Dental Problems

Pit and Fissure Caries – Introduction

The high susceptibility of pit and fissures to caries presents a major dental problem and provides the rationale for caries control of these areas. While occulsal surfaces represent approximately 10% of the enamel surface at risk, they account for almost 50 percent of the caries in human dentition. Read on to know more about the pit and fissure caries which is discussed briefly below in this article.

dental care and womenPit and Fissure Caries:

The pit and fissure caries process, particularly in the first and second molars, usually starts soon after eruption. It is usually rapid and can often result in the loss of the tooth. The very presence of pit and fissure may be the single most important factor in determining the presence of caries in these sites.

However at the turn of century, Black (1987) noted that pit and fissure don’t cause caries process. They instead provide a sanctuary to those agents, which cause caries. They permit the entrance of microorganisms and food into this sheltered, warm, moist, richly provided incubator and the Pit and Fissure Cariesdental plaque can be expected to form here.

In a caries susceptible person, when carbohydrate in food comes in contact with the plaque, acidogenic bacteria in the plaque create acid. This acid damages the enamel walls of the pit and fissure and thus it results in caries formation. The enamel present at the bottom of the pits and fissures might be very thin, such that an early dentin involvement occurs frequently.

In occlusal pit and fissure caries, the form of caries lesion is different from that of smooth surface lesion. Caries follows the direction of the tooth enamel rods and characteristically form a cone shaped or triangular shaped lesion with its apex towards the outer surface and its base towards DEJ. Pit and fissure produces greater cavitation than the proximal smooth surface caries.

With this understanding of the onset of occlusal caries, the eradication of pit and fissures would eliminate them as caries opportunity sites this preventing the disease.

Definition of Pit and Fissure

Pit:

Pit is defined as a small pinpoint depression located at the junction of developmental grooves or at terminals of those grooves. The central pit describes a landmark in the central foddae of the molars where developmental grooves join.

Fissure:

It is defines as deep clefts between adjoining cusps. They provide areas for retention of caries producing agents. These defects occur on occlusal surfaces of the molars and premolars, with tortuous configurations that are difficult to assess from the surfaces. These areas are impossible to keep clean and highly susceptible to advancement of the carious lesion.

Morphology of Pits and Fissures:

Pits and fissures are enamel faults, narrow shafts or cracks of some length whose blind ends are directed more or less towards the dentino-enamel junction. These differ from grooves that are shallow linear depressions formed by the perfect joining of the different lobes.

Nango

(1960) in a study of crown sections described four principal types of fissures, based on the alphabetical description of shape.

  1. V type
  2. U type
  3. I type
  4. K type
  1. The shallow, wide V and U shaped fissures tend to be self-cleansing and somewhat caries resistant.
  2. Deep, narrow I shaped fissures are quite constricted and resemble a bottleneck. They have a narrow slit like opening with a larger base as it extends towards the dentino enamel junction. These caries susceptible, I shaped fissures may also have a number of different branches.
  3. Similarly, K shaped fissures are also very susceptible to caries.
  4. Usually, non-invasive technique is recommended for U and V shaped fissures and invasive technique for I and K type fissures.

The above article briefs about the introduction of pit and fissure caries, definition of pits and fissures and morphology of pits and fissures.

Leave a reply

Your email address will not be published. Required fields are marked *