Nama : Samuel King Kurniawan

NIM : 121221069
Kelas : IUP

IKGM ASSIGNMENT: DENTAL MATERIAL

Pit and Fissure Sealant

1. Definition
A pit and fissure sealant is a dental material used to prevent tooth decay, especially in
molars and premolars' deep grooves and fissures. These grooves, which are often difficult
to clean with a toothbrush, can trap food particles and bacteria, forming cavities. Pit and
fissure sealants are applied as a protective coating to these vulnerable areas on the
chewing surfaces of the teeth.

The sealant material is usually a flowable resin-based substance that can flow into and fill
the deep pits and fissures of the teeth. After application, it is hardened using a special
curing light. Once in place, the sealant acts as a physical barrier, preventing food
particles, plaque, and bacteria from accumulating in these hard-to-reach areas. By sealing
off the pits and fissures, pit and fissure sealants reduce the risk of tooth decay. (Waggoner
and Siegal, 1996)

Pit and fissure sealants are commonly used in pediatric dentistry to protect children's
newly erupted permanent molars and premolars. They can also be used for preventive
purposes in adult dentistry when the dentist determines that a patient's teeth are
susceptible to decay in these areas. (Simonsen, 2002)

2. Composition of Pit and Fissure Sealant

Pit and fissure sealants are typically composed of resin-based materials. The specific
composition may vary slightly between different sealant products, but the main
components commonly include:
 - Resin Monomers: These are the primary building blocks of the sealant.
Bisphenol-A glycidyl methacrylate (Bis-GMA) and urethane dimethacrylate
(UDMA) are the most common monomers used. These monomers can flow into
the pits and fissures and then harden to create a protective barrier. (Cvikl, et al.,
2018)

- Fillers: Some pit and fissure sealants may contain small inorganic fillers, such as
silica or glass particles. These fillers improve the mechanical properties and wear
resistance of the sealant.

- Photoinitiators: To harden the sealant, photoinitiators are added. When exposed to

a curing light, these initiators activate the polymerization process that solidifies
the resin.

- Plasticizers: Plasticizers are included to improve the flowability of the sealant,

allowing it to penetrate the deep grooves and fissures of the teeth more
effectively.

- Fluoride: Some sealants may also contain fluoride, which can help strengthen the
adjacent tooth structure and provide additional protection against decay.
(Kühnisch, et al., 2012)

3. Pit and Fissure Sealant traits

Pit and fissure sealants are dental materials designed to protect teeth, particularly molars
and premolars, from the development of dental caries (cavities). They possess several key
traits that make them effective in this role.

Sealants are biocompatible and safe for use in the oral cavity. They do not cause allergic
reactions or harm to oral tissues. Biocompatible sealants do not leach or release
potentially harmful components into the mouth. They maintain their integrity and
stability over time (Azarpazhooh, et al., 2002).
 Many pit and fissure sealants are translucent or tooth-colored, ensuring that they blend in
with the natural tooth color and do not alter the appearance of the tooth. Sealants can be
cured rapidly using a curing light. This fast-curing process allows for immediate use of
the treated teeth for eating and drinking. Sealants are durable and can last for several
years, providing long-term protection against dental caries. They are designed to
withstand the stresses of normal chewing.

Pit and fissure sealants act as a physical barrier to protect susceptible tooth surfaces. They
are applied to teeth with deep grooves that are challenging to clean thoroughly with
regular toothbrushing. In addition to that, the application of pit and fissure sealants is a
non-invasive and painless procedure. It does not require drilling or anesthesia.

Research has shown that the use of sealants on susceptible teeth can significantly reduce
the risk of developing dental caries, particularly in children and adolescents. Sealants
require little maintenance. Regular dental check-ups are necessary to monitor their
integrity, and any worn or damaged sealants can be easily repaired or replaced.

4. Pit and Fissure Sealant Function

Pit and fissure sealants serve an essential function in dentistry, particularly in preventive
care. The main purpose of pit and fissure sealants is to prevent the development of dental
caries, commonly known as cavities, in the deep grooves and fissures of molars and
premolars. These areas, due to their complex anatomy, are often challenging to clean with
a toothbrush, making them more susceptible to decay. (Simonsen, 2002)

Sealants create a physical barrier over the vulnerable chewing surfaces of teeth. This
barrier effectively seals off the pits and fissures, preventing food particles, plaque, and
bacteria from entering and accumulating in these hard-to-reach areas. By blocking access
to the grooves and fissures, sealants reduce the availability of nutrients and shelter for
decay-causing bacteria. This minimizes the bacterial activity and acid production
responsible for tooth decay (Ripa, 1993).
 By preventing cavities from forming in the first place, pit and fissure sealants reduce the
need for more invasive and costly restorative dental procedures, such as fillings or dental
crowns. Pit and fissure sealants are durable and can provide long-term protection. When
applied and maintained properly, they can remain effective for several years, particularly
during the most cavity-prone years in a person's life, such as childhood and adolescence.
(Li, et al., 2011)

In conclusion, pit and fissure sealant increases overall oral health and well-being by
reducing the risk of cavities. They help maintain the structural integrity of teeth,
preventing the need for more extensive dental interventions. (Morgan, et al., 1998)

5. Pit and Fissure Sealant Weakness

While pit and fissure sealants are an effective preventive measure against dental caries,
they do have certain weaknesses and limitations that should be considered. Over time,
sealants may wear down or chip away due to the normal forces of chewing and biting.
This can create areas where food particles and bacteria can accumulate, potentially
leading to decay. Regular check-ups are necessary to monitor the integrity of sealants
(Pardi, et al., 2006).

Sealants are most commonly applied to children's teeth, particularly molars and
premolars, which are the most susceptible to decay. Adults may not receive the same
preventive benefit from sealants, as they are less prone to develop cavities in these areas.
However, both ages that are applied with pit and fissure sealants have better oral health
compared to no sealants at all (Ahovuo‐Saloranta, et al., 2017).

6. Pit and Fissure Sealant Mechanism

The mechanism of pit and fissure sealants involves the application of a protective barrier
over the deep grooves and fissures of molars and premolars. This barrier prevents the
accumulation of food particles and bacteria, reducing the risk of dental caries (cavities).
Here is a step-by-step explanation of the mechanism:
Patient Assessment: A dentist or dental hygienist assesses the patient's dental anatomy,
focusing on the molars and premolars. They identify deep grooves and fissures that are
difficult to clean effectively with a toothbrush.

Cleaning: The tooth surface to be sealed is cleaned thoroughly to remove any plaque,
debris, or contamination. This cleaning ensures that the sealant will bond securely to the
enamel.

Isolation: To maintain a dry field, a dentist may place a rubber dam or use cotton rolls to
isolate the tooth, preventing saliva from interfering with the sealant application.

Etching: A mild etching solution, usually containing phosphoric acid, is applied to the
chewing surface of the tooth. The etching process roughens the enamel, creating a
microscopically porous surface that enhances the bond between the sealant and the tooth
(Geiger, et al., 2000)

Rinsing and Drying: After a brief etching period, the tooth is thoroughly rinsed and dried.
It is essential to remove any residual etching solution before applying the sealant.

Sealant Application: The dentist applies the pit and fissure sealant material onto the
tooth's chewing surface. The sealant is a flowable resin that can penetrate into the
grooves and fissures, filling them to create a protective barrier.

Curing: A curing light, often an LED or UV light, is used to polymerize and harden the
sealant. This process usually takes only a few seconds and ensures that the sealant forms
a solid and durable barrier. (Beslot-Neveu, et al., 2012)

The mechanism of pit and fissure sealants involves the creation of a physical barrier that
prevents food particles, plaque, and bacteria from entering the deep grooves and fissures.
This barrier reduces the risk of dental caries by minimizing the bacterial activity and acid
production responsible for tooth decay.
Reference
Ahovuo‐Saloranta, A., Forss, H., Walsh, T., Nordblad, A., Mäkelä, M. and Worthington,
H.V. (2017). Pit and fissure sealants for preventing dental decay in permanent teeth.
Cochrane database of systematic reviews, (7).

Azarpazhooh, A. and Main, P.A. (2008). Is there a risk of harm or toxicity in the
placement of pit and fissure sealant materials? A systematic review. Journal of the
Canadian Dental Association, 74(2).

Beslot-Neveu, A., Courson, F. and Ruse, N.D. (2012). Physico-chemical approach to pit
and fissure sealant infiltration and spreading mechanisms. Pediatric Dentistry, 34(3),
pp.57E-61E.

Cvikl, B., Moritz, A. and Bekes, K. (2018). Pit and fissure sealants—a comprehensive
review. Dentistry Journal, 6(2), p.18.

Geiger, S.B., Gulayev, S. and Weiss, E.I. (2000). Improving fissure sealant quality:
mechanical preparation and filling level. Journal of dentistry, 28(6), pp.407-412.

Kühnisch, J., Mansmann, U., Heinrich-Weltzien, R. and Hickel, R. (2012). Longevity of

materials for pit and fissure sealing—results from a meta-analysis. Dental Materials,
28(3), pp.298-303.

Li, F., Li, F., Wu, D., Ma, S., Gao, J., Li, Y., Xiao, Y. and Chen, J. (2011). The effect of an
antibacterial monomer on the antibacterial activity and mechanical properties of a
pit-and-fissure sealant. The Journal of the American Dental Association, 142(2),
pp.184-193.

Morgan, M.V., Crowley, S.J. and Wright, C. (1998). Economic evaluation of a pit and
fissure dental sealant and fluoride mouthrinsing program in two nonfluoridated regions of
Victoria, Australia. Journal of public health dentistry, 58(1), pp.19-27.
Pardi, V., Sinhoreti, M.A.C., Pereira, A.C., Ambrosano, G.M.B. and Meneghim, M.D.C.
(2006). In vitro evaluation of microleakage of different materials used as pit-and-fissure
sealants. Brazilian dental journal, 17, pp.49-52.

Ripa, L. (1993). Sealants revisted: an update of the effectiveness of pit-and-fissure

sealants. Caries Research, 27(Suppl. 1), pp.77-82.

Simonsen, R.J. (2002). Pit and fissure sealant: review of the literature. Pediatric dentistry,
24(5), pp.393-414.

Simonsen, R.J. (2002). Pit and fissure sealant: review of the literature. Pediatric dentistry,
24(5), pp.393-414.

Waggoner, W.F. and Siegal, M. (1996). Pit and fissure sealant application: updating the
technique. The Journal of the American Dental Association, 127(3), pp.351-361.