Fissure sealing

Over the years, the urgency of the problem of caries and the need for preventive measures to prevent it is not reduced. As shown by observations, the prevalence of this disease of the oral cavity today is observed in the range of 60-98% among children of twelve years. At the same time, the main increase in the incidence and rapid progression of the disease is observed within one and a half to two years after the appearance of permanent teeth, that is, it falls on the age of six to seven and to eleven or thirteen years. This period is characterized by incomplete mineralization of the teeth. Along with this, in almost 90% of cases, the localization of carious cavities occurs on the chewing surfaces.

The enamel of the immature tooth is distinguished by its high porosity and lower packing density of the crystals, it contains few fluorapatite-like crystals, less soluble in acids than hydroxylapatites. This, in turn, makes it more vulnerable to acids.

Often the sealing of fissures in children occurs spontaneously, naturally. In this case, dense, highly mineralized formations having a heterogeneous structure are detected in them. These formations are located on the bottom of the fissures. Such a zone is the only area of concentration of centrifugal currents of cerebrospinal fluid coming from nearby folds and hillocks. Thus, the fissure is sealed naturally by the enamel liquor.

In the case of a health disorder and in the presence of local risk factors that contribute to the development of caries, spontaneous sealing does not occur.

Fissures are distinguished by the type of structure. They can be funnel-shaped, drop-shaped, cone-shaped. There are also polyps.

Funnel-shaped anatomical depressions of the teeth are more open, good mineralization. There is no delay in food residues, which is caused by free washing of the oral fluid. Funnel-shaped fissures are considered caries-resistant.

The conical anatomical dental cavities are mineralized, mainly due to the fluid in the oral cavity. However, they form the conditions for the retention of microorganisms and food residues.

Mineralization of polypous and drop-shaped depressions is carried out mainly on the dental pulp side. This process is of lesser intensity, as a result of which they remain insufficiently mineralized for a long period.

Sealing fissures is an obturation with adired materials. This procedure is aimed at creating a barrier that prevents the effects of external cariogenic bacteria.

Sealing teeth promotes remineralization of enamel. This is due to the inclusion of active ions in the composition of the materials used.

It should be noted that the tactics of sealing healthy teeth during the maturation of enamel are selected in accordance with the data on their initial level of mineralization (IMU).

The sealing of fissures is mainly in the first months of eruption. This fact often causes fear. They are associated with the appearance of difficulties in the maturation of hard tissues. This can be facilitated by the presence of a sealant, which prevents the penetration of oral fluid. However, most modern researchers agree that mineralization as a whole does not exert any influence on the partial interruption of enamel maturation.

In addition, the elements contained in the saliva can freely diffuse partially and along the edge through the coating material. This, in turn, provides a physiological level of metabolic processes in hard dental tissues under the sealant, while preventing the penetration of large protein molecules.