1

SIMONSEN…. “material that is introduced into the Occlusal pit

and fissure of caries susceptible teeth,
thus forming a micromechanically–bonded, protective layer
cutting access of caries producing bacteria from their source of
nutrients.”
 1) Shallow, wide v-shaped

 2) Deep, narrow I-shaped

Classification (NANGO 1960)

34% 14%

V-shape U-shape

7% 26%

IK
19%

λ -shape I - shape Hour glass pattern

Why pit and fissures are more prone?????

Failure of mechanical cleansing…….

Failure of self cleansing…….
Systemic fluoride ……..

Topical fluoride-……
Based on generation-

First e.g. Activated by UV light.

Nuva-seal

Second e.g. self curing.

Concise [3M] white sealant , Delton

Third e.g. visible light activated

Prisma shield,

Fourth e.g. fluoride releasing.

Fluoro-sheild and Delton plus
Helio-seal
 Based on filler content-

Unfilled e.g. concise white, Delton

Filled e.g. Nuva –cote

Based on translucency- Based on curing-

• Clear • Auto-polymerizing

• Tinted/ opaque • Light cure

• Colored
Materials used as pit and fissure
sealants
RESINS-

1. Bis –GMA

2.Polyurethane

3. Cynoacrylate

4. Cynoacrylate with fluoride

 Indications:-
1. Deep retentive pits and fissures
which may cause wedging or catching
of an explorer

2. Stained pits and fissures with minimum

appearance of decalcification
3. Questionable enamel caries in pit and fissures

4. Active lesions

Carious lesions present in the teeth which are

restored

Factors associated with increased caries

incidence
5. Morphology of pit and fissures are at risk of caries

7% 26%

19% IK

6. Caries pattern with more than 1 lesion per year

7. Routine dental care with active preventive dentistry

program

8. Community based sealant.

9. Medically compromised patient.

Contra-indications:-

Well coalesced Partially erupted/ Dentinal caries

5
isolation not possible

R/g or clinical Evidence of proximal

Caries free for 4 yr caries
Life expectancy of tooth is limited
REQUIREMENTS FOR OCCLUSAL SEALANTS

1. Viscosity…..
2. Working time…...
3. Setting time/ Curing time……
4. Adhesion to the enamel……
5. Water sorption and solubility……
6. Wear resistance…..
7. Biocompatibility ……
8. Casio-static action…...

14
STEPWISE APPLICATION OF SEALANT:-
1.SELECTION OF TEETH
2. CLEANING THE TOOTH
3. ISOLATION
4. DRYING THE TOOTH
5. ETCHING OF TOOTH SURFACE
6. RINSING AND DRYING OF TOOTH
7. APPLICATION OF BONDING AGENT (OPTIONAL)
8. PLACEMENT AND POLYMERIZATION OF SEALANT
9. OCCLUSAL EVALUATION
1.SELECTION OF TEETH:-

SIMONSEN 1983….

Group 1-
Caries free patients, no risk at decay—obseravation
and follow up

Group 2-
Patients judged at moderate
….. risk of decay- pit and
fissure sealant

Group 3-
Patients with rampant caries, high risk group-
restorative treatment.
Conventional methods-

What is the need???????

 1
3.Isolation
Need ???????

1. Rubber dam-

2
2. Cotton roll-

3. Vac-Ejector system- 3
4. Etching
Need????????

Agent used……37% phosphoric acid

How to do…

flow
What does etching do?

Enamel surface before and after etching-

Low energy High energy

Weakly reactive Highly reactive
Hydrophobic Hydrophilic
Rapid attraction of sealant
 How Long??

STEP PRIMARY PERMANENT

Acid etch 30 sec 20 sec

Mineral content
BUT WHY PRIMARY
TEETH TAKES Prismless enamel
LONGER TIME TO
ETCH
Direction of enamel rod

Contaminated with salvia- 10 seconds

Additional time for fluorosed teeth
5.Rinse & dry etched tooth surface

30 sec air water irrigation + 15 sec drying……

Lack of frosted white appearance

1. Insufficient etching….
2. Saliva contamination…

Now how to proceed?????

7. PLACEMENT AND POLYMERIZATION OF
SEALANT-

Wear eye protecting glass

Tip of light cure unit as close as possible …….

 8.Occlusal evaluation-

Before dismissed the patient

Evaluate sealant retention
Last and most important

Education of patient & the parents about the

importance of periodic re-evaluation of the
sealants.
THANK YOU 26