Académique Documents
Professionnel Documents
Culture Documents
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HISTORY
‰.. Buonocore (1955) described
the technique of acid etching as a
simple method of increasing the
adhesion of self-curing methyl
methacrylate resin materials to
dental enamel.
‰.. Bowen et al (1965) developed the
BIS-GMA resin, Which is the chemical
reaction product of
BISPHENOL A + GLYCIDYL
METHACRYLATE.
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DEFINITIO
N
‰..Pits:-- small pinpoint depressions
located at the junction of
developmental grooves or at
terminals of those
‰..Fissures:-- grooves
fissures are shallow
lines or grooves between primary
parts of the Crown on the occlusal
surface.
‰..Grooves having non-coalesced
enamel are termed as fissures &
non-coalesced enamel in fossae is
termed as awww.FourthMolar.com
pit. 3
TYPES OF FISSURES
1. - Shallow
- Medium deep
- Deep
- Very deep
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CLASSIFICATION OF FISSURES
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EPIDEMIOLOGY OF PIT & FISSURE CARIES
‰.. IN THE PERMENANT DENTITION,OCCLUSAL
CARIES ACCOUNTS FOR ALMOST 60% OF THE
TOTAL CARIES EXPERIENCE IN CHILDREN
& ADOLASCENTS.
‰..PIT & FISSURE CARIES (INCLUDING THAT OF
BUCCAL & LINGUAL SURFACES) ACCOUNT FOR
ATLEAST 80% OF THE TOTAL CARIES
EXPERIENCE IN CHILDREN & ADOLASCENT.
‰..CARIES POTENTIAL IS DIRECTLY RELATED TO
SHAPE & DEPTH OF THE PITS & FISSURES &
CARIES SCLDOM BEGINS ON SMOOTH,& EASILY
CLEANSED SURFACES.-ROBERTSON(1889)
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‰..43% TO 45% OF ALL CARIOUS SURFACES IN
THE PERMENT DENTITION ARE ON THE GRINDING
SURFACES-G.V.BLACK(1936).
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DIAGNOSIS OF PIT & FISSURE
CARIES
CRITERIA FOR DETECTION & DIAGNOSIS OF PIT &
FISSURE LESIONS ARE AS FOLLOWS:
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REQUIREMENTS FOR OCCLUSAL
SEALENTS:
‰.. PIT & FISSURE CARIES OR RESTORATION OF PITS & FISSURES IN OTHER
PRIMARY OR PERMANENT TEETH.
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‰..USE OF OTHER PREVENTIVE TREATMENT SUCH AS SYSTEMIC OR
TOPICAL FLOURIDE THERAPY TO INHIBIT INTERPROXIMAL CARIES
FORMATION.
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‰..CHILDREN WHOSE LIFE STYLE, DEVELOPMENTAL OR BEHAVIOURAL
PATTERNS, OR LACK OF FLORIDE EXPOSURE PUT THEM AT HIGH RISK
FOR DENTAL CARIES.
‰.. CHILDREN & YOUNG PEOPLE WITH IMPAIRMENTS IN WHOM THE GENERAL
HEALTH WOULD BE JEOPARDIZED BY DEVELOPMENT OF ORAL DISEASES OR
THE NEED FOR DENTAL TREATMENT.
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The tooth to be sealed is isolated
The feasure is cleaned with 10 % poly acrylic acid conditioning
agent supplied by the manufacturer for 30 to 60 seconds
The tooth is washed and dried .
GI material , mixed to a consistency which will just flow, is applied
along the fissure and firmly burnished in to the positions. Excess
material is easily removed with the burnishers.
A layer of unfilled BISGMA resin is applied to GIC and light cured
to prevent it drying out while it completes its setting reaction .
The occlusion is checked and should “ a high spot “ required a
reduction , the further layer of varnish is applied to protect the
freshly set material .
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DENTIN BONDING AGENTS AS
SEALENTS
Low viscosity resins used for adhesion of a
restoration enamel &/or dentin are generally
referred to as bonding agents
Acid etching of enamel results in numerous
microscopic undercuts and irregular surface
features into which a fluid resin can be
applied and cured to produce a
micromechanical bond.
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CLASSIFICATION OF
SEALANTS
FIRST GENERATION SEALANTS – [ nuva-seal ]
Polymerised with UV light at a wavelength of 356
nm
Classified as ‘ provisionally accepted ‘ by ADA in
1972 and ‘ accepted ‘ 1976 .
Failed due to 1) poor clinical technique [ moisture
contamination , in adequate post - etch washing
and drying ] , 2) inconsistency of wavelength from
the UV light source and 3) the potential for retinal
damaged with long term exposure to UV light .
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Second generation sealants
Better formulations
May be self cured chemically cured
Mostly unfilled resin
Better retension clinically then first
generation sealants [ ripa , 1993 ]
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THIRD GENERATION SEALANTS-
Light cured by visible ( blue ) light at a
wavelength of 430 nm & 490 nm
May be unfilled or filled
Have similar retention rates in the second
generation once
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DEPENDING ON COLOUR :
Clear – detection requires tactile exploration
of the seal surface
Opaque
Tinted
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DEPENDING ON FILLER
Filled – much higher wear and abrasion
resistance then unfilled resins with the same
bond strength ,setting times and retention
rates as unfilled resins( clear , yellowish –
white or tan ).
Unfilled – white
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DEPENDING ON METHOD OF
POLYMERIATION
SELF – CURING
Light – curing UV light
Visible light
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SURFACE CLINICAL DO SEAL DONOT
DIAGNOSIS CONSIDER SEAL
ATION
CARIOUS OCCLUSAL IF PITS & FISSURES CARIOUS PITS OR
ANATOMY ARE SEPERATED BY FISSURES
TRANSVERSE
RIDGE ,SOUNDS,PIT
OR FISSURE MAY
BE SEALED.
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1.POLISH THE TOOTH SURFACE
IT IS ABSOLUTELY NESESSARY TO REMOVE PLAQUE &
DEBERIS FROM THE ENAMEL & THE PIT FISSURESBOF
THE TOOTH.
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2.ISOLATE & DRY THE TOOTH SURFACE
RUBBER DAM PROVIDES THE BEST ISOLATION .
HOWEVER, IT MAY BE IMPRECTICCAL TO APPLY IN ALL
CIRCUMSTENCES.
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3.ETCH THE TOOTH SURFACE;
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4.RAINSE THE TOOTH SURFACE
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7.MATERIAL APPLICATION
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8.EVALUATE THE SEALANT
9.CHECK OCCLUSION
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