Dental sealant

Definition

(Other names: Pit and fissure sealant)A cement or a resin material that is introduced into unprepared occlusal pits and fissures of caries susceptible teeth forming a micro-mechanical reten and physical protective layer that acts to prevent the demineralization of the enamel by blocking the interaction of cariogenic bacteria and their nutrient substances, thus eliminating the harmful acidic byproducts.

Indications

1. Sound deep pits and fissures
2. Recently erupted teeth
3. Patients who are highly susceptible to caries.

Contraindications

1. Carious pits and fissures
2. Caries exists on other surfaces of the same tooth
3. When large occlusal restoration is already present

Types of Pit and Fissure Sealants

Based on generation

• First generation: Activated by UV Light.
• Second generation: Chemical cure (auto polymerization), e.g. 3M (concise).
• Third generation: Activated by visible lights, e.g: fissurit (Voco), Delton (Johnson and Johnson).
• Fourth generation: Fluoride containing sealants, e.g. GIC sealant.

Based on filler

• Free of fillers: Have better flow.
• Semi-filled: More resistant to wear.

Based on color

• Clear: Difficult to identify during follow up.
• Tinted: Easily identified.
• Opaque: Easily identified.

Based on materials

• BIS –GMA (Bisphenol- a glycidyl methyl acrylate).
• Cyanoacrylates
• Polyurethanes
• GIC

Factors for maximum retention of sealants

• Tooth should have maximum surface area.
• Presence of deep irregular pits and fissures.
• Teeth should be clean and absolutely dry and not contaminated with saliva.
• Type of sealants used.
• Age of the patient.
• Clinical skill of the operator.

Procedure

1. Polish the tooth surfaces.
2. Isolation and drying of surfaces.
3. Etching by using 37% of orthophosphoric acid for 15–30 seconds.
4. Rinsing the tooth surfaces for 15 seconds.
5. Isolation and drying of surfaces.
6. Apply bonding agent.
7. Material application: Care should be taken to prevent air trap.
8. Evaluate the sealants.
9. Check occlusion.
10. Recall and periodic maintenance.

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