Fissuursealants

Fissuursealants, commonly known as dental sealants, are thin protective coatings applied to the chewing surfaces of permanent molars and premolars. They are intended to prevent dental caries by occluding deep pits and fissures that are difficult to clean, reducing plaque accumulation and acid exposure in these areas.

The sealant procedure is typically performed by a dental professional. The tooth surface is cleaned and isolated, often with cotton rolls or a rubber dam. The enamel is etched with a phosphoric acid solution to create micro-roughness, rinsed, and dried. A bonding agent may be used before applying the sealant material, which is then cured with a blue light in the case of resin-based sealants. The sealant hardens to form a protective barrier that can be either resin-based or glass ionomer.

Sealants can be resin-based or glass ionomer. Resin-based sealants generally provide higher retention and better long-term protection when a dry field can be achieved, while glass ionomer sealants are more fluoride-releasing and less moisture-sensitive, though they may have lower longevity.

Indications for fissure sealants include newly erupted permanent molars or premolars, teeth with deep or complex fissures, and patients at moderate to high caries risk. Contraindications include gross caries on the biting surfaces, inability to maintain a dry field, or very small and easily cleaned fissures where sealants are unlikely to provide added benefit.

Evidence indicates that sealants reduce the incidence of pit-and-fissure caries, particularly in children and adolescents. Longevity varies with material and technique, often requiring periodic reapplication or resealing as retention wanes. Regular dental follow-up is advised to monitor sealant integrity and reapply if needed.