Fissure sealants

Question 1

What is a fissure sealant

Answer 1

A material that is placed in the pits and fissures of teeth in order to prevent or arrest the development of dental caries

Question 2

Types of pit and fissure sealants

Answer 2

1. Resin
2. GIC
3. Compomer
4. Fluoride containing sealants

Question 3

What is a resin sealant

Answer 3

They are bonded to the underlying enamel by the use of acid etch technique (pure resin composites or compomers). Prevention of caries via a tight seal preventing leakage of nutrients to the microflora in the deeper parts of the fissures. Cured chemically or by light

Question 4

Benefits of GIC sealant

Answer 4

Ability to bond chemically to dentine and enamel without the use of acid-etch technique- less moisture control sensitive. Fluoride release. high within the first 24 hours, then plateaus.

Question 5

Compomer sealants

Answer 5

Still being investigated. Fluoride release is less than that of GIC

Question 6

Can you seal carious fissures?

Answer 6

Yes. Studies by Handelman 1991 and Mertz-Fairhurst et al 1986. FS isolates the carious lesion from the surface biofilm

Question 7

Patient and tooth selection for fissure sealants

Answer 7

1. Medically, physically and intellectually impaired children - apply FS to all susceptible sites
2. Children with acute signs of caries activity
3. Children with no signs of caries but have susceptible tooth surfaces i.e. deep pits and fissures

Question 8

Cochrane review 2009. Pits and fissure sealants for preventing decay in permanent teeth in children and adolescents

Answer 8

Sealing is a recommended procedure to prevent caries of the occlusal surfaces of permanent molars. The effectiveness of sealants is obvious at high caries risk but information on the benefits of sealing specific to different caries is lacking

Question 9

What tooth morphology do you need to consider when sealing teeth

Answer 9

1. Deep pit and fissure patterns
2. Buccal pits of lower molars
3. Palatal fissures of upper molars
4. palatal pits of upper incisors

Question 10

How can you isolate the tooth for fissure sealants

Answer 10

Cotton wool rolls, dry guards, curly wurly, rubber dam, patient position

Question 11

How effective are fissure sealants at preventing caries

Answer 11

Cochrane review Ahovuo-Saloranta et al 2008. First permanent molar teeth sealed with resin based sealant had 78% less caries on the occlusal surfaces after 2 years and 60% less after 4-4.5 years compared with unsealed molars.