The bottom of surges and fissures varies anatomically from person to person, the deeper they are the more plaque retention and the greater probability for a cavity spur. The enamel in these bottoms does not beneficiate from the common systems of fluoridation, being more vulnerable to acids.

PRESCRIPTION

The sealing is prescribed to all dental pieces with the occlusal side recently erupted, and above all in patients with a history of cavities in temporal pieces and/or family.

It is also prescribed when the depth of the surges or fissures is excessive.

Sealing of the first molar

COUNTER INDICATIONS

In cases with multiple active cavities

In patients with a lack in dental hygiene and also in uncooperative patients.

ADVANTAGES AND DISADVANTAGES

The sealing completes other forms of preventive treatments (dental hygiene, systemic or topic fluoridation, and diet control).

It is an easy treatment, comfortable, it is not bloody, and does not imply the destruction of dental tissue when the sealer is applied.

The sealer can also inactivate an initial cavity.

The main disadvantage is that it can come undone and therefore they will have to be placed again.

APPLICATION TECHNIQUE

It is necessary to have a good technique at the time of applying the sealer, since the life span of the sealer depends on it.

It is also necessary to eliminate all traces of dental plaque from the surface of the dental piece and for this we can use abrasive pastes or toothpastes not containing fluorine applied using a circular toothbrush or rubber buckets. In a surface free of dental plaque the sealer adheres much better.

The tooth involved must be isolated from the rest of the dental pieces as to avoid saliva contamination therefore insuring the sealer's best retention.

Cotton Roll later placed between the molars to absorb saliva

The ideal mean to isolate the dental piece is using rubber dam, but this requires that the patient must be anaesthetize in order to place the clamps, it is better and therefore recommended, the use of alternative means of isolation like cotton rolls, aspiration and separation of the tongue using dental mirrors.

An acid etching using orthophosphate acid at 37% is done, both the gel form or watery solution can be use for this.

The etching must be generous, and after 1-2 minutes the dental piece is rinsed abundantly during 15-20 seconds, as to eliminate all acid remains that are present in the tooth.

Then proceed to dry the dental piece, waiting to observe the typical off white or chalk white color of the etched dental enamel, which indicates the success of the dental etching.

The sealer is then applied using a brush, dispenser or any other instrument that carries the sealer into the fissures, one must try to eliminate all possible air bubbles in the sealer since they tend debilitate the sealing.

Sealers can be either self-curing or photocuring. In our private practice, we use photocuring, curing the sealer by means of applying fluorescent light.

Since surges, fosses or fissures are a place of occlusal support cusp, we must verify the occlusion, using articulating paper, to avoid premature contact in central occlusion. If present, eliminate them using a simple steel bur to extract the exceeding material.

Sealing Material

Rubber Dam placed in dental pieces to be intervened