[Pit and fissure morphology and its implication for caries prevention and treatment]

Dental caries is a chronic and progressive destruction of dental hard tissue under the combined action of multiple factors, with the pits and fissures on the occlusal surfaces of posterior teeth being the most susceptible sites. During tooth development, fissure morphology is regulated by the enamel knot. The depth, width, and shape of fissures directly influence plaque retention and cleaning difficulty, thereby determining caries susceptibility. Deep and narrow fissures, which are difficult to clean, pose a higher risk of caries. Pit and fissure caries begin with enamel demineralization caused by acid production from biofilm metabolism, with the lesion progressing along the direction of the enamel rods. The susceptibility of caries is positively correlated with the depth of pits and fissures. In addition to traditional diagnostic methods, new technologies such as quantitative light-induced fluorescence, DIAGNOdent and optical coherence tomography are also employed to assist in the early diagnosis of caries. Comprehensive prevention strategies, including fluoride application, minimally invasive restorations, pit and fissure sealants, and artificial intelligence-assisted management, collectively form a prevention and control system for pit and fissure caries. This article systematically elaborates on the relationship between fissure development, morphological characteristics, and caries occurrence, and reviews advances in diagnostic and preventive technologies, aiming to provide a theoretical basis and practical direction for the precise prevention and early intervention of pit and fissure caries.