Department of Public Health and Dentistry (PHD) Seminar Topic : Pit & Fissures

1. Pit and Fissures
Department of Public Health Dentistry
Submitted by
Aswanth.E.P

2. Contents :
Introduction
History
Morphology
Types of pit and fissures
Types of sealants
Materials used
Procedure
Factors affecting sealant retention
Cost effectiveness
Preventive resin restoration
Conclusion
reference

3. Introduction
Caries potential is directly related to pit and fissures of teeth.
 Success of fluorides in caries prevention on smooth tooth
surfaces has made caries primerily a disease of pit & fissures
of teeth.
They prone to harber microbes which may cause occlusal caries

4. History :

5. Morphology :
Pit & are enamel faults.
Pits are pin point depressions on junction of
developmental grooves / at terminals of those grooves.
Fissures are long clefts in betveen cusps or ridges.
Types of fissures :
V and U types are self clensing and non invasive technique
recommented

6. I type is constricted ,carries susceptible and require
invasive technique
Types of Pit and fissure sealants
1) 1st generation :
Polymerized with UV light of wavelength
Absorbs UV light excessively and prevent
complete polymerization of sealant.

7. 2nd generation
Selfcured or chemically cured
Transparant/opaque/tinted
Filled show more wear and abrasion resistance
than unfilled .
3rd generation
Cured at visible light
White if unfilled and clear if filled.
4th generation
With addition fluoride for added benifit.

8. Materials Used as sealants :
1)Cyanoacrylates
In trace moisture they polymerize rapidly to
hard and brittle polymers on etched tooth surface.
Mechanical durability not satisfied and are not
biodegradable.
2)Polyurethanes
Poor mechanical properties,oral durability and toxicity.
Eg : Epoxylite

9. 3)Dimethacrylates
Methyl methacrylate (MMA) is highly volatile
and lack penetration.
EnamIte uses MMA-PMMA system and bind better
& less affected by immersion in water.
4)Glass ionomer
Hydrophilic,good adhesion ,biocompatible,
fluoride release.
Used for fissure whose orfice exceeds 100

10. Pit & fissure Sealant products :
Baritone L3
Helioseal
Seal-Rite
Concise White Sealant
Procedure of sealant application :
1)Polish the tooth surface :
To remove plaque and debris from enamel and
from pit & fssures.

11. If they retain there,it will interfere with etching
process and sealant penetration .
Carried out by using prophylaxis cup and pumice.
2)Isolate and dry the tooth surface.
Rubberdam provides best isolation
To keep tooth free from salivary contamination.
3)Acid itching :
Remove organic materials & debris from surface
& produces micropores into which monomer
can penetrate.

12. It depends on nature and concentration of acid,
duration of exposure ,site of enamel...
30-50% orthophosphoric acid is used for 30-60 sec.
 This allows swalant to penetrate 50 micrometer
of enamel depth.
4)Rinse the tooth
5)Isolate & dry the tooth :
Dry until a chalky,frosted appearence obtained.
Moisture contamination at this stage is the
common cause of sealant failure.

13. 6)Material application
Apply according to instructions without incorporate
air bubbles.
7)Evaluate the sealant
Evaluate visually & tactically.
If material is deficient,more sealant should be applied.
8)Check occlusion :
Check for high points.

14. 9)Retention and periodic maintenance :
Re-evaluate sealants at recall
If there has sealant loss new sealant can be
applied over old material
Requirements of pit & fissure sealants :
Clean surfaces
Good moisture control when being placed
Appropriate etching &drying time
Appropriate coverage of surface

15. Factors affecting sealant retension in the mouth :
1)Type of sealants
2)Position of teeth in the mouth
3)Clinical skill of the operator
4)Age of child
5)Eruption status of teeth
Sealants long-last if :
a. The case selected correctly
b. Correct tooth selection
c. Appropriate placement
d.Adequate maintenance is provided.

16. Cost effectiveness :
Cost of treatment can be minimized by :
1. Selective application on teeth with greatest
caries risk
2.Following meticulous application protocol
3.Applying sealants in conjuction with optimal
fluoride therapy
4.Delegating treatment to auxillary personnel
where legally permitted

17. Preventive Resin Restorations
Natural extension of use of occlusal sealants
Conservative answer to conventional “extension
for prevention” philosophy of class 1 amalgam
cavity preparation.
Simonsen classification :
3 types
Type A
Used when caries removal limited to enamel
Local anasthesia not required

18. Slow speed ¼ or ½ round bur used to remove
decalcified enamel .
Sealant is placed
Type B
Incipient lesion in dentin that is small & confined
No local anesthesia is needed
Base placed in areas of dentin exposure,composite
resin is placed & remaining pit & fissure are covered
with a sealant.

19. Type C
More dentinal involvement & requires
restorations with posterior composite materisl.
Base is placed over dentin.
Pit & fissure covered wuth a sealant
Local anesthesia is required.

20. Conclusion
Cariostatic properties of sealants are attributed
To physical obstruction of pit & fissures.
This prevent penetration of fermentable
carbohydrates & so remaining bacteria cannot
produce acid in cariogenic Concentrations.

21. Reference :
Peter s; pit and fissure:essentials of public health
Dentistry:community dentistry;6 th edition