet and awareness.
Pit and fissure sealants are major
cornerstone of modern preventive dentistry
in prevention of caries in susceptible teeth.

DR.TINET MARY AUGUSTINE.MDS
5

6. PRINCIPLE
Any procedure must be carried out at the
earliest possible time after eruption to
make effective preventive use of fissure
sealants

GREWAL 2008
DR.TINET MARY AUGUSTINE.MDS
6

7. DEFINITION
Pit (Ash, 1993):
A small pinpoint depression located at the
junction of developmental grooves or at
terminals of those grooves.
Fissures (Orbans, 1954):
Deep clefts between the adjoining cusps.
They provide areas for retention of caries
producing agents.
DR.TINET MARY AUGUSTINE.MDS
7

8. A material that is introduced into the
occlusal pit and fissure of caries
susceptible teeth, thus forming a micro-
mechanically bonded, protective layer
cutting access of caries producing
bacteria from their source of nutrients‖
(Simonsen RJ, 1978)
DR.TINET MARY AUGUSTINE.MDS
8

9. Fissure sealants are materials designed to
prevent pit and fissure caries when they
are applied to the occlusal surfaces of
teeth in order to obliterate occlusal
fissures and remove the sheltered
environment in which caries may thrive.‖
(Gordon-1962)
DR.TINET MARY AUGUSTINE.MDS
9

10. It is a material that is placed in the pits and
fissures of teeth in order to prevent or arrest
the development of dental caries

R Welbury, M Raadal, N Lygidaks, EAPD
Policy Document, 2003
DR.TINET MARY AUGUSTINE.MDS
10

11. According toADA
An adhesive material that is applied to
pits & fissures of teeth in order to isolate
from rest of the oral cavity.
DR.TINET MARY AUGUSTINE.MDS
11

12. HISTORY

DR.TINET MARY AUGUSTINE.MDS
12

13. DR.TINET MARY AUGUSTINE.MDS
13

14. Classification of pit and fissure
sealent
Nagano, 1961
1.V – type (34%)
2.U – type (14%)
3.I – type (19%)
4.IK – type (26%)
5.Inverted Y – type (7%).
DR.TINET MARY AUGUSTINE.MDS
14

15. Classification of pit and fissure
sealants (Mitchell and Gordon
1990)
DR.TINET MARY AUGUSTINE.MDS
15

16. DR.TINET MARY AUGUSTINE.MDS
16

17. Indication (Ekstrand and
Christiansen, 2005 )
active fissure caries has been diagnosed.
a high risk had been established.
fissures are deep and the patient or
parent either cannot, or will not remove
plaque effectively.
DR.TINET MARY AUGUSTINE.MDS
17

18. Rationale (British society of
pediatric dentistry 2000)

Very high proportion of dental decay
occurs in pits and fissures. Recent data
shows that relative proportion of pit and
fissure lesions has increased to 84% of total
new caries experience.
Pits and fissures remain at risk of caries for
long periods of time, not just within the first
few years of eruption.
DR.TINET MARY AUGUSTINE.MDS
18

19. Fluoride has limited effect in preventing
pit and fissure caries.
Fissure sealants are effective at
preventing pit and fissure caries and are
best used as a part of overall preventive
program.

DR.TINET MARY AUGUSTINE.MDS
19

20. Advantages
• It is a non-invasive technique.
• Sealing of pits & fissures prevents tooth
decay.
• Fluoride release from fluoridated sealants
can confer protection to adjoining areas.
• Sealants can be used at the community
level for prevention of caries.

DR.TINET MARY AUGUSTINE.MDS
20

21. Limitations (Hallstrom, 1993)

Adverse reaction- allergy to resin
Caries susceptibility of etched enamel.
Economic feasibility.
Inadvertent placement over carious sites
Detection of lost sealant.

DR.TINET MARY AUGUSTINE.MDS
21

22. REQUIREMENTS OF MATERIALS USED
AS SEALANTS (Brauer 1978, HienNGO 2012)
A viscosity allowing penetration into deep
and narrow fissures.
Adequate working time.
Rapid cure
Good and prolonged adhesion/bonding
to enamel
DR.TINET MARY AUGUSTINE.MDS
22

23.  Low sorption and solubility.
Resistance to wear.
Be compatible with oral tissues.
Cariostatic action

DR.TINET MARY AUGUSTINE.MDS
23

24. Patient selection
Simonsen 1983.
Group 1 – Caries free patients judged at
no risk to decay.
Group 2 – Patients judged to be at
moderate risk to decay.
Group 3 – Patients with rampant caries at
a high risk to decay.


DR.TINET MARY AUGUSTINE.MDS
24

25. 3-4yrs : Primary molar sealant
application.
6-7yrs : First permanent molar .
11-13yrs : Second permanent molars
and the premolar.
DR.TINET MARY AUGUSTINE.MDS
25

26. WF Waggoner and M Siegal. Pit and fissure sealant application: An updating technique. J Am Dent Assoc, 1996; 127: 351-361.
DR.TINET MARY AUGUSTINE.MDS

27. 27
DR.TINET MARY AUGUSTINE.MDS

28. 34
DR.TINET MARY AUGUSTINE.MDS
28

29. SALIVA CONTAMINATION
Silverstone 1984- glycoprotein reduce
bond strength
I sec saliva contamination wont clear
even after 30 seconds of copious irrigation
DR.TINET MARY AUGUSTINE.MDS
29

30. Hitt, 1992 and Fiegal, 2002 postulated that applying
halogenated bonding agent after etching can
increase bond strength in saliva contaminated
enamel (0.0005 to 17.8 Mpa) and in
uncontaminated enamel (16.7 to 20.5 Mpa)
because bonding agent displaces saliva from
enamel, improving sealant wetting of surface.

DR.TINET MARY AUGUSTINE.MDS
30

31. TOOTH PREPARATION
Brockleherst, 1992 suggested that air
abrasion with aluminum oxide particles is
the best method of cleaning as it results in
an improved surface for resin wetting,
more number of resin tag formation and
more depth of sealant penetration.
DR.TINET MARY AUGUSTINE.MDS
31

32. Sol et al. 2000 found out that use of
sodium bicarbonate air polishing system
resulted in higher retention of cement.

DR.TINET MARY AUGUSTINE.MDS
32

33. Garcia Godoy et al. (1994) and Zervou et
al. (2000) recommended enameloplasty
as it increases the surface area and
decreases microleakage

DR.TINET MARY AUGUSTINE.MDS
33

34. FISSUROTOMY BUR
It cuts a smooth, minimally invasive
groove in suspicious fissures to allow for
explorer access
DR.TINET MARY AUGUSTINE.MDS
34

35. ETCHING TIME
Buonocore (1955) Observed that, after
treatment of the enamel with
concentrated phosphoric acid
solution, attachment of acrylic resin to
tooth surfaces was greatly increased.
DR.TINET MARY AUGUSTINE.MDS
35

36. Duggal et al. (1997) have used different
etching timing of 15, 30, 45 and 60
seconds and concluded that there is no
difference is retention of sealant using
different etching time.
DR.TINET MARY AUGUSTINE.MDS
36

37. Tandon S et al. (1989) have proposed an
etching time of 15 sec to be sufficient for
primary teeth
Etching of 2mm on either side of exposed
groove

DR.TINET MARY AUGUSTINE.MDS
37

38. Application times (IADR sealant
symposium in 1991).

DR.TINET MARY AUGUSTINE.MDS
38

39. ZONES OF ETCHING
(SILVERSTONE 1976)
DR.TINET MARY AUGUSTINE.MDS
39

40. CURING
Chosak and Eidelman found that the longer sealants were
allowed to sit on the etched surface before being
polymerized, the more the sealant penetrated the
microporosities, creating longer resin tags, which are
critical for micromechanical retention.
Hicks et al. (2000) found that argon laser curing of sealant
material may enhance caries resistance.

DR.TINET MARY AUGUSTINE.MDS
40

41. RETENSION-
Wintrobe 1989
DR.TINET MARY AUGUSTINE.MDS
41

42. The sealant effectiveness
can be assessed by
CCC sealant evaluation
system
The sealant effectiveness can
be assessed by CCC sealant evaluation
system
C – Colour: validity of sealant
identificationa nd caries diagnosis.
C – Coverage: effectiveness of the sealant.

C – caries: caries status on the surface.


DR.TINET MARY AUGUSTINE.MDS
42

43. Codes for evaluation of sealant-
Ana Luiza Falavinha VieiraI et al 2006
43
DR.TINET MARY AUGUSTINE.MDS

44. TYPES OF SEALENTS
1. Glass ionomer cement sealants
2. Sealants with bonding agents
3. Self-etching light cured sealants
4. Fluoride releasing sealants
5. Moisture-resistant sealants
6. Colored versus clear sealants

DR.TINET MARY AUGUSTINE.MDS
44

45. RECENT ADVANCEMNETS
REMINERALIZING SEALENTS
FLOURIDE INCORPORATED
ACP INCORPORATED
NOVAMIN
RESIN BASED
SEALENTS WITH OPTIC PROPERTIES
CLEAR
COLOURED
FLOURESCENT
HYDROPHILIC BOND SEALENTS
BIOLOGICAL SEALENTS-BPA FREE SEALENTS
SEALENTS WITH NANOPARTICLES






DR.TINET MARY AUGUSTINE.MDS
45

46. TRADE NAMES

Fluoride releasing sealants—Seal-Rite® (Pulpdent),
FluoroShield® (Dentsply), Conceal F® (SDI)
Clear pit and fissure sealant—Helioseal®
Colored pit and fissure sealant—Clinpro®
Fluorescing pit and fissure sealant—Delton
Seal-N-Glo®

DR.TINET MARY AUGUSTINE.MDS
46

47. Moist bonding pit and fissure sealant—
Embrace WetBond®
Pit and fissure sealant with acp—Aegis
Pit® and fissure sealant
Hydrophilic fluorescent BPA free Pit and
fissure sealant—UltraSeal XT® hydro.

DR.TINET MARY AUGUSTINE.MDS
47

48. FLOURIDE RELEASING SEALENT
(Seal-Rite® (Pulpdent), FluoroShield® (Dentsply),
Conceal F® (SDI).
FLOURIDE RELEASE:2-3 MICROGRAMS/ML/DAY


DR.TINET MARY AUGUSTINE.MDS
48

49. Evolution
fluoride-releasing sealants were introduced by
SWARTZ in 1976
The sealants developed by Dr. H. Ralph Rawls
of the Louisiana State University School of
Dentistry, research associate Barbara
Zimmerman, and dental by ion exchange.
This process leaves the sealant structure intact
while providing a long-term, steady rate of
release
 Zimmerman, B.F.; Rawls, H.R.; and Bassett, R.G., Jr. Fluoride release
and physical properties of an experimental resin-filled sealant. J
Dent Res 63:295, abstract no. 1116, 1984.

DR.TINET MARY AUGUSTINE.MDS
49

50. Current commercial fluoride-releasing
sealants contain either a soluble fluoride
salt such as sodium fluoride (NaF) or
fluoride-releasing glass filler or both

DR.TINET MARY AUGUSTINE.MDS
50

51. Garcia Godoy (1997) found out that all
the fluoridated sealant had the greatest
amount of fluoride release by 24 hours
after mixing and the fluoride release
declined sharply thereafter.

DR.TINET MARY AUGUSTINE.MDS
51

52. Dr. Harald Loe 1986
DR.TINET MARY AUGUSTINE.MDS
52

53. PRINCIPLE
The long-term capability of resin sealants and glass
ionomer cements to release fluoride to the sealed
enamel and the adjacent unsealed pit and fissure
associated to a reduction in pit and fissure caries
experience for children (CHESTNUTT 1994)

Act as rechargeable fluoride release devices
(FOSTEN 1991)
Contact to adjacent teeth prevent
demineralization (DONLY KJ 1999)
DR.TINET MARY AUGUSTINE.MDS
53

54. Cooley et al. (1990) and Hicks et al.
(1992) conducted lab studies on a
fluoride releasing sealant material
composed of a modified urethane Bis-
GMAresin.
They concluded that fluoride release dips
considerably as the days go by. But, they
showed that 60 percent reduction in
secondary caries and enhanced degree
of caries resistance was seen.
DR.TINET MARY AUGUSTINE.MDS
54

55. LEVEL OF FLOURIDE RELEASE
This benefit of fluoride release and
subsequent adsorption is found not only in
enamel immediately adjacent to
restorations, but also in areas up to 3 mm
away from the restoration margins and may
even protect the entire tooth

ARNADA M 1994
DR.TINET MARY AUGUSTINE.MDS
55

56. RECHARGE OF FLOURINE
The higher fluoride release from glass
ionomer cements during the first days is
named ―burst effect‖ (ATTAR N 2003)
Sealent materials with higher initial fluoride
release have higher recharge capability
(XU X 2003)
Regular use of fluoride toothpastes
(WEIGAND A2007)
DR.TINET MARY AUGUSTINE.MDS
56

57. DR.TINET MARY AUGUSTINE.MDS
57

58. NO F
DR.TINET MARY AUGUSTINE.MDS
58

59. Fissurit FX/Voco showed significantly higher fluoride release than
Grandio Seal/Voco till day 49The application of fluoride varnish
Profluorid Varnish enhanced the fluoride release for all sealants than
highly fluoridated fluoridated CPP-ACP toothpaste
DR.TINET MARY AUGUSTINE.MDS
59

60. Refluoridation of flouridated sealants supported by:

Takahashi K, Emilson C G, Birkhed D. Fluoride release
in vitro from various glass ionomer cements and resin
composites after exposure to NaF solutions. Dent
Mater. 1993;9:350-4.
Attar N, Turgut MD. Fluoride release and uptake
capacities of fluoride-releasing restorative materials.
Oper Dent. 2003;28:395-402.
DR.TINET MARY AUGUSTINE.MDS
60

61. DR.TINET MARY AUGUSTINE.MDS
61

62. CLEAR PIT AND FISSURE
SEALENT
 Helioseal®: Changes from green to white
DR.TINET MARY AUGUSTINE.MDS
62

63. OPAQUE PIT AND FISSURE
SEALENST
DR.TINET MARY AUGUSTINE.MDS
63

64. Concern
Inappropriate application of sealants and
subsequent micro-leakage might lead to
the progression of caries .Therefore,
periodic recall visits should be arranged to
assure their effectiveness.

Wells MH. Pit and fissure sealant: scientific and clinical rationale. In:
Cassamassimo PS, Field HW, Mctigue DJ, Nowak AJ, editors. Pediatric
dentistry: Infancy through adolescence. 5th ed. St Louis: Saunders Elsvier; 2013.
pp. 467–489.


DR.TINET MARY AUGUSTINE.MDS
64

65. Evaluation
Visual evaluation
A possible method to achieve this goal is
to employ Laser flourescence by
DIAGNOdent



LF Clinical study of the use of the laser fluorescence device DIAGNOdent for detection of
occlusal caries in children.Anttonen V, Seppä L, Hausen H Caries Res. 2003 Jan-Feb;
37(1):17-23.
Effect of sealants on laser fluorescence caries detection in primary teeth.Askaroglou E,
Kavvadia K, Lagouvardos P, Papagiannoulis LLasers Med Sci. 2011 Jan; 26(1):29-34.


DR.TINET MARY AUGUSTINE.MDS
65

66. Advanatge of clear sealents
As clear sealants allow visual examination
of carious lesions beneath the sound
enamel, they seem to be the best option
to clinically detect the caries


The influence of pit and fissure sealants on infrared fluorescence measurements.Diniz
MB, Rodrigues JA, Hug I, Cordeiro RC, Lussi A Caries Res. 2008; 42(5):328-33.

DR.TINET MARY AUGUSTINE.MDS
66

67. Opaque sealers
The most common opacifying filler in
sealants is TiO
2. This filler facilitates the
application of sealant and its visual
assessment in recall visits
DR.TINET MARY AUGUSTINE.MDS
67

68. Ti02
As TiO
2 content increases, fluorescence
transmission is weakened thus it might
interfere with the fluorescence transmitted
from caries or laser devices.
Delton opaque sealants contain 1.5%
TiO
2, and also SiO
2 .
Helioseal opaque sealant, contained 2%
TiO
2. Effect of sealants on laser fluorescence caries detection in primary
teeth.Askaroglou E, Kavvadia K, Lagouvardos P, Papagiannoulis L Lasers Med
Sci. 2011 Jan; 26(1):29-34.

DR.TINET MARY AUGUSTINE.MDS
68

69. Reading on recalls
intrinsic fluorescence of clear and
opaque sealants significantly affects LF
readings
 Therefore, it might lead to increased false
positive results and therefore caries
overestimation.

An in vitro evaluation of the effect of sealant characteristics on laser
fluorescence for caries detection.Gostanian HV, Shey Z, Kasinathan C,
Caceda J, Janal MNPediatr Dent. 2006 Sep-Oct; 28(5):445-50.
DR.TINET MARY AUGUSTINE.MDS
69

70. Controversy
Deery et al.(2006) and Sonmenz et
al.(2011) have concluded that
fluorescence measurements was
significantly decreased after applying
clear sealants


storing media was 1% aqueous thymol
solution
DR.TINET MARY AUGUSTINE.MDS
70

71. Thin sealer thickness-0.5-1mm
DR.TINET MARY AUGUSTINE.MDS
71

72. The ability of LF in detecting caries beneath the filled
and unfilled clear sealants as well as the sealants
containing titanium dioxide was evaluated.
Clear sealants (not containing opacifying agents)
weakened LF signals, considering the fact that filled
sealants decreased LF values more profoundly than
unfilled sealants (p< 0.001). Also, as the concentration of
titanium dioxide reaches 0.5%, the transmission of
fluorescence signals was significantly decreased
Gostanian HV, Shey Z, Kasinathan C, Caceda J, Janal MN Pediatr Dent. 2006 Sep-Oct; 28(5):445-
50.

DR.TINET MARY AUGUSTINE.MDS
72

73. In an in vitro study by Diniz et al., the influence of
Delton clear, Delton opaque and Helioseal clear pit
and fissure sealants was evaluated on infrared
fluorescence measurements. By using conventional LF
and an LF pen device for measurements, no
statistically significant changes were observed after
the application of the clear sealant, while values
tended to decrease when using Delton and Helioseal
opaque sealants
Diniz MB, Rodrigues JA, Hug I, Cordeiro RC, Lussi A Caries Res. 2008; 42(5):328-33.

DR.TINET MARY AUGUSTINE.MDS
73

74. DR.TINET MARY AUGUSTINE.MDS
74

75. COLORED PIT AND FISSURE
SEALENT
Clinpro®—changes to pink on setting.

DR.TINET MARY AUGUSTINE.MDS
75

76. DENTEX SEAL
- Available in yellow , white n pink in
color

DR.TINET MARY AUGUSTINE.MDS
76

77. CLINPRO SEALANT
Colour changes technology to visualize
placement
Low viscosity to flow easily into pit and
fissures

DR.TINET MARY AUGUSTINE.MDS
77

78. 3M ESPE KETAC MOLAR PIT
ANDFISSURE SEALANT

Light cure
Low viscosity
Colour change technology to visualize
placement.

DR.TINET MARY AUGUSTINE.MDS
78

79. COMPOMER PIT AND FISSURE


SEALANT
Tooth coloured
Opaque fissure sealant
Releases fluoride
Contains bactericidal zinc ions

DR.TINET MARY AUGUSTINE.MDS
79

80. FLOURESCING PIT AND FISSURE
SEALENT
Delton Seal-N-Glo (Dentsply).

DR.TINET MARY AUGUSTINE.MDS
80

81. Advanatge of flouresecent
sealers
Eliminates the guess works involved in the
placing of sealents and confirming
placement during recall appointments
Use of UV pen light. Seal-N-Glo Fluoresces
a blue/white color.
Thus easiest way to verify retension and
inspect margins
DR.TINET MARY AUGUSTINE.MDS
81

82. DR.TINET MARY AUGUSTINE.MDS
82

83. DR.TINET MARY AUGUSTINE.MDS
83

84. SELF ETCHING SEALENTS
-Self etching
-Light cure
-Release fluoride
-Natural white


According, to the company, Enamel Loc
is:
“The First Self-Etching Light-Cured Pit &
Fissure Sealant. “

DR.TINET MARY AUGUSTINE.MDS
84

85. Beauti Fill sealant
Fluoride releasing / recharging
Tooth colored
Free of Bis –phenol A
Hydroxyethylene methacrylate (HEMA)


DR.TINET MARY AUGUSTINE.MDS
85

86. DR.TINET MARY AUGUSTINE.MDS
86

87. DR.TINET MARY AUGUSTINE.MDS
87

88. In a study to Compare effectiveness of traditional acid
etching and of the self-etching agent in sealant
retention,the results showed that there was No significant
difference was seen in the retention of fissure sealants
placed on occlusal surfaces following the use of an
traditional acid etching technique and Self Etching
bonding agent, after 6 months.
88
Mohammed IP, Jaleel BF, Hiremath SS, Manjunath C, Amarah U, Krishnamoorthy
A. Comparison of effectiveness of traditional acid etching and of the self-etching agent in sealant retention: A randomized
controlled trial. J Indian Assoc Public Health Dent 2016;14:4-9
DR.TINET MARY AUGUSTINE.MDS

89. DR.TINET MARY AUGUSTINE.MDS
89

90. DR.TINET MARY AUGUSTINE.MDS
90

91. Pit and Fissure Sealant with
Amorphous Calcium Phosphate)-
Aegis® Pit and fissure sealant.

DR.TINET MARY AUGUSTINE.MDS
91

92. Advantage

It is a light-cured sealant
contains the ―smart material‖ amorphous
calcium phosphate (ACP) that is more resilient
and flexible, creating a stronger, longer lasting
sealant.
Also it releases calcium and phosphate ions
when the pH drops to 5.9. Once the calcium
phosphate is released, it will act to neutralize the
acid and buffer the pH. ACP acts as
reinforcement to the tooth’s natural defense
system only when it is needed.
DR.TINET MARY AUGUSTINE.MDS
92

93. It has a controlled flowability that keeps
the sealant on the tooth structure while
completely filling occlusal surfaces and it forms a
chemical and thermal barrier protecting the tooth
enamel on the occlusal surface from carious
attacks.
DR.TINET MARY AUGUSTINE.MDS
93

94. ACP-Amorphous calcium phosphate
sealant )
Eg: Bosworth Aegis pit & fissure sealants


Zawaideh FI, Owais AI, Kawaja W. Ability of pit and fissure sealant-containing
amorphous calcium phosphate to inhibit enamel demineralization. Int J Clin
Pediatr Dent 2016;9(1):10-14.
DR.TINET MARY AUGUSTINE.MDS
94

95. DR.TINET MARY AUGUSTINE.MDS
95

96. DR.TINET MARY AUGUSTINE.MDS
96

97. DR.TINET MARY AUGUSTINE.MDS
97

98. DR.TINET MARY AUGUSTINE.MDS
98

99. Saliva contamination

DR.TINET MARY AUGUSTINE.MDS
99

100. Moisture tolerant pit & fissure sealants.
Eg: Embrace WetBond™ (Pulpdent
Corporation).

Akurathi Ratnaditya et al. Clinical Evaluation of Retention in Hydrophobic
and Hydrophillic Pit and Fissure Sealants-A Two Year Follow-Up Study .
Journal of Young Pharmacists 2015 ;7( 3);171-179
DR.TINET MARY AUGUSTINE.MDS
100

101. Embrace WetBond™
(Pulpdent Corporation).
Hydrophilc.
Embrace is activated by moisture.
Embrace WetBond contains no bis-
GMA and no bisphenol A.
It contains fillers (aluminum powder, carbon
fiber, graphite, calcium carbonate, silica,
clay)





DR.TINET MARY AUGUSTINE.MDS
101

102. ENAMEL WETBOND
Resin cement medium viscosity Brand
names

1.EMCA
2.EMCAR
3.EMCAR2
4.EMCM
5.EMCMR
6.EMCMR2

DR.TINET MARY AUGUSTINE.MDS
102

103. DELTON FS +
Direct delivery system
Fluoride releasing
Low viscosity
Retention rate – 30.4%
High wetting ability

DR.TINET MARY AUGUSTINE.MDS
103

104. When placed in the presence of moisture, the
sealant spreads over the enamel surface (A
traditional sealant does not spread over a moist
tooth surface because of its hydrophobic nature).
 Because of its unique chemistry, Embrace
WetBond is miscible with water and flows into
moisture-containing etched enamel and
combines with it.
DR.TINET MARY AUGUSTINE.MDS
104

105. Sealing ability
It forms a unique resin acid-
integrating network (RAIN) that
improves penetration into pits and fissures
and provides superior sealing of the
margins.
DR.TINET MARY AUGUSTINE.MDS
105

106. Bonding
It bonds chemically and micromechanically to
the moist tooth, integrating with the tooth
structure to create a strong, margin-free bond
that virtually eliminates microleakage.

DR.TINET MARY AUGUSTINE.MDS
106

107. Advantage
Wet bonding,
Tooth integrating,
no marginal chipping,
no need of bonding agent
contains no Bisphenol A Bis-GMA or Bis-
DMA.
DR.TINET MARY AUGUSTINE.MDS
107

108. CONCERN
Feigal came up with the novel concept
that hydrophilic bonding materials that
contain water, may, when applied under
a sealant, minimize the bond strength
normally lost when a sealant is applied in
a moist environment.

DR.TINET MARY AUGUSTINE.MDS
108

109. DR.TINET MARY AUGUSTINE.MDS
109

110. DR.TINET MARY AUGUSTINE.MDS
110

111. DR.TINET MARY AUGUSTINE.MDS
111

112. DR.TINET MARY AUGUSTINE.MDS
112

113. 113
•The Hydrophillic sealant (79.6) showed significantly more retention

than Hydrophobic sealants(73.4).
Akurathi Ratnaditya et al. Clinical Evaluation of Retention in Hydrophobic
and Hydrophillic Pit and Fissure Sealants-A Two Year Follow-Up Study .
Journal of Young Pharmacists 2015 ;7( 3);171-179
DR.TINET MARY AUGUSTINE.MDS

114. DR.TINET MARY AUGUSTINE.MDS
114

115. HYDROPHILLIC FLOURESCENT BPA
FREE PIT AND FISSURE
SEALENTUltraSeal XT® hydro.

DR.TINET MARY AUGUSTINE.MDS
115

116. Advantage

Hydrophilic chemistry,
Advanced adhesive technology,
Fluorescent properties,
Thixotrophic viscosity,
Bpa-free formula.
DR.TINET MARY AUGUSTINE.MDS
116

117. DR.TINET MARY AUGUSTINE.MDS
117

118. Thus not only can it be used in wet
environment but also is easy to place
owing to thixotrophic viscosity and is easy
to follow up due to fluorescence.

To prevent nay estrogenicity issues the
manufacturer has kept it BPA free.

DR.TINET MARY AUGUSTINE.MDS
118

119. DR.TINET MARY AUGUSTINE.MDS
119

120. Pen type handling of sealants.
Eg: Ecuseal
(Ecu-PEN is autoclavable up to 130 °C. It will
withstand 100 autoclave cycles.)

DR.TINET MARY AUGUSTINE.MDS
120

121. Nano composites as sealants.
Eg: Transeal (Deep penetration and
excellent flow rate)

DR.TINET MARY AUGUSTINE.MDS
121

122. DR.TINET MARY AUGUSTINE.MDS
123

123. DR.TINET MARY AUGUSTINE.MDS
125

124. DR.TINET MARY AUGUSTINE.MDS
126

125. Advances in curing of sealants
1. U.V light cure (320-395nm)
2. LED CURING LIGHT (440-490nm)
3. Tungsten halogen curing light (400-500nm)
4. PlasmaArc (400-500nm)
5. LSAER (LightAmplification by Stimulated
Emission Radiation)
Eg: Co2 laser improved retention of sealant
(10600nm).
Argon laser improved mechanical retention of
sealant (488, 514nm).

DR.TINET MARY AUGUSTINE.MDS
127

126. DR.TINET MARY AUGUSTINE.MDS
128

127. Compared sealed and unsealed teeth in
the same mouth.
Teeth which were initially sound had
caries rate 13% at 5 years when unsealed
and
DR.TINET MARY AUGUSTINE.MDS
129

128. Studies on Sealant
130
•Huda Nazar et al (2013) conducted a study on
Effectiveness of Fissure Sealant Retention and Caries Prevention
with and without Primer and Bond. Results showed that There
was no difference between teeth sealed with primer and bond and
teeth sealed without primer and bond retained sealant.
Huda Nazar et al. Effectiveness of Fissure Sealant Retention and Caries
Prevention with and without Primer and Bond. Med Princ Pract
2013;22:12–17 DR.TINET MARY AUGUSTINE.MDS

129. 131
Priscilla Santana Pinto Goncalves et al(2016)
Conducted a study with Pit and Fissure Sealants
with Different Materials: Resin Based vs Glass
Ionomer Cement. Both the sealants, Fluroshield
(Dentsply) and Clinpro TM Varnish® XT(GIC) were
effective in preventing caries lesion within 6
months, although Fluroshield sealant showed
better clinical retention.
Ref: Priscilla Santana Pinto Goncalves et al. Pit and Fissure Sealants
with Different Materials: Resin Based x Glass Ionomer Cement – Results
after Six Months .Brazilian Research in Pediatric Dentistry and Integrated
Clinic 2016, 16(1):15-23
DR.TINET MARY AUGUSTINE.MDS

130. Comparison 1.
Sealants versus nonuse of sealants. The
results of 9 studies (3,542 participants).
Participants who received sealants reduced
their risk of developing new carious lesions
by 76% compared with participants who did
not receive sealants.

DR.TINET MARY AUGUSTINE.MDS
132

131. Comparison 2.
Sealants versus fluoride varnishes. The results
of 3 studies (1,715 participants) Participants
who received sealants had a 73% reduction
in the risk of developing new carious lesions
compared with participants who received
fluoride varnishes.
DR.TINET MARY AUGUSTINE.MDS
133

132. DR.TINET MARY AUGUSTINE.MDS
134

133. Priscilla Santana Pinto Goncalves et
al(2016) conducted a study Pit and Fissure
Sealants with Different Materials: Resin Based vs
Glass Ionomer Cement. Both the sealants,
Fluroshield (Dentsply) and Clinpro TM Varnish®
XT(GIC) were effective in preventing caries
lesion within 6 months, although Fluroshield
sealant showed better clinical retention

Priscilla Santana Pinto Goncalves et al. Pit and Fissure Sealants with
Different Materials: Resin Based x Glass Ionomer Cement – Results
after Six Months .Brazilian Research in Pediatric Dentistry and
Integrated Clinic 2016, 16(1):15-23
DR.TINET MARY AUGUSTINE.MDS
135

134. DR.TINET MARY AUGUSTINE.MDS
136

135. Huda Nazar et al (2013) conducted a
study on Effectiveness of Fissure Sealant
Retention and Caries Prevention with and
without Primer and Bond. Results showed
that There was no difference between
teeth sealed with primer and bond and
teeth sealed without primer and bond
retained sealant.

Huda Nazar et al. Effectiveness of Fissure Sealant Retention and Caries Prevention
with and without Primer and Bond. Med Princ Pract 2013;22:12–17
DR.TINET MARY AUGUSTINE.MDS
137

136. Imran Pasha Mohammed et al (2016) conducted a
study on Comparison of effectiveness of traditional
acid etching and of the self-etching agent in sealant
retention: A randomized controlled trial. The study
results showed that there was No significant
difference was seen in the retention of fissure
sealants placed on occlusal surfaces following the
use of an traditional PAE technique and SE bonding
agent, after 6 months.

Mohammed IP, Jaleel BF, Hiremath SS, Manjunath C, Amarah U,
Krishnamoorthy A. Comparison of effectiveness of traditional acid
etching and of the self-etching agent in sealant retention: A
randomized controlled trial. J Indian Assoc Public Health Dent
2016;14:4-9
DR.TINET MARY AUGUSTINE.MDS
138

137. SOME REVIEW STUDIES
DR.TINET MARY AUGUSTINE.MDS
139

138. DR.TINET MARY AUGUSTINE.MDS
140

139. DR.TINET MARY AUGUSTINE.MDS
141

140. DIFFERENT OPTIONS
DR.TINET MARY AUGUSTINE.MDS
142

141. DR.TINET MARY AUGUSTINE.MDS
143

142. DR.TINET MARY AUGUSTINE.MDS
144

143. DR.TINET MARY AUGUSTINE.MDS
145

144. DR.TINET MARY AUGUSTINE.MDS
146

145. AAPD GUIDELINES

DR.TINET MARY AUGUSTINE.MDS
147

146. EVALUATED
Resin-based sealants,
Glass ionomer (GI) cements, GI sealants,
Polyacid-modified resin sealants,
Resin-modified GI sealants.
DR.TINET MARY AUGUSTINE.MDS
148

147. Resin-based sealants
Resin-based sealants are urethane dimethacrylate,
―UDMA,‖ or bisphenol A-glycidyl methacrylate (also
known as ―bis- GMA‖) monomers polymerized by
either a chemical acti- vator and initiator or light of a
specific avelength and intensity.
Resin-based sealants come as unfilled, colorless, or
tinted transparent materials or as filled, opaque,
tooth- colored, or white materials.
DR.TINET MARY AUGUSTINE.MDS
149

148. GI sealants
GI sealants are cements that were
developed and are used for their
fluoride-release properties, stemming from
the acid- base reaction between a
fluoroaluminosilicate glass powder and
an aqueous-based polyacrylic acid
solution.
DR.TINET MARY AUGUSTINE.MDS
150

149. Polyacid-modified resin
sealants
Polyacid-modified resin sealants, also
referred to as compo- mers, combine
resin-based material found in traditional
resin-based sealants with the fluoride-
releasing and adhesive properties of GI
sealants.
DR.TINET MARY AUGUSTINE.MDS
151

150. Resin-modified GI sealants
Resin-modified GI sealants are essentially
GI sealants with resin components. This
type of sealant has similar fluoride- release
properties as GI, but it has a longer
working time and less water sensitivity
than do traditional GI sealants.
DR.TINET MARY AUGUSTINE.MDS
152

151. DR.TINET MARY AUGUSTINE.MDS
153

152. DR.TINET MARY AUGUSTINE.MDS
154

153. Conclusion
To make significant gain in decreasing
caries in children, it is necessary for dental
professionals to educate and inform the
general public, parents and physicians
about cost effectiveness and caries
preventive benefits of sealants.
DR.TINET MARY AUGUSTINE.MDS
155

154. THANK YOU
DR.TINET MARY AUGUSTINE.MDS
156