TYPES OF PIT AND FISSURE SEALANTS. INDICATIONS AND CONTRAINDICATIONS FOR SILANIZATION. REVIEW

Background: Dental sealants have been used to reduce the incidence and severity of dental caries in the pits and fissures of teeth for over 40 years. Since that time, numerous scientific discoveries have led to the development of multiple generations of new sealant materials. Aim: The aim of this paper is to summarize the findings of reviews regarding the types of pit and fissure sealants, indications and contraindications for their use. Methods and materials: Previous systematic reviews on this topic were used as the basis for the current review. Cochrane, MEDLINE, Embase, and a few other bibliographic databases were searched for English and Bulgarian-language articles. The year of publication of the searched articles was limited from 2000 to 2020. Only articles in English and Bulgarian languages were read in full. Results: A total of 114 articles were identified by the literature search, the title and abstract of the articles were examined. Twenty-four original research studies met the inclusion criteria. They were read in full, and evidence was extracted for types of pit and fissure sealants, as well as indications and contraindications for their use. Conclusion: Evidence derived from the literature led to the conclusion that sealants are effective in preventing pit and fissure occlusal carious. The selection of the material used for silanization is made depending on a few factors that should be considered, such as patient's and tooth age, child's behavior and ability to isolate the surfaces which are going to be sealed. Regular examinations are required to be able to determine the need for reapplication of sealants and to maximize the effectiveness and results of the treatment.

Pit and fissure sealants — A review

Caries on the occlusal surface of dentition is a significant dental health problem. Among all of the teeth particularly molars and premolars have greater susceptibility to caries. Their susceptibility to caries is probably related to its occlusal morphology. Use of fissure sealant and fluoride have been shown to play an important role in reducing caries. This can be possible through converting the caries susceptible areas like pits and fissures into glazed surface which prevent bacterial colonization and makes the tooth easy to clean. Pit and fissure areas of enamel do not receive sufficient protection from topical or systemic fluorides, the reason for ineffectiveness of fluorides in the pit and fissure caries may be due to inaccessibility to these areas and due to the differences in enamel thickness. The most efficient way to prevent pit and fissure caries is by effectively sealing the fissures using resins called pit and fissure sealants.

Pit and fissure depth in the enamel of mandibular third molars: An open gate for microleakage?

The aim of this descriptive ex vivo study was to evaluate qualitatively the depth of pit and fissures (P&F) of the enamel in human mandibular third molars. Fifty (n=50) extracted human mandibular third molars were cleaned and disinfected. All tooth surfaces were coated with nail varnish except for a 1-mm margin around the periphery of the occlusal surface. The teeth were immersed for 48 hours at 37 °C in 1% methylene blue dye solution prepared in artificial saliva. After cleaning, the crowns were separated from the root at the cementoenamel junction and subsequently sectioned longitudinally in buccolingual direction at the location of the central fossa. All sections were examined using a stereoscopic microscope and photographed. The images were downloaded on a computer. The length of penetration of the P&F was recorded using the following scoring system: C1: P&F extended to half of the enamel thickness; C2: P&F extended beyond half of the enamel thickness without reaching the dentine-enamel junction; C3: P&F extended to the dentine-enamel junction. For pits, C1, C2 and C3 were observed in 35, 9 and 6 teeth, respectively, while for fissures, C1, C2 and C3 were observed in 15, 18 and 17 teeth, respectively. The P&F detected in the samples extended to the deepest portions of enamel, quite frequently reaching the enamel-dentine junction. Clinicians should recognize that even if pits and fissures are not clinically obvious, they penetrate deep into the enamel and frequently reach the dentine-enamel junction. Effective treatment is recommended to block access to P&F, thus preventing ingress of bacteria.

An Efficacy Study between High Viscosity Glass Ionomers and Resin Sealants in Fissure Caries Prevention: A 2-Year Split Mouth Randomized Controlled Trial

Objectives This clinical trial compared the efficacy of atraumatic restorative treatment (ART) sealants against resin-based sealants in terms of their retention and fissure caries preventive benefits over a period of 24 months among a section of school children in the Southern Indian state of Telangana. Materials and Methods A split mouth clinical trial employed 198 children, who received these sealants on their lower permanent first molars. Retention was assessed 6 monthly and caries annually Statistical Analysis Chi-square tests were utilized to analyze the retention rate and the incidence of dental caries between the two groups. Kaplan–Meier survival analysis plotted the cumulative survival percentage of partially, and fully retained sealants and the survival of dentin carious free pits and fissures among both the groups. A linear binary logistical regression analysis calculated the odds ratio. Results A statistical significant difference was observed in the retention rate between these sealants at every follow-up stage. The cumulative survival percentage of ART and resin sealants was calculated to be 30.9 and 37.5% by the end of 2 years. The Kaplan–Meier analysis showed no significant difference with regard to the survival of dentin carious free pits and fissures. The odds ratio for this trial was 0.747 (95% confidence interval: 0.493–1.13) Conclusion Resin sealants fared better than ART sealants in the field of retention. However, no significant differences were observed with regard to fissure caries prevention by the end of the study period.

Accuracy of different tooth surfaces on 3D printed dental models: orthodontic perspective

Background Few studies have been reported regarding the accuracy of 3D-printed models for orthodontic applications. The aim of this study was to assess the accuracy of 3D-printed dental models of different tooth surfaces. Methods Thirty volunteers were recruited from the hospital, and then their dental models were produced by means of oral scanning and a stereolithography-based 3D printer. Each printed model was digitally scanned and compared with the oral-scanned STL file via superimposition analysis. A color map was used to assess the accuracy of different surfaces (occlusal, buccal, lingual) of anterior and posterior teeth. The Tukey test was used to evaluate the differences between the superimposition. Results Statistically significant differences were found in the average deviations of different tooth surfaces (P < 0.05). The mean average absolute deviations of the occlusal surfaces of posterior teeth were greater than those of other surfaces. Percentages of points beyond the upper and lower limits of different tooth surfaces displayed the same results (P < 0.05). Conclusions Occlusal surfaces, especially pits and fissures of posterior teeth on 3D printed maxillary dental models, showed greater distortions than those of other teeth and regions.

Prevalence and gender comparison of children requiring class I restorations in primary mandibular second molars - A retrospective study

Dental caries is a worldwide health problem and about 621 million children are affected around the world. The most common type of caries that affects the children are the class 1 caries, given by GV blacks classification. Pediatric restorations of the various lesions are commonly done using GIC and composite. Posteriors molars are more prone to caries when compared to the anteriors as they have deeper pits and fissures. This research aims on the assessment of prevalence of class I restorations using GIC and gender comparison of the class 1 restorations in the second molars of pediatric patients between 5-12 years. ​​The study was performed in the outpatient department of Pediatric and Preventive Dentistry. Data required for the study was procured by reviewing the patient records visiting the dental college. The data was sorted in excel and statistically analysed using the IBM SPSS software analysis and the results interpreted in graphs and tabulations. ​Results revealed that prevalence of GIC restorations were 41.16% and Composite restorations were 58.54% in all the primary teeth. Distribution of GIC and composite restorations on the primary mandibular second molars revealed prevalence of GIC restorations as 57.27% and prevalence of composite restorations as 42.73%. Association of gender and types of restorations among children reveals distribution of GIC restorations as 55.11% among males and 44.89% among females and the distribution of composite restorations as 50.62% among males and 49.38% among females respectively. This difference was statistically significant (p=0.001). Within the limitations of the current study, glass ionomer restorations were higher in primary mandibular second molars when compared to composite restorations. On gender comparison, females received higher composite restorations when compared to males who received a Glass ionomer cement restorations.

Accuracy of 3D-Printed Dental Models of Different Tooth Surfaces

Background: Few studies have been reported regarding the accuracy of 3D-printed models for orthodontic applications. The aim of this study was to assess the accuracy of 3D-printed dental models of different tooth surfaces.Methods：Thirty maxillary dental models were produced by means of a stereolithography-based 3D printer. Each printed model was digitally scanned and compared with the oral-scanned STL file via superimposition analysis, with a colour map used to assess the accuracy of different surfaces of anterior and posterior teeth.Results: Statistically significant differences were found in the average deviations of different tooth surfaces. The mean average absolute deviations of the occlusal surfaces of posterior teeth were greater than those of other surfaces. Percentages of points beyond the upper and lower limits of different tooth surfaces displayed the same results.Conclusions: The occlusal surfaces of posterior teeth on 3D-printed dental models show greater deviations than those of other regions, especially in pits and fissures.

Direct composite restoration using stamp technique and pizza technique: A case report

Introduction: The purpose of a restoration is to restore the shape, function, and phonetics and aesthetics of damaged teeth. The disadvantage of direct composite restorations is the formation of dental anatomical structures that require operator skills so that they can optimally restore tooth occlusion. Case report: Case 1: A 21-year-old female patient with D4 caries, Site 1 size 2 on tooth number 37 and the patient's dental diagnosis was Reversible Pulpitis. The patient was treated with a composite restoration using the stamp technique. Case 2: A 50-year-old male the patient with D5 caries, Site 1 Size 2 on tooth number 46 and patient’s dental diagnosis was Irreversible Pulpitis. The patient was treated with a composite restoration using the pizza technique. Conclusion: Stamp technique is indicated for hidden caries in pits and fissures or proximal parts of the tooth with intact anatomical forms. The pizza technique can be used in caries with incomplete anatomical forms but requires operator skills to form biomimetic dental anatomy.

Clinical Evaluation of the Retention of Resin and Glass Ionomer Sealants Applied as a Part of School-Based Caries Prevention Program

BACKGROUND: Using of sealant on pits and fissures is likely one of the most generally well-known strategies by the new cavity-prevention systems. AIM: The purpose of this research is to measure the retentiveness of sealants of resin-modified ionomer glass cement (GIC) and resin pits and fissures, on the first permanent molars of special patients as a part of caries prevention program in schools. METHODS: The sample was comprised by 60 molars. Resin-based sealants on one side and glass-ionomer sealant on the contralateral side of the mouth. The molars were examined in three and six months after application for retention with three standards: TR: Totally Retained; PR: Partially Retained; and CL: Completely Lost. RESULTS: by the end of the study 60% of resin sealant was present. While 55% of GIC were retentive after 6 months. CONCLUSION: Resin sealants are more retentive than glass ionomer sealants in school-based carries prevention program.