Pit and Fissure Sealants

Question 1

when to place sealants

Answer 1

deep pits and fissures that cause an explorer to bind/catch
stained pits and fissures with minimal or no signs of decalcification
minor pit and fissure caries in primary teeth when there are no signs of interproximal decay

Question 2

fissure anatomy

Answer 2

provide excellent mechanical shelter for bacteria
shape of the fissure dictates extent of shelter and ease of cleansing

Question 3

if a molar has a need for a sealant should also consider

Answer 3

placing one on the contralateral molar

Question 4

roadblocks to success

Answer 4

moisture control
access into pits and fissures
time and cost effectiveness

Question 5

overview of the process

Answer 5

clean surfaces with clean toothbrush
rinse thoroughly
isolate teeth being treated
etch surface with acid etch
rinse thoroughly and dry with air
gently dab on bonding material
place sealant material
light cure (20 sec)

Question 6

surface treatment clean

Answer 6

clean toothbrush
no toothpaste
to remove surface layer of biofilm and debris

Question 7

surface treatment etch

Answer 7

acid etch
20 seconds on surface
rinse thoroughly
re-etch if salivary contamination occurs
etched area should extend beyond area to be sealed

Question 8

on a microscopic level the enamel will appear to

Answer 8

have many tags

Question 9

bonding agent

Answer 9

improves marginal seal
single step bonding can be effective if bond is sufficiently acidic
laser etching + bonding agent can also decrease micro-leakage
gently dab to prevent breaking enamel tags

Question 10

surface treatment burs

Answer 10

high speed and 1/4” round bur or fissurotomy burs
aim is not to remove much tooth material but to clean the pit and fissure system

Question 11

bur preps show less micro leakage than other methods to

Answer 11

better penetration of resin into opened pits and fissures
increase in bondable surface area
better removal of microflora

Question 12

what is necessary before placing pit and fissure sealants

Answer 12

preparation

Question 13

resin

Answer 13

some are fluoride releasing
better long term retention
allow for some saliva contamination
caries prevention no longer available once sealant lost

Question 14

GIC

Answer 14

all are fluoride releasing
increased risk of micro-leakage
continued anti-caries effect even when appear partially or completely lost