Fissure Sealing

This is a procedure for sealing the grooves on the chewing surfaces of molars in both children and adults.

It is performed to prevent the development of fissure caries, which can occur due to the accumulation of food particles and plaque in the grooves. After the grooves are sealed with a special filling material, a protective barrier is created. This barrier prevents food from accumulating in the crevices and protects against the harmful effects of caries-causing bacteria. If the sealant contains fluoride ions, sealing these natural grooves additionally promotes the remineralization of enamel.

Depending on their shape, the following types of grooves are distinguished:

• Funnel-shaped: Food particles hardly get stuck in them. With regular and proper oral hygiene, the risk of developing caries is minimal.
• Cone-shaped: Food particles are more likely to get stuck in cone-shaped grooves. These require more thorough oral care.
• Drop- or polyp-shaped: These are the most dangerous, often leading to fissure caries. If present, dentists strongly recommend undergoing fissure sealing.

The procedure is recommended in the following cases:

• Presence of intact grooves on newly erupted premolars/molars;
• Thin enamel (caries prevention);
• Pigmentation in the fissure area;
• Deep, narrow grooves on the chewing surfaces of permanent premolars/molars.

Temporary contraindications include:

• Poor oral hygiene;
• Excessive tartar buildup;
• Caries at the bottom of the groove or on the lateral surface of the tooth;
• Tooth eruption stage.

Composites (Sealants)

These are made from a special composite resin that is either chemically or light-cured.

Unfilled sealants have high fluidity, which allows them to fill narrow, hard-to-reach grooves. However, they wear down quickly (lifespan of up to 5 years).

Filled composites are durable and resistant to wear (they can protect the tooth for up to 8 years), but they are less fluid and do not penetrate as deeply. They are commonly used in invasive sealing methods.

Some of the best composite sealants include Fissurit F, Admira Seal, Helioseal, Estisial LC, Concise White Sealant, and Estisial LC.

Glass Ionomer Cements

These contain fluoride, calcium, zinc, and aluminum, elements with strong anti-caries effects. They cure chemically. Their low fluidity helps seal deep fissures using invasive techniques, i.e., without widening the grooves with a drill. Their lifespan is up to 2 years.

Popular glass ionomer sealants include Glass Ionomer, Dyract Sea, Prima Flou, Fuji, ASPA, and Aqua Ionoseal.

Compomers

These are light-cured composites that also contain fluoride, calcium, and other components. Compomers combine the benefits of glass ionomer cements and composite sealants: high fluidity, resistance to moisture, fluoride ion release, and more. However, they wear down after 2 years.

Non-invasive

Indications:

• Risk of caries development (moderate or high) in permanent premolars and molars;
• Eruption of teeth with a moderate UIM (degree of fissure mineralization).

Non-invasive fissure sealing on the chewing surfaces of premolars or molars is only performed if the depth of the grooves can be visually assessed. Before applying the sealant, the surface of the problematic tooth is cleaned, isolated from saliva, and etched with acid.

Invasive

Indications:

• Early-stage fissure caries;
• Deep, narrow grooves;
• Pigmented grooves on teeth with poor enamel mineralization.

Invasive sealing involves opening the fissures using a dental drill.

Children do not have their sixth molars in the primary set of teeth. These molars erupt at around 6-7 years old. Their complex groove structure, along with weakly mineralized enamel, makes them vulnerable to fissure caries. Pediatric dentists strongly recommend sealing the grooves of newly erupted molars.

If the grooves are wide and shallow, they are easily cleaned of plaque and show no signs of caries, making sealing unnecessary.

• How long does the effect last?

  Depending on the sealant used, the sealing remains effective for up to 5 years, though its protective properties can last up to 10 years. The sealant layer gradually wears down, requiring a repeat sealing procedure.

• Does the sealant block beneficial substances from penetrating the enamel?

  No, the tooth continues to receive necessary minerals through the enamel. The applied sealing material does not affect the natural growth of the tooth.

• What influences the risk of fissure caries development?

  The level of enamel mineralization:

  • Low. The enamel is porous, with a chalky appearance. If the grooves are not sealed, there is a high risk of caries within 6-12 months.
  • Medium. Chalky spots are present in the grooves. Without sealing, caries may affect the enamel within 24 months.
  • High. The enamel is spot-free and dense, showing high resistance to caries formation.