Pit and Fissure Sealants: Types, Effectiveness, Retention, and Fluoride Release: A Literature Review

Sealing occlusal pits and fissures in teeth is a common and highly effective preventive method. The main purpose of sealing the pits and fissures is to prevent plaque microflora and food debris accumulation in the fissures where saliva cannot reach and clean the debris, re-mineralise initial lesions, and buffer the acid produced by cariogenic bacteria. Resin-based sealants, as well as glass ionomer materials, are used for pit and fissure sealing. The resin-based sealants require the use of acid for preparation of the enamel surface of the teeth, which is then rinsed and dried before the sealant material is applied. The success of this procedure depends on good isolation of the teeth and prevention of any contamination of the etched enamel surface by saliva or water. Tooth isolation may be achieved by the use of cotton rolls or rubber dam. Additionally it has been suggested that the benefit provided by protecting pits and fissures is based on good retention and the integrity of the sealant material. However, since the retention of the sealant is not permanent, this physical effect could be enhanced if the material simultaneously released fluoride. The durability of fluoride containing sealants would now appear to be comparable to conventional resin sealants. However, further long-term clinical trials are necessary to determine the clinical longevity of sealant retention is not adversely affected by the presence of incorporated fluoride. Also the clinical importance of fluoride in sealants in terms of ca ries prevention remains to be shown.