Pit And Fissure Sealant

Supervisor: Dr. Rana Darwish Done by : Ahlam Taweel 20911199

Sajidah Sarahnah

Preventive dentistry lab.2011-2012

PIT AND FISSURE

SEALANTS_ BETTER

TO BE SAFE THAN !!!

SORRY

A thin plastic coating placed in the pit and fissures of the teeth to act as

a physical barrier

to decay.

As a way to prevent caries and protect the tooth .strategy based on assessment of caries risk

include application of fluoride varnish, education, nutritional counselling and regular clinical review

WHAT & WHY!?

The molar teeth have many fissures and pits, which can be very difficult to keep clean.

These are the sites most susceptible to developing

decay

resin-based sealants :o May or may not contain filler particles or fluoride.o The setting reaction can be automatic(auto-

polymerised) or light activated (light-polymerised). .

o Low viscosity resin-based RM (flowable composite) have also been used as fissure sealant.

o retention rates 2%–80% better than the GIC sealants.

TYPES OF P&F SEALANT MATERIALS:

glass ionomer sealants :

o can adhere directly to tooth substance.o release fluoride over time. o Less sensitive to moisture contamination than

resin-based materials.o Retention is a major problem with GIC sealants, but if this concern can be resolved, there

maybe advantages to the GIC sealants through the release of fluoride.

How effective are fissure sealants at

preventing caries?

Sealants are able to:

o prevent pit and fissure caries initiation .

o arrest caries progression by providing a physical barrier that inhibits micro-organisms and food particles from collecting in pits and fissures.

the effectiveness of sealants decreased over time and was higher in populations exposed to fluoridated water.

o type of sealant materialo placement technique o retention of sealanto cooperation of patient o follow-up timeo the content of fluoride in the drinking water o dietary, oral hygieneo the socioeconomic factors

factors influence the effectiveness of sealants:

What are the indications

and the contraindicatio

ns of the sealant

treatment?

all permanent molar teeth without cavitation (i.e., free of caries or incipient caries).

early (non- cavitated) carious lesions in children, adolescents and young adults to reduce the percentage of lesions that progress (Griffin et al. 2008).

teeth that have deep and narrow pit and fissure morphology (the caries risk is increased because of difficulties to clean the tooth).

teeth with stained grooves

: Indications

on the primary molars of children who are susceptible to caries (i.e., high caries risk).

Sealants should be placed on first and second permanent molar teeth within 4 years after eruption.

Sealants should not be placed on partially erupted (i.e., once there is gingival tissue on the crown)

Teeth with cavitation or caries of the dentin

Contraindications:

Which teeth should

be sealed?

the most important teeth for sealant application are the first and second permanent molar teeth.

Other teeth, such as premolars, third molars or the palatal surfaces of incisor teeth, may be considered for sealant application, based on:

o caries risk status.o and assessment of the tooth surface.

So we can say: 1 .Child with occlusal caries on one of the first

permanent molar.

Seal the remaining sound first permanent molars.

2 .Occlusal caries affecting one or more first permanent molars

Need to seal the second permanent molar as soon as they have erupted sufficiently.

3 .Tooth should be sealed within 2 years of eruption.

for some children, such as those with medical or other conditions where the development of

caries or its treatment could put the child’s general health at risk, sealing primary molar teeth should

be considered as part of a comprehensive caries-preventive program .

How should teeth be

checked for sealant?

Teeth should be clean, dry and well-illuminated for visual assessment.

A probe should not be used to explore pits or fissures

((Forceful use of a probe can damage tooth surfaces)) Radiographs should not be taken for the sole

purpose of placing sealants. Other diagnostic technologies are not necessary for

the sole purpose of placing sealants.

Are teeth that have lost sealant or have partially

retained sealant at higher risk of

caries than teeth that were never

sealed?

The results indicated that teeth with fully or partially lost sealant are not at higher risk of developing caries than teeth that were never seal in order to reduce the possibility of formerly sealed teeth returning to their original risk status, sealants need to be maintained .

answer be yes just if : This is particularly

true for children who have sealants applied to teeth with demineralised enamel or suspicious lesions .

When should sealants

be applied?

as soon as the tooth is sufficientlyerupted to be isolated. Time of eruption: first permanent molars :o 6.0–6.3 years for girlso 6.3–6.5 years for boys second permanent molars:o 11.5–12.3 years for girlso 11.8–12.4 for boys

Are pit and fissure

sealants safe?

patients are not at risk of exposure to BPA from the use of dental sealants, but recommendedprecautionary measures to reduce potential exposure to BPA from dental sealants which include:

rinsing the surface of the cured material for 30 seconds with water while using effective suction;getting the patient to rinse for 30 seconds and spit out after the procedure; removing the surfaceresidual monomer layer with pumice on a cotton pellet or a prophy cup.

Should dental sealant

be placed on primary or

permanent teeth or both?

the placement of sealants should be on permanent molar teeth as both cost-effective and efficacious in the prevention of caries.

the supporting evidence of the placement of sealants on primary molars is more limited.

Does dental sealant

susceptible to occlusal wearing?

بسرعه انزل الزم بس عالنتبطيءلالسف

Is there any optimum time for

reviewing?

the recall interval for high caries risk children should not exceed 12 months.

if isolation has been difficult to achieve or the

sealant has been applied over a suspicious lesion, recall within 6 months.

OPTIMUM TIME FOR REVIEWING

Pit and fissure sealant

VS Fluoride

varnish

In a randomized trial (Bravo et al. 2005), after nine years, caries reduction was:

65.4% (SE=8.5%) for sealants 27.3% (SE=10.2%) for varnish

Furthermore, the varnish programe was not effective during the discontinuation period.

How Can Retention

of Sealants be Enhanced?

by isolation of the teeth. application of bonding agents ((use of

flowable resin, following phosphoric acid gels))

How Important is

Isolation?

it is very important to adequately isolate the teeth because the salivary contamination is the major cause of loss of sealants in the first year.

Just remember Isolate the tooth to be sealed with either a dental dam or cotton wool rolls/isolationshields combined with effective aspiration

What are the factors

associated with an

increased risk of failure?

(1) age (2) dmft (3) no fluoride (4) operator

Thanks for discussion

Application Technique

Video

Tooth selection :

Cleaning

Isolation

Sealant retention should be checked with a probe after polymerisation to ensure that all fissures are completely sealed.

If any material is dislodged, the sealant should be reapplied after re-cleaning (if necessary.

Testing Retention

Thank you