Pit and fissures Sealants

Step into the world of pit and fissure sealants with us – a key player in modern dentistry's arsenal. Join our journey as we uncover how these protective coatings are meticulously applied to shield your teeth from cavities. Designed for all ages, these sealants offer a hassle-free way to bolster your oral health. Let's explore their simple yet effective role in keeping your smile vibrant and cavity-free!
Remember, with pit and fissure sealants, we're not just preventing cavities – we're outsmarting them! 🦷💪

1. Pit and Fissure Sealants ASHUTOSH KUMAR GUPTA Manipal College of  Dental Sciences, Mangalore.

2. What is Pit and Fissure ? Pit  - It is defined as small pinpoint depression located at a junction of developmental grooves. Fissure : Fissure is defined as deep clefts     between adjoining cusps.  

3. MORPHOLOGY OF PITS AND FISSURES Although only 12.5% of all tooth surfaces are occlusal these surfaces develop more than 75% of total caries of children..  The fissure contains organic plug composed of -       - Reduced enamel epithelium,       - Microorganism forming dental plaque and       -  OAral debris.

4. The increased susceptibility of occlusal  surface to caries is due to the fact that fissure provides a protected niche for plaque accumulation. Recently erupted teeth have a porous enamel lining  ! Now this  porous zone of enamel bordering the fissures offers three-dimensional honeycombed structure into  which fissure  sealants could be locked.

5. Therefore, any procedure must be carried out at the earliest possible time after eruption to make   effective preventive use of fissure sealants.

6. There are five types of pits and fissures - : 1. V – type  (34%)  2. U – type  (14%)  3. I – type  (19%)  4. IK – type  (26%)  5. Inverted Y – type   

7.  (34%) ​ (14%) ​  (19%) ​  (26%) ​ (7%).  V – type 

8. What is Pit & Fissure sealant ?   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 .

9. TYPES OF 

10. 1. According to chemical structures of monomers used 

11. 2. Based on generations   • First generation sealants:   Polymerized with UV light with wavelength of 356  μm . Had excessive absorption and incomplete polymerization  of sealant at its depth  e.g. - Nuva -lite (Caulk/Dentsply) . 

12. •  Second generation sealants:   Self cure or chemical cure resins  Based on accelerator catalyst system  Eg.  -  Concise White (3M)  • Third generation sealants:   Light cured with visible (blue) light of 430–490 μm   e.g. -  Helioseal   • Fourth generation:   – Fluoride releasing sealants . E.g. - Seal right ( Pulpdent ). 

13. 3. Based on filler content:   • Unfilled :   Advantages include better flow and more  retention but, abrade rapidly  • Filled : Advantages include resistance to wear but, may  need occlusal adjustments. 

14. 4.  Based on color :   • Clear:   Esthetic  Difficult to detect in recall visit  e.g.  Helioseal • Tinted/opaque:   Can be identified  For example, Delton  • Colored:   Based on color change technology  Easy to see during placement and recall  eg. Clinpro pink 

15. 5. Based on curing : • Autopolymerizing • Light cure.

16. Indications of Pit and Fissure Sealant  

17. REQUISITES  

18. Contraindications for Sealant Usage

19. Factors affecting Sealant retention Type of Sealants – Studies have shown that the second generation sealants provide better retention than first generation sealants. Posiition of tooth in the mouth -           Anterior  > Posterior           Mandibular > Maxillary Age of the child  Eruption status of teeth – In molars which are early in eruption placement of sealants will far more likely require replacement within 3 years 

20. Procedure of Sealant Appplication

21. Step 1: Tray Set-up Prior to the start of the procedure, a tray with all necessary instruments, supplies, and equipment should be prepared. The items included in the sample tray set-up aremouth mirror, slow speed handpiece, explorer (No. 5),toothbrush, cotton pliers, material, isolation device, saliva ejector, curing light, syringe tip, articulating tape.

22. Step 2: Isolation of Tooth The tooth should be isolated from salivary contamination by use of rubber dam or by cotton rolls and suctioning .

23. Step 3: Tooth Preparation There are different methods of enamel surface preparation   prior to etching and sealant application -  Air abrasion with aluminum oxide particles  Use of sodium bicarbonate Air polishing system Enameloplasty

24. Step 4: Acid Etching Tooth Surface Apply the etching agent to the tooth surface- 37 percent phosphoric acid using a fine Brush gently rub the etchant applicator over tooth surface including 2 to 3 mm of cuspal inclines and reaching into any buccal or lingual pits and grooves that are present. Etching time:  -                    Step                      Primary tooth Permanent tooth Acid etch  30 seconds   20 seconds Wash    30 seconds 30 seconds Dry   15 seconds    15 seconds

25. ZONES OF ETCHING 

26. Etched tooth surface

27. Step 5: Rinse and Dry Etched Tooth Surface • Rinse the etched tooth surface with air water spray for 30 seconds. • This removes the etching agent and reaction products from etched enamel surface. • Dry the tooth for 15 seconds with uncontaminated compressed air. • The dried etched enamel should have a frosted white appearance

28. Step 6: Application of Bonding Agent

29. Step 7: Application of Sealant The sealant material can be applied to the tooth in a variety of methods. In mandibular teeth, apply the sealant distally and allow it to flow mesially with the inverse being true for the maxillary teeth.

30. Step 8: Cure the Sealant Cure according to the manufacturer’s recommended time for curing For light cured sealants, polymerization should be initiated quickly after the sealant is placed on the etched surface to help minimize potential contamination.

31. Step 9 : Explore the Sealed Tooth Surface and Evaluate Occlusion

32. Step 10: Recall and Re-evaluation Recall and check the patient at subsequent visits.  It is necessary to re-evaluate sealed tooth surface for loss of material, exposure of voids and caries development, especially in the first 6 month of placement.

33. And the teeth is protected ..

34. Current Sealants Used - Fluoride Releasing Sealants Hydrophilic Fluorescent BPA   free Pit and Fissure Sealant Moist Bonding Pit and Fissure Sealant Pit and Fissure Sealant with ACP 

35. Points to Ponder ! In deep fissures if caries is present in part of pits and fissures it is restored and remaining pits and fissures are protected with sealants .. This process is termed as ?

36. Preventive Resin Restorations or  Conservative Adhesive resin restoration

37.                   Thank You !                                    Stay Safe !