European International Journal of Multidisciplinary Research
and Management Studies
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TYPE
Original Research
PAGE NO.
79-83
DOI
OPEN ACCESS
SUBMITED
20 February 2025
ACCEPTED
19 March 2025
PUBLISHED
21 April 2025
VOLUME
Vol.05 Issue04 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
Modern Materials for
Hermetization Of Fissur
Used in Pediatric Dentistry
Shukurova Nodira Tillaevna
Assistant of the Therapeutic Dentistry Department, Samarkand state
medical university, Uzbekistan
Abstract:
Fissures are special natural grooves and
grooves located on the dental enamel of the chewing
surface of teeth between the chewing cusps. The
method of sealing consists of obturation of fissures and
other anatomical recesses.
Healthy teeth with adhesive materials in order to create
a barrier for external cariesogenic factors.
Keywords:
Fissure
sealing,
caries
prevention,
composite materials.
Introduction:
Purpose of the work
: to hermetically
protect the fissures of teeth against caries
Functions of fissure sealing: creates a barrier for
cariesogenic bacteria; has a remineralizing effect on
enamel, if the sealant contains active fluoride ions.
Four types of fissure structure: Funnel-shaped fissures
- more open, well mineralized, they do not retain food
residues due to free washing with oral fluid, are caries-
resistant. Cone-shaped - mainly mineralized due to oral
fluid, but there are conditions for the retention of food
residues and microorganisms. Mineralization of drop-
shaped and polyp-shaped fissures occurs mainly from
the pulp side of the tooth. This process is less intensive
than mineralization due to oral fluid, and fissures
remain hypomineralized for a long time. Given the high
caries resistance of hard tissues, in teeth with a high
initial level of mineralization (IUM) fissure sealing is not
recommended. General hygienic measures are
sufficient. For teeth with medium BMI - immediately
after eruption it is recommended to conduct a one-
month course of topical application of calcium-
phosphate-containing
and
fluoride-containing
preparations with subsequent sealing with a composite
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European International Journal of Multidisciplinary Research and Management Studies
sealant. It is not recommended to use composite
sealants with 38% orthophosphoric acid as an etching
agent for teeth with low fissure IUM. In this case, glass
ionomer sealants are used, or invasive sealing with
composite sealants, or if indicated - the method of
prophylactic filling. The presence of pigmented fissures
and natural cavities in teeth at the stage of maturation,
unlike teeth with mature enamel, indicates an active
process and requires invasive methods of sealing.
Initial caries is an indication for invasive sealing with
composite sealants.
Contraindications to sealing: the presence of intact
wide, well communicating fissures; teeth with healthy
pits and fissures, but with carious lesions on the
aproximal surfaces; pits and fissures that remain
healthy for 4 years or more, do not require sealing; poor
oral hygiene.
Indications for sealing and prophylactic procedures for
fissures of erupted teeth with immature enamel based
on fissure enamel electrometry values (µA): Low ELM
(up to 8 μA)
- hygienic measures, observation; medium
ELM (9 to 20 μA)
- hygienic measures, course of
fluoride-
and
calciumphosphate-containing
preparations, fissure sealing; high ELM (up to 20 μA)
-
hygienic
measures,
course
of
fluoride-
and
calciumphosphate-containing preparations, fissure
enlargement, prophylactic filling.
For fissures after enamel maturation: 0 μA, healthy
enamel - hygienic measures, observation 1-
2 μA, initial
caries - hygienic measures, a course of fluoride- and
calcium-phosphate-containing preparations, fissure
sealing; up to 8 μA, progressive initial or superficial
caries - hygienic measures, a course of fluoride- and
calcium-phosphate-containing preparations, fissure
enlargement, prophylactic filling.
This complex approach is taken into account by the
world's leading manufacturers of prophylactic agents.
VOCO company (Germany, Kuxhafen) produces
fluoride-
containing rinse “Profluoride M”, gel for
applications “Profluoride Jelly”, two
-component self-
curing multi-purpose fluoride-containing varnish
“Bifluoride 12”, a series of sealants “Fissurite” and a
unique high-
filled sealant based on ormoker “Admira
Sil”.
High efficiency (preventive effect of fissure sealing) is
estimated by different authors from 55% (Going, Coti,
Hough, 1976) to 99, 1% (Buonocore 1974) and small
cost of the method of fissure sealing in combination
with the general complex prophylaxis of dental diseases
will significantly reduce the growth of dental caries in
the area of fissures and fossae.
Nowadays, in order to seal blind pits and fissures of
teeth, sealants belonging to three classes of materials
are used: composite chemo- and photo-curing
materials, glass ionomer cements and compomers.
The material used for fissure sealing (silant) is usually a
special composite resin that cures chemically or with
light. Due to their high flowability, unfilled silants easily
penetrate even very narrow and deep fissures to the
bottom, smoothing the chewing surface of the tooth
and facilitating hygiene. They have better marginal
adaptation, longer retention, wear and deterioration.
Filled silants have a shallower penetration depth,
smaller micromechanical bonding area, shorter
retention times, but are more resistant to abrasion.
They are used for invasive sealing technology, but their
technological application process is relatively complex,
time-consuming and sensitive to moisture. Sealants do
not adversely affect the normal mineralization process
of enamel. Mineral elements from the oral fluid can
freely diffuse along the edge and partially through the
coating substance itself. This allows the physiological
level of metabolic processes in the hard tissues of the
tooth under the coating to be ensured, while
preventing the penetration of large protein molecules.
The material is moisture-proof and very strong, which
allows to protect teeth from fissure caries for a long
time (up to 5-8 years). In addition, the sealant promotes
saturation of tooth enamel and peri-dental
environment with fluoride in the reaction of ionic
exchange due to the added soluble salt (fluorides)
within 1-28 days.
Types of composite sealants
: 1) Self-polymerizing or
chemo-
curing “Concise White Sealant”. “Delton”
(Johnson and Johnson), ‘Delton’, ‘Fis Sil’ (Russia); 2)
Photopolymerizable ‘Estisial LC’
(Kulrer), ‘Sealant’
(Bisco), ‘Fissurit’, ‘Fissurit F’ (Voco), ‘Delton
-
S’, ‘Fis Sil
-
S’
(Russia), Helioseal, Prisma Sheild.1) The following types
of composite sealants: 1) Self-polymerizing or
chemically curing ‘Concise White Sealant’. Opaque (not
transparent) - easy to control, but do not imitate the
color of the tooth and it is impossible to monitor the
state of enamel under them; 2. Transparent - aesthetic,
allow to monitor the state of enamel under them, but
poorly distinguishable when controlling preservation;
a) Colored (chameleons) have a bright color only at the
time of polymerization, and after that correspond to
the natural tone of the tooth or transparent “ClinPro
Sealant” (3M ESPE, USA), “Helioseal Cler Chroma”
(Ivoclar Vivadent); b) Not colored. A. Fluoride-
containing (Fissurit); B. Fluoride-free (Fissurit F).
The third generation of CPMs are materials curing
under the influence of visible light with wavelengths
from 430 to 490 nm (“Fissurit”, “Helioseal”, “Estisial
LC”), they are one
-component, working time is long, the
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European International Journal of Multidisciplinary Research and Management Studies
completeness of polymerization is determined by light
escaping, the risk of destruction during the curing test
is minimal. These materials are based on low viscosity
methacrylic acid derivatives. Borosilicate glass with
99% particle size less than 1 micron is used as a filler in
the preparations, which provides good penetration
properties.
The release of fluoride from Fissurit F and its entry into
enamel lasts more than 190 days, Fissurit F gives during
this period 4-5 mg of fluoride to strengthen dentin
enamel.
Another preparation of the company VOCO (Germany,
Kuxhafen) with fluoride light-
curing sealant “Admira
Sil” contains spatially inorganic
-organic copolymers
(ormokers), providing excellent mechanical properties
and ideal biocompatibility (no toxic resin).
The procedure of fissure sealing starts with a thorough
cleaning of the tooth from plaque by brushing and
paste, and then air drying. Next, the fissures are treated
with 32% orthophosphoric acid for etching (a process in
which the acid destroys the core or shell of enamel
prisms) for 30-40 seconds, rinsed with distilled water
and dried again. Then they are filled with the liquid
phase of composite filling material. Under the influence
of a special lamp, the material hardens in 40-45
seconds, after which a hard carborundum head is used
to remove the excess and grind the material on the
chewing surface.
Prophylactic efficiency of materials is determined by
the degree of their preservation in fissures and
retention of this class of sealants ranges from 20 to 90%
and depends on the accuracy of sealing technology.
Glass ionomer cements - Dyract seal (Dentsply), Prima
flou (DG), Vitacryl (Medpolymer), ASPA (Dentsply), Fuji
(WHS), Glass Ionomer (Shofu Inc.), Alfa-dent, Aqua
Ionoseal (Voco) have cariesstatic effect, due to the
contained F, Al, Zn, Ca, due to fluorine release these
materials have a pronounced cariesstatic effect. SIC are
chemically fixed on the tooth surface, do not require
etching of enamel before the procedure, have high
biocompatibility, less than CPM requirement for drying
of the working field, but have a number of technological
inconveniences (the need for mixing, difficulty of
placement, short working time, long curing), low
aesthetic properties, low fluidity, large marginal
leakage, are not strong enough compared to
composites, and quickly abrade. For sealing purposes,
type II glass ionomer cements (designed for dental
restorations) can be used for loaded restorations. Some
studies show that the use of glass ionomer materials as
fissure sealants may be appropriate in newly erupted
teeth with extremely low mineralization of the fissures.
The difficulty in such cases is associated with the need
for a longer enamel etching followed by the application
of composite sealants. When it is necessary to perform
prophylactic filling (when the tip of the probe gets stuck
in the fissure during the examination of the fissure), we
offer condensable highly esthetic glass ionomer cement
-
“VOCO Ionofil Molar”
- characterized by three
excellent properties. They are easy to apply and less
sensitive to the technique of execution, allowing them
to be used without etching or the use of an adhesive.
The plastic-free classical glass ionomers have a
coefficient of thermal expansion similar to dentin, and
they also have the so-
called “battery” effect of
continuously releasing a significant amount of active
fluorides. Preservation of SIC in 1, 6, 12, 24 months.
Accordingly 90, 80, 60 and 20% respectively, after 3
years - 10% (composite silant - 90%), but nevertheless,
SIC provide a high level of reduction of caries of occlusal
surfaces - 80-90% for 2 years, teeth, even after
macroscopic loss of material, have twice less risk of
caries than teeth not covered with SIC.
Compomers - light-curing composite materials, which
by virtue of their composition have some of the
properties of glass ionomer cements, namely - a little
more than composites, hydrophilicity, fluidity and the
ability to release fluoride in small quantities in contact
with oral fluid. Dyrect Seal (Dentsply) is a compomer
sealant.
It is used with NRC (Non-Rise Conditioner) and the fifth-
generation adhesive system Prime&Bond NT, which
ensures a deeper sealing of the fissures with the
polymer. NRC conditioner simultaneously partially
dissolves mineral components and prims tooth tissues,
Prime&Bond NT is applied on top of it, to which the
sealant itself is fixed. The developers of this system
consider this technique as an alternative to invasive
fissure sealing. Wear of compomer silants is higher, and
retention is lower than that of CPM. In 2 years the
retention of composite silant is 32%, compomer silant
0%; complete loss is 10 and 38% respectively, but caries
develops less frequently after compomer loss than
after CPM loss.
The efficacy of caries prevention has been confirmed by
many studies. Coating of teeth with fluoride-containing
varnish resulted in reduction of caries growth on
treated surfaces up to 70% and reduction of CPM up to
35%. The highest efficiency of caries prevention is
provided by the method of fissure sealing: the
reduction of fissure caries growth for a year amounted
to 92.5%.
Achievement of high results of prophylaxis by sealing is
conditioned by fulfillment of two main functions of
sealants:
1. Creation of a physical barrier on the tooth surface for
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European International Journal of Multidisciplinary Research and Management Studies
cariesogenic factors.
2. Remineralization of enamel in the fissure area, in the
presence of active fluoride ions in the composition of
the sealant.
CONCLUSION
Evaluation of the effectiveness of sealants showed that
the reduction of dental caries growth depends on the
retention of sealants on the occlusal surfaces of teeth,
the ability to release fluoride ions into the tooth tissue
and oral fluid, and the effectiveness of prevention of
caries of permanent teeth increases significantly when
combining the sealing of fissures and pits with local
fluoride prophylaxis and oral hygiene.
Scientific studies have proven that a properly
performed procedure is 100% effective in protecting
tooth surfaces from decay, as it serves as a physical
barrier to possible decay. The effectiveness of the
procedure is halted or stopped when the bonding
agents between the film and the tooth are destroyed or
lost. However, teeth that have been sealed are
significantly less susceptible to cavities later in life than
teeth that have never been treated. Sealing is effective
for 5 years, but can remain effective for up to 10 years.
Reports from doctors show that 7 years after sealing,
about 49% of teeth remain completely sealed. But
sealing should not be considered as a permanent
procedure. Regular visits to the dentist for preventive
checkups are necessary to monitor the condition of the
sealed teeth. The essence of fissure sealing is to protect
the teeth from plaque, which is a precursor to tooth
decay.
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