Operative Dentistry - Best Practices
Caries Management: Pit and Fissure Caries Non-cavitated & Cavitated
(last modified September 1, 2016)
We follow the ADA Council of Scientific Affairs, Use of Pit and Fissure Sealants: Evidence-based clinical recommendations. JADA 2008, for the management of pits and fissures at risk for caries lesion development and pits and fissures that have non-cavitated lesions. See chair side guide shown below.
Overall management of pit and fissure caries is summarized in the figure below which was adapted from our pre-doctoral teaching textbook, Summitt’s Fundamentals of Operative Dentistry 4th Edition, Figure 5-24.
A recent systematic review supports arresting initial pit and fissure lesions, that is, ICDAS 1 and 2, with therapeutic sealants. See http://www.ncbi.nlm.nih.gov/pubmed/27470525