Pit and fissure sealants are thin plastic coatings placed in the pits and fissures of teeth to act as a physical barrier against decay. They were introduced in the 1960s using acrylic polymers and composites. Studies show sealants can arrest incipient caries by being placed over initial decay after removal. Tooth morphology determines susceptibility, with deep narrow fissures at highest risk. Sealant placement involves cleaning and etching teeth to increase adhesion, then applying and curing the sealant material in the pits and fissures to form a protective barrier. Regular checkups are needed to assess sealant retention and repair any failures from contamination.

1. PIT AND FISSURE SEALANTS
Presented by:
Varsha vishwakarma
BDS final year
2 October 2020 1

2. Pit and fissure sealants
 A thin plastic coating placed in the pit and
fissures of the teeth to act as a physical barrier to
decay the teeth and prevent further caries
progression.
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3. History of Sealants
 Acrylic polymers introduced to dentistry -1937
 Composites - 1960
 “Occlusal Sealing” - 1965
 Glass ionomers -1972
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4. Incipient Caries
 Studies have shown that sealants can be placed over
incipient caries which arrests the caries process.
 Most dentists choose to use air abrasion, a bur, or a
laser to remove the caries before the sealant is placed.
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5. Tooth morphology
 Pits and fissures
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6. Tooth morphology
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7. Tooth morphology
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8. 2) I Type-
 Is deep, narrow and quite constricted , resembling a
bottle neck.
 Are caries susceptible.
 Requires invasive technique.
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Types Of Fissures :-
1) V Type & U Type-
 Are shallow and wide and tend to be self cleansing
and somewhat caries resistant.
 Non-invasive technique is recommended.

9. Types of Pit and Fissure Sealants
Based on types characteristics
A]Generations 1st generation .activated by ultra-violet light
.no more used as U-V light is harmful
to the body
2nd generation .chemical curing resins, based on catlyst
.accelerator system e.g. Concise( 3M)
3rd generation .activated by visible light
4th generation .fluoride containing ( double protection)
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10. Based on types characteristics
B]Fillers unfilled .flow is better
semifilled .more resistant to wear
C]Color clear .esthetic but difficult to detect at recall
examination
tinted .can be easily identified
opaque .can be easily identified
pink .Can be easily identified
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11. Preventive Programs as Related to Sealants
 Tooth brushing and flossing - mechanical plaque
removal .
 Fluoride – chemical prevention.
 Dental visits – mechanical plaque removal and
chemical prevention.
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12. Diet
 Minimize exposure to cariogenic foods and liquids that
have little or no nutritional value.
 Minimize solid and sticky foods.
 Minimize slowly dissolving foods.
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13. Other Preventive Programs
 Community water
fluoridation
 School water
fluoridation
 Fluoridated toothpaste
 Fluoride mouthrinse
 In-office treatment
 50-60% (18-40%)
 40%
 15-30%
 31%
 26%
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14. Retention of Sealants –
Non-fluoride
releasing sealant
 95% retention
 10% caries rate
Fluoride releasing
sealant
 91% retention
 10% caries rate
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15. Sealant Failure
 Debris and/or saliva contamination.
 Air inclusion during manipulation – voids.
 Manipulating self-cured sealants late in the setting
reaction.
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16. Loss of Sealant
 A contaminated site from faulty technique will likely
result in complete or partial loss of the sealant within
6-12 months.
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17. Indications
 1:-Deep fissures.
 2:-Incomplete or ill formed pits.
 3:-Newly erupted teeth.
 4:-High caries rate.
 (a) Children.
 (b) Molars .
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18. Contraindications
 Shallow fissures.
 Well coalesced pits.
 Fluoride rich enamel.
 Low caries rate.
 Occlusal or proximal caries.
 Adults.
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19. Operculum
(gum flap) –
leaks
crevicular
fluid.
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20. Sealant Kits
1. Cavity Indicators,
2. Drying / bonding agent (optional).
3. Acid etch.
4. Sealant material.
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21. Acid Etch
 Gel.
 Liquid.
 3M Innovation
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22. Acid etch Phosphoric acid 35%-40%-50%.
 Mainly 37% phosphoric acid is
used.
 Dissolves organic portion of
enamel.
 “micromechanical retention”
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23. Acid etch - continued
 Creates more
surface area for
better
adhesion.
 Also it provide
high energy
surface area for
bonding.
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24. Acid etch - Precautions
 Avoid contact with
adjacent teeth or soft
tissues.
 Can use mylar strips
or matrix bands .
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25. Drying agent (PrimaDry)
 Acid etching and
Primadry (alcohol
based) allows enamel
to be easily “wetted.”
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26. PrimaDry – precautions
 Active ingredient – ethyl alcohol.
 If skin contact – wash with soap and water.
 If eye contact – flush with lots of water.
Ingestion- give large amounts of water or
milk.
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27. Sealant composition
 1:-A type of
specialized
plastic (resin) or
glass ionomer
material.
 2:-Matrix.
 3:-Filler.
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28. Sealant Types
1:-Resin Sealants
 (Bis-GMA) Bisphenol A-
glycidyl methacrylate
resins.
 Urethane-based resin.
2:-Glass Ionomer Sealants
 Anticariogenic.
 More viscous, less
retention, more brittle
and less resistant to
occlusal wear.
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29. Chemical cure sealant materials
Advantages
 No cure light or risk of eye damage.
 Can apply sealants to several teeth..
Disadvantages
 Variation in setting time (appx 2 min).
 Voids from mixing material.
 Changes in viscosity over time.
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30. Light cured sealant materials
Advantages
 Short setting time (appx 20 seconds).
 No mixing required.
 Won’t set-up – longer working time.
 Does not get thick .
Disadvantages
 Potential eye damage due to light cure.
 Additional cost of cure light.
 Cure time increased with number of teeth sealed.
 Difficult to manipulate cure light for posterior teeth.
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31. Sealant Shades
 Clear
 Tinted
 Opaque
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32. Types of curing for sealants
Chemical cured – “autopolymerization”
 Base and catalyst
Monomer & Initiator + Diluted monomer & 5% Organic
Amine Accelerator = Sealant
Visible light cured – “photopolymerization”
 Pre-mixed
Dimethacrylate + Diluent + Activator + Light = Sealant
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33. Concepts of bonding
 Mechanical bonding – interlocking.
 Chemical bonding – use of adhesive.
 Physical bonding – attraction of atomic charges.
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34. Strength and Viscosity Characteristics
Viscosity
 The thicker the sealant the
less likely to penetrate to
depth of fissure.
Wear of Sealants
 Considerations for wear –
less filler, more wear and
visa versa.
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35. Curing units
 Conventional cure light with halogen bulb = 20
seconds cure for each surface
 Plasma arc or laser = 5-10 seconds
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36. Material Used As Sealants
a)Cynoacrylates:
 Used as surgical adhesive and tooth sealants.
 In presence of traces of moisture they polymerize rapidly to hard
and brittle polymers on etched tooth surface.
 Mechanical durability is not satisfactory and they are not
biodegradable.
b)Poly Urethanes:
 Not regularly used due to poor mechanical properties and oral
durability and toxicity.
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37. c)Dimethacrylates:
 Methyl methacrylate (MMA) is highly volatile and lacks penetration.
d)Glass ionomer:
 Hydrophilic , good adhesion, biocompatible , fluoride release.
 Used for fissure whose orifice exceeds 100 micrometer.
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38. Pit & Fissure Sealant Products
 Alpha-Dent Light Cure Pit and Fissure Sealant
 Baritone L3
 Concise Light Cure White Sealant
 Concise White Sealant
 Helioseal F
 Helioseal
 Prisma Shield Compule Tips Tinted Pit and Fissure
Sealant
 Prisma Shield VLC Filled Pit and Fissure Sealant
 Seal – Rite
 Seal – Rite Low Viscosity
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39. Prepare the tooth
 Bristle brush or
rubber cup and plain
pumice.
 Dentist can use bur,
air abrasion or laser.
 Sharp explorer to
clean out debris.
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40. Prepare the Tooth - continued
 air abrasion, bur,
prophy jet or laser
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41. Isolate tooth/teeth
Treat quadrants
separately
 To control isolation.
 To prevent
contamination by
moisture.
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42. Apply acid etch
 Apply acid etch for15-
20 seconds. Use blue
micro tip or brush tip.
 Apply only in pit and
fissures.
 For liquid – dab but
do not rub.
 Re-etch 10 seconds if
saliva contamination.
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43. Apply acid etch
 Etch pit and
fissures,Extend 1-2 mm
beyond pit and fissures.
 Do not apply acid etch
on cusp tips
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44. Rinse tooth/teeth
 Use air/water
syringe.
 Rinse the tooth
Properly – usually
20 seconds.
 Avoid saliva
contamination.
 If salivary
secretion is larg
then Re-isolation
is done.
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45. Dry tooth/teeth
 Tooth Should appear
chalky or frosty white
if etched properly.
 If not, re-etch for
another 10 seconds if
not contaminated
with saliva.
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46. Apply drying agent (PrimaDry)
 Use brush tip.
 Apply and leave for 5
seconds.
 Gently blow air to
dry.
 DON’T RINSE.
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47. Apply bond agent
 A bond agent will
improve retention.
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48. Apply sealant material
 Extend 1-2 mm beyond
pit and fissures.
 Gently work into pits and
fissures.
 Don’t overfill
 “pop” bubbles in sealant
with explorer or brush tip
before curing.
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49. Light cure for 20 seconds
 20 seconds each
tooth.
 Don’t touch tip of
cure light to sealant
material.
 Don’t let saliva
contaminate the
field…..
Note: sealant will
appear shiny/wet
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50. Check sealed teeth
 Use explorer to check
hardness of material
after curing,
 Tooth should be
smooth but not soft,
 Re-apply sealant, if
necessary,
(Remove uncured
sealant with wet
cotton roll)
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51. Remove isolation materials
After removal of
isolation material
Rinse the patient’s
mouth,
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52. Check occlusion & contact(s)
 Use Articulating
paper for checking
the occlusion.
 Ask patient how it
feels.
 Dentist can adjust
with bullet-shaped
finishing bur or
polishing stone.
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53. Give patient instructions
 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 composite sealant the bite will self
adjust in 2-3 days).
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54. Failure of sealants
 Main cause –
moisture
contamination.
 Maxillary and
mandibular 2nd
molars.
 Early loss means less
retention of the resin.
2 October 2020 54

55. Risks associated with sealants
 It does not have carcinogens or toxic materials.
 Have xenoestrogens – concentrations too low
so its harmness not affect the body.
 Potential chemical burns from phosphoric
acid.
 It causes Occlusal trauma,
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56. Repair of sealant
Reapply if totally lost.
Repair partial loss
 Roughen with
diamond stone.
 Re-etch 20 seconds.
 Reapply sealant.
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57. Finished!
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Thank you