Fissure Sealants

- Those materials are used to prevent occlusal pit and fissure caries by filling the deep pits and fissures, and this is very conservative way of tackling of problem of occlusal caries

- Fluoride, systemically, has an effect on reduction of smooth surface caries but it has less effect on occlusal caries.

- Sealants can reduce the overall cariogenic challenge to teeth.

- Few dentists don't recommend using pits and fissure sealants at all, their motto here is that they fear the procedure would induce caries later on because of the preparatory steps , and giving a chance for later caries development.

Note: The earlier the fissure sealing procedure, the better the results.

- Types:
1- Resins
2- GIC
3- Compomers
4- Flouride containing sealants

The choice between resin/composite and glass ionomer Fissure Sealant should be based on adequacy of moisture control.

- Requirement Of Fissure Sealants:
1- Good adhesion to enamel for a long period.
2- Biocompatible.
3- Simple in application and easy in manpulation.
4- High flow capacity to enter narrow pits & fissures
5- Have proper setting and working time
6- Have very low solubility in the oral fluids.
7- Not causing miecroleakage at the enamel sealant interfaces.
8- It not necessary to fill the entire depth of pit & fissures but it should fill and seal the entire length.

- Indications of Fissure Sealant:
1- Newly erupted un maatured teeth with narrow deep pit& fissure
2- Patient with high susceptibility to caries
3- Patient with history of high caries in his primary teeth
4- The presence of incipent caries
5- PRR or normal restoration

- Contraindication of Fissure Sealant:
1- Patients who are not susceptible to caries
2- Tooth with Large occlusal restoration.
3- Presence of open occlusal restoration or carious on an other surface of the same tooth
4- Patient's behavior which may not permit adequate dry field throughout procedures
5- Matured carious free teeth present in oral cavity for more than four years with wide shallow pits & fissures

- Steps of application of Fissure Sealant:
1- Use Rubber Dam or Cotton Roll and Suction, to isolate the tooth.
2- Clean the tooth very well using a non-fluoridated prophylactic paste and low Rubber Cup.
3- Dry the tooth very well.
4- Acid etch the tooth very well by the use of 30%-50% phosphoric acid or citric acid, for 60 seconds for permanent teeth, and 90 seconds for primary teeth.
5- Wash by water and dry by air very well.
6- Fissure sealant is then applied to the propely etched pit and fissure using its brush or applicator.
7- Make sure that the material is filling the etched pits & fissures.
8- Cure the material if it is light cure, OR, Leave it if it's chemically cured.
9- Check for retention and high spots, by asking the patient to bite or by using articulating papper.
10- Apply fluoride gel on the teeth surfaces to remeneralize the demenralized areas wich may not be covered by the fissure sealant.
11- Ask your patient to avoid rinsing or drinking for 30 secounds.

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This Article is authored by :: World Of Dentistry :: TEAM

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:: World Of Dentistry :: TEAM