Fissure (tooth)

Tooth fissures

As a fissure ( latin fissura , column ',' groove ',' cut ') refers to the dimples in the occlusal surface relief of the posterior teeth . In contrast, the elevations are called "humps".

The teeth usually have a main fissure that runs in the longitudinal direction and is therefore called a longitudinal fissure. Similarly, the many smaller transverse fissures are called transverse fissures.

Emergence

The mineralization centers of the teeth, i.e. the zones in which the hard tissue formation begins, are located in the area of ​​the later cusp tips and marginal ridges (these are the upper edges of the chewing surfaces, which point to the anterior and posterior neighboring tooth - if any). From here the pre-eruptive (i.e. before the tooth eruption) formation of the tooth enamel ( enamelum ) begins , which spreads in all directions. If two of these mineralization fronts meet, the tissue is compressed, similar to plate tectonics . The tissue turns inside out, creating trenches or funnels that can later be perceived as fissures on the chewing surface.

Fissure caries

After the teeth have erupted, the fissures can be colonized by microorganisms. Since fissures can sometimes be very deep (up to 1  mm ) and very narrow (50  μm ), effective cleaning is often impossible.

Cariogenic (i.e., caries-causing ) bacteria can invade the fissures, attack the enamel, which is thinner at that point, and cause fissure caries to penetrate deep into the crown. Detecting fissure caries is difficult because it is often not visible from the outside (the enamel surface can be completely intact) and the dental diagnosis is made even more difficult by the narrowness of the fissures. Also, X-rays are inaccurate because of thick enamel coat the crown absorbs radiation and small carious lesions often overshadowed.

In the case of people at risk of caries, the dentist can therefore seal the still caries-free fissures with a low-viscosity synthetic resin or composite material shortly after the tooth eruption in order to prevent colonization by the oral flora ( fissure sealing ). If the fissure is already colonized, it must first be cleaned and possibly expanded a little by grinding (expanded or invasive fissure sealing). There are studies in which the further course of small carious structures after being enclosed by seals, i.e. without sacrificing tooth substance, was observed. Most of the time, there were slowdowns, stops or even reductions in caries.

Web links

• Fissure sealing (PDF; 115 kB) Scientifically proven patient information from the German Dental Association and the German Society for Dentistry, Oral and Maxillofacial Medicine
• Fissure sealing - German Society for Dentistry, Oral and Maxillofacial Medicine 03/2010
• Fissure sealing - Dental Health Working Group - independent consumer u. Patient advice

Individual evidence

1. ^ C. Deery: Caries detection and diagnosis, sealants and management of the possibly carious fissure . In: BDJ . 214, No. 11, 2013, ISSN  0007-0610 , pp. 551-557. doi : 10.1038 / sj.bdj.2013.525 .

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !