pit and fissure

PIT AND FISSURE SEALANT

By ;

Dr.Mohmed rahil

DEFINITION OF SEALAR

• Material that is introduced

into pits and fissures of

caries susceptible teeth, thus

forming protactive layer,

cutting access of caries

producing bacteria from

their sources of nutrients .

• Deep fissures• Incomplete or ill formed pits• Newly erupted teeth• High caries rate• Children• Molars

INDICATIONS

• Shallow fissures• Well coalesced pits• Fluoride rich enamel• Low caries rate• Occlusal or proximal caries• Adults

CONTRAINDICATIONS

• Potential chemical burns from phosphoric acid

• Occlusal trauma

• No carcinogens or toxic materials

• Danger from cure light

RISKS ASSOCIATED WITH SEALANTS

IDEAL PROPERTIES OF FISSURE SEALANT

• Should seal the pits and fissures against every penetration by oral flora

• Adhere to enamel (high retention rate)

• Should have a cariostatic action (F release)

• Resistant to oral fluid and diet (acid, alcohol, etc)

• Low viscosity

IDEAL PROPERTIES OF FISSURE SEALANT

• Adequate mechanical properties on setting (strength, abrasive resistance)

• Simple to use

• Non toxic

• Should be detectable

• Have short setting/polymerization time

TYPES OF SEALANTS • Resin-based fissure sealants• Unfilled resin (bis-GMA)• Lightly filled resin• Fluoride containing resin

• Compomer

• Glass ionomer cements

RESIN-BASED SEALANT

• Light cured or Chemical cured

• Chemical cured is no longer available

• Unfilled or slightly filled resin

• filler particles are added to improve abrasive resistance

• Translucent or opaque (or coloured)

COMPOMER SEALANT

• Composition• Polymerisable Strontium-Modified

carboxylic acid

• Phosphate-modified monomers

GLASS IONOMER SEALANT

• Powder-liquid form

• Chemical cured

• Finer filler particles

PROCEDURES

• Give a local anesthetic if necessary

• Isolate the tooth

• Remove calculus or debris

PROCEDURES

• If enamel caries is present, use ¼ round bur to widen the fissure and remove caries

• Clean the pit and fissure surfaces with prophy brush and pumice

PROCEDURES

• Etch the surface with acid etchant

• Wash and dry

PROCEDURES

Apply sealant

Light cure

PROCEDURES

• Check occlusion

PROCEDURES

• Adjust occlusion using

white stone or finishing

bur

The sealant is hard so you don’t have any restrictions on eating

If it feels “high” after you go home – you can come in to get it adjusted

We will keep checking the sealant at subsequent appointments

(if using unfilled corposite sealant the bite will self adjust in 2-3 days)

PATIENT INSTRUCTION

BACTERIA REMAINING IN SEALED FISSURES;

• Studies have shown a

decrease in numbers of

microorganisms in lesions

under intact sealants, and

caries progression

appeared negligible

SEALANT FAILURE

• Usually occurs at enamel-resin interface

• Mostly caused by saliva or moisture contamination during application

RECALL

• Maintenance and periodic review is essential

• Replacement of sealant should be done if marginal debonding or sealant loss is observed

Reapply if totally lost

Repair if partially lossed• Roughen with diamond stone• Re-etch 20 seconds• Reapply sealant

REPAIR OF SEALANT

صورة من بالدي // مدينة حديثة