Replacement of an old filling and fissure sealant application in a 13-year-old patient

The teenager came to the appointment with his parents because the old filling on the molar 1.6 not only stood out visually but also posed a risk of developing secondary caries. The parents were also interested in preventive measures for the adjacent teeth, as it was difficult for the child to thoroughly clean the chewing surfaces.

Examination and Diagnostics

The clinical examination revealed:

• a filling on tooth 1.6 with compromised marginal integrity, which could lead to plaque accumulation and secondary caries;
• pronounced fissures on teeth 1.4 and 1.5, with plaque accumulation noted — a common risk zone for adolescents.

Treatment Plan

• Replace the old filling with a modern composite restoration that restores the anatomical shape of the tooth.
• Perform preventive fissure sealing on teeth 1.4 and 1.5 to prevent the development of caries.

Treatment Procedure

1. Under local anesthesia, the old filling was removed, and the cavity was thoroughly cleaned and prepared.
2. A new composite restoration with proper marginal adaptation and high aesthetics was placed on tooth 1.6.
3. Fissures on teeth 1.4 and 1.5 were sealed using a special material: surface cleaning, application of the sealant, and light polymerization.

Result

• The chewing tooth 1.6 was restored with proper anatomy, esthetics, and functional integrity.
• The risk of secondary caries at the site of the previous filling was completely eliminated.
• Teeth 1.4 and 1.5 were protected from future caries through fissure sealing.
• The patient and parents were satisfied with the esthetic outcome and the preventive approach.

Why This Is Important

Many parents assume that if a child has no complaints, treatment is unnecessary. However, during adolescence, the fissures of molars are especially prone to caries: plaque accumulates in these deep grooves and is difficult to remove even with regular brushing. Timely fissure sealing helps maintain dental health and avoid restorative treatment in the future.

At DentalDate, we emphasize a comprehensive approach — combining esthetic restoration and preventive care to ensure long-term results for patients of all ages.