pit and fissure
TRANSCRIPT
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