Pit and fissure

1. PITANDFISSURESEALANT
By ;
Dr.Mohmed rahil

5. 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 .

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

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

8. • Potential chemical burns from
phosphoric acid
• Occlusal trauma
• No carcinogens or toxic materials
• Danger from cure light
RISKS ASSOCIATED WITH SEALANTS

9. 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

10. 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

12. TYPES OF SEALANTS
• Resin-based fissure sealants
• Unfilled resin (bis-GMA)
• Lightly filled resin
• Fluoride containing resin
• Compomer
• Glass ionomer cements

13. 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)

15. COMPOMER SEALANT
• Composition
• Polymerisable Strontium-Modified
carboxylic acid
• Phosphate-modified monomers

16. GLASS IONOMER SEALANT
• Powder-liquid form
• Chemical cured
• Finer filler particles

17. PROCEDURES
• Give a local anesthetic if
necessary
• Isolate the tooth
• Remove calculus or
debris

18. 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

19. PROCEDURES
• Etch the surface with
acid etchant
• Wash and dry

20. PROCEDURES
 Apply sealant
 Light cure

21. PROCEDURES
• Check occlusion

22. PROCEDURES
• Adjust occlusion using
white stone or finishing
bur

24.  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

25. BACTERIA REMAINING IN SEALED FISSURES;
• Studies have shown a
decrease in numbers of
microorganisms in lesions
under intact sealants, and
caries progression
appeared negligible

26. SEALANT FAILURE
• Usually occurs at enamel-resin interface
• Mostly caused by saliva or moisture contamination
during application

27. RECALL
• Maintenance and periodic review is essential
• Replacement of sealant should be done if marginal
debonding or sealant loss is observed

28.  Reapply if totally lost
 Repair if partially lossed
• Roughen with diamond stone
• Re-etch 20 seconds
• Reapply sealant
REPAIR OF SEALANT

29. ‫لادي‬‫ب‬‫ن‬‫م‬‫ورة‬‫ص‬//‫ة‬‫ن‬‫ي‬‫د‬‫ح‬‫ة‬‫ن‬‫ي‬‫د‬‫م‬