Герметизация фиссур для профилактики кариеса зубов

Dental treatment to prevent tooth decay
Dental sealants (also termed pit and fissure sealants, or simply fissure sealants) are a dental treatment intended to prevent tooth decay. Teeth have recesses on their biting surfaces; the back teeth have fissures (grooves) and some front teeth have cingulum pits. It is these pits and fissures that are most vulnerable to tooth decay because food and bacteria stick in them and because they are hard to clean areas. Dental sealants are materials placed in these pits and fissures to fill them in, creating a smooth surface which is easy to clean. Dental sealants are mainly used in children who are at higher risk of tooth decay, and are usually placed as soon as the adult molar teeth come through.

Dental caries is an upset of the balance between loss and gain of minerals from a tooth surface. The loss of minerals from the teeth occurs from the bacteria within the mouth, fermenting foods and producing acids, whereas the tooth gains minerals from our saliva and fluoride that is present within the mouth. These sealants are a plastic material placed in the pits and fissures (the recesses on the chewing surfaces) of primary (baby) or permanent (adult) molar and premolar teeth at the back of the mouth. These molar teeth are considered the most susceptible teeth to dental caries due to the anatomy of the chewing surfaces of these teeth, which inhibits protection from saliva and fluoride and instead favours plaque accumulation. This approach facilitates prevention and early intervention, in order to prevent or stop the dental caries process before it reaches the ends stage of the disease, which is also known as the "hole" or cavitation of a tooth. As dental sealants are clear or white, they are only visible upon close inspection. Multiple oral health care professionals including dentists, dental therapists, dental hygienists, oral health therapists and dental assistants (in some states in the US) are able to apply dental sealants to teeth. G. V. Black, the creator of modern dentistry, informed that more than 40% of caries incidences in permanent teeth occurred in pits and fissures due to being able to retain food and plaque. One of the first attempts to prevent occlusal caries occurred as early as 1905 by Willoughby D. Miller. Miller, a pioneer of dentistry, was applying silver nitrate to surfaces of teeth, chemically treating the biofilm with its antibacterial functions against both Streptococcus mutans and Actinomyces naeslundii, which are both carious pathogens. Silver nitrate, which was also being practiced by H. Klein and J. W. Knutson in the 1940s, was being used in attempt to prevent and arrest occlusal caries. In 1921, T. P. Hyatt, a pioneer researcher, was the first person to recommend prophylactic odontotomy (preventive operation). This procedure involved creating Class 1 cavity preps of teeth that were considered at risk of developing occlusal caries, which included all pits and fissures. First generation: set with UV curing. the Australian Dental Association, the British Dental Association, and the Canadian Dental Association.

GIC materials bond both to enamel and dentine after being cleaned with polyacrylic acid conditioner. Some other advantages GICs have is that they contain fluoride and are less moisture sensitive, with suggestions being made that despite having poor retention, they may prevent occlusal caries even after the sealant has fallen out due to their ability to release fluoride.

It was shown that GIC materials were more effective in prevention of development of caries despite the higher non successful rate compared to resin based sealants. This may be accounted for due to the fluoride releasing property of GIC which increases salivary fluoride level that may aid in preventing dental caries. Resin based sealants are normally the preferred choice of material for denture sealants. GIC material may be used as a provisional protective material when there are concerns regarding adequate moisture control.

In the US, 42% of children aged 6–11 and 48% of adolescents aged 12–19 had fissure sealants on permanent teeth during 2011–2016. In Greece, in a study from 2011, 8.3% of 12 year olds and only 8% of 15 year olds had at least one dental sealant on a molar tooth. When sealants were applied, DMFS scores were reduced by 11% in the 12 year olds and 24% in the 15 year olds. In other European countries, such as Portugal, a study has shown that over half (58.8%) of adolescents had a fissure sealant applied on at least one tooth. In Denmark, 66% of 15 year old children had at least one sealed molar. In the UK in 2003, 13% of 8 year olds, 25% of 12 year olds and 30% of 15 year olds had at least one fissure sealant. In Ireland, the rates were 47%, 70% and 69% comparatively. Around 25% of Japanese children have at least one sealed molar. A study surveying fissure sealants and dental caries in primary school girls in Saudi Arabia in 2017 found that only 1.3% of the children had at least 1 fissure sealant applied, but in another study, the overall figure was 9%.