Pit and fissure sealant
This section covers all the aspects of pits and fissures, the need for sealing them , the materials used and the procedure involved which will give a clear insight of the management of pits and fissures.
1. Why should pit and fissures be sealed?
Pits and fissures result from an incomplete coalescence of enamel which are very prone to caries. Sealing those pit and fissures with sealant materials like Urethane dimethacrylate or BIS-GMA provide an effective method of preventing caries. Only caries free pit and fissures or incipient enamel lesions with no dentinal extensions are sealed.
Ref: Theodore.M.Roberson,Harald.O.Heymann,Edward.J.SwiftJR.Sturdevant's Art and Science of Operative Dentistry.Mosby publications;2002;541
2. What is the objective for using sealants for the pits and fissures?
The sealant resin penetrates into the pits and fissures and polymerizes and those areas are sealed against the bacteria and their debris thereby preventing caries attack.
Ref: Science of Dental Materials, Skinner, Prism books private limited,9th Edn, 244
3. Why should the sealant material have a low viscosity?
The material used as a sealant should have a low viscosity so that it can flow readily, into the deep pits and fissures and wet the tooth. Also, as the tooth is first conditioned by etching with acid, microporosities are produced into which the sealant with a low viscosity can flow easily to ensure mechanical retention of the sealant.
Ref: Science of Dental Materials, Skinner, Prism books private limited,9th Edn, 245
4. Why are light cured sealants preferred over traditional ionomer?
The traditional ionomer cement is viscous and hence cannot penetrate deep into the fissures which is an ideal requirement for a sealant to be successful.
Ref: Science of Dental Materials, Skinner, Prism books private limited,9th Edn, 463
5. Why is proper isolation essential during placement of a sealant?
Sealant is usually placed in younger patients whose molar teeth are not fully erupted, creating difficulty in isolation. If there is no proper isolation, the sealant material cannot bond properly to the occlusal surface leading to a loss of the sealant or recurrent caries under the sealant.
Ref: Theodore.M.Roberson,Harald.O.Heymann,Edward.J.SwiftJR.Sturdevant's Art and Science of Operative Dentistry.Mosby publications;2002;541
6. Why is a bristle brush preferred for pumice prophylaxis?
The bristle brush reaches the faulty areas which are the deep pits and fissures better than a rubber cup which tends to burnish the debris and pumice into the pits and fissures.
Ref: Theodore.M.Roberson,Harald.O.Heymann,Edward.J.SwiftJR.Sturdevant's Art and Science of Operative Dentistry.Mosby publications;2002;541
7. Why are liquid acid etchants used in pits and fissures?
The gel acid etchants cannot effectively penetrate the pits and fissures and hence liquid etchants are used with a sponge, brush or an applicator tip.
Ref: Theodore.M.Roberson,Harald.O.Heymann,Edward.J.SwiftJR.Sturdevant's Art and Science of Operative Dentistry.Mosby publications;2002;541