MODERN VIEW ON FISSURE SEALING IN CHILDREN

The aim of the article is to analyse the indications for fissure sealing, its technique and materials used, as well as the factors that affect the efficacy of sealing. The authors searched for articles and scientific publications in Scopus and Pubmed databases using the keywords “fissure sealing”, “fissure sealant”, and “preventive resin restorations”. Indications for dental fissure sealing are deep retention fissures (preventive sealing) and non-cavitated occlusal lesions (therapeutic sealing) of permanent and temporary molars or premolars in children with high risk of caries. Glass ionomer cements are the first choice for sealing half-erupted hypomineralized teeth and in a case of problems with saliva isolation. Superiority of composite materials, glass ionomer cements or compomers in sealing has not been proven yet. The sealing technique does not include opening the fissures with bur; a pumice-free paste with or without fluoride can be used to clean the fissures. After fissure sealing, follow-ups should be scheduled at six-month intervals or more time depending on the caries risk level. Prophylactic restorations combine sealing of deep fissures with caries restoration by composite on the same occlusal surface; they are divided into 3 types and performed in children aged 6-16 years, having lower efficacy as compared to sealing. The lack of evidence-based studies about prophylactic restorations does not allow to make clinical recommendations. The efficacy of sealing and preventive filling depends on the dentist's manual skills, the patient's compliance with oral hygiene, and the possibility of control check-ups. Indications for dental fissure sealing are deep retention fissures and non-cavitated occlusal lesions of permanent and temporary molars and premolars within 2 years after eruption in children with high risk of caries. Glass ionomer cements are the best for half-erupted and hypomineralized teeth that are difficult to isolate from oral fluid; in other cases, composite sealants and compomers can be used for sealing in addition to glass ionomers. Preventive conservative restorations are less effective than fissure sealing. Adherence to the technique at all stages of sealing or preventive restoration and patient cooperation during the procedure with subsequent follow-up are factors that affect their effectiveness.