Asalaam Alekum
12/2/2015
Pit and Fissure Sealants

At the end of lecture students should know:
Introduction & definition of Dental (Pit & fissure)
sealants
 Role of sealants in preventive dentistry
 Indications
 Contraindications
 Types
 Glass ionomer & Resin based sealants
 Recommendations
 Factors affecting long term success
 Placement technique
 Advantages

Pit and Fissure Sealants

Dental sealants also known as pit & fissure sealants
are defined as a preventive dental treatment,
where a plastic material is placed in the pits and
fissures of primary or permanent molar & premolar
teeth

Provide mechanical barrier against cariogenic
bacteria

The procedure is esthetic, non-invasive, and costeffective
Pit and Fissure Sealants
Role of dental sealants in preventive
dentistry:
 Posterior teeth (mainly molars) are considered the most
susceptible teeth to dental caries due to the occlusal
anatomy, which unfortunately inhibits protection from
saliva and fluoride and favors plaque accumulation
 Sealants are used in combination with patient
education, effective personal oral hygiene, and the use
of fluorides for the prevention of dental caries.
Pit and Fissure Sealants







A history of dental caries
Deep retentive pits and fissures
Early signs of dental caries
Poor plaque control
Cariogenic diet
Enamel defects, such as enamel
hypoplasia
Orthodontic appliances
Patients or teeth that are at high risk of dental caries
Pit and Fissure Sealants
A balanced diet low in sugars or carbohydrates
 Exceptionally good oral hygiene
 Teeth with shallow, self-cleansing pits and fissures
 Teeth that are partially erupted which are very
difficult to isolate
 Teeth with previously restored pits and fissures
 Carious teeth
 Primary teeth close to exfoliation
 Allergy to sealant material

Patients or teeth that are at a low risk of dental caries
Pit and Fissure Sealants

According to chemical nature:

Glass ionomer based
Compomer based
Resin based


•
Conventional
Fluoride releasing

According to setting mechanism:

Auto cured (chemical cured)
Light cured
Dual cured
•


Glass ionomer v/s Resin-based sealants:
 Adhere directly to the tooth
 Fluoride releasing glass ionomer sealants are a
good choice for teeth that are:
 Partially erupted
 Difficult to isolate
 Glass ionomer sealants are moisture tolerant
 Excellent as a transitional sealant
Pit and Fissure Sealants
Glass ionomer v/s Resin-based sealants
 Once the tooth is totally erupted, a resin-based
sealant should be placed
 Resin-based sealants provide higher bond
strengths and longer retention than glass ionomer
sealants
Pit and Fissure Sealants
Are sealants recommended for both children
and adults?
Susceptibility to decay can exist in any tooth with
pits and fissures
This includes the primary teeth of children, and
the permanent teeth of children and adults
The caries risk status of an individual can change
over a period of time during both adolescence and
adulthood
Therefore - sealants really aren’t “just for kids”.
Pit and Fissure Sealants
Factors affecting long-term Success of
Sealant Therapy
 Frequent recall and repair if necessary
 Preparation of the fissure by removal of plaque
and debris prior to placement
 Isolation of teeth from saliva during placement
 Good operator techniques
Pit and Fissure Sealants
Sealant Placement Technique
Using a Resin-Based Material
(Traditional Technique)
Pit and Fissure Sealants
1. Select teeth to be sealed and isolate
Pit and Fissure Sealants
2. Clean the tooth surfaces with an air polisher or
prophy paste using a rubber prophy cup or brush
Pit and Fissure Sealants
3. Enamel cleaned of debris
Pit and Fissure Sealants
4. Etch the enamel (minimum of 15
seconds).
Pit and Fissure Sealants
5. Rinse and dry etched
enamel
Pit and Fissure Sealants
6. Gently rinse etchant and look for a frosty white
appearance
Pit and Fissure Sealants
7. Apply sealant material
Pit and Fissure Sealants
8. Light cure for time period recommended via product
instructions. Colored sealant material turns from pink
to tooth colored after light-curing.
Pit and Fissure Sealants
9. Check sealant coverage using articulating paper.
Arrows indicate the points of contact.
Pit and Fissure Sealants
Advantages of use of dental sealants:
 One of the best preventive measures we can offer
patients
 Cost effective, simple and fast
 When properly placed and maintained:
 Sealants have proven longevity
 Will aid in the prevention of caries
 Patients appreciate the preventive efforts
Sturdevant's art & science of operative dentistry-2006Theodore M. Roberson, Harald O. Heymann, Edward J. Swift, Jr.
 Principles of operative dentistry (2005)- A.J.E. Qualtrough,
J.D. Satterthwaite, L.A. Morrow and P.A. Brunton.
 Fundamentals of Operative Dentistry- 2nd Edition- Summitt &
Robbins
