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Isolation of the operating field
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Goals of isolation
 Moisture control – excluding sulcular
luquid, saliva, gingival bleeding, cooling
spray, restorative debris
 Relatively and absolutely dry operatiog
field
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Relative dry operation field
 Excluding sulcular luquid, saliva, gingival
bleeding, cooling spray, restorative debris
The operating field is not isolated against
moist air - high relative humidity in oral
cavity.
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Absorbents
Minidam
Cotton rollers
Cotton pellets
Cotton cups
Suctions
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Wooden wedge
Compression of gingiva
Separation of teeth
Adaptation of matrices
Retraction cords
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Special materials – light curing
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Absolute moisture control
 Rubber dam
- A dry, clean operating field
- Improved access and visibility
- Potentilally improved properties of dental
materials (curing, bonding)
- Protection of the patient (aspirating,
swallowing,protection of soft tissues, mercury
exposure) and operator (infection control
barrier)
- Operating efficiency
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Disadvantages
Breathing difficulties (asthma)
Teethe that have not erupted
sufficiently to
support a retainer
Extremely malpositioned teeth
Psychologic reasons
Latex allergy
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Instruments and materials
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Rubber dam material
-Deteriorates over time
-lower tear strength
-Available
-Sheets (12,5 x 12,5 or 15x 15 cm)
-Roll
-Thickness:
-Thin, medium, heavy, extra heavy,
-special heavy
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Rubber dam holder - frame
Maintains the rubber dam in position
U ahaped
Closed
Closed with joint
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Rubber dam retainers - clamps
Bow
Hole
Jaw
Prong (4 prongs)
Anchore the rubber dam
to the most posterior tooth to be isolated
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Wings
Wingless and winged
retainers
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The retainer must not move
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Rubberdam template
Rubberdam stamp
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Rubber dam punch
Cuts the puncture
in the rubberdam
Ainsworth
Ivory
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Rotating metal table – disk
Six holes of varying size
Tapered plunger
centered in
the cutting hole
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Retainer forceps
For placement and removal of the retainer
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Lubricant
Rubberdam napkin
Neck strape
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Perforace blány
Vyražení otvoru
Okraje okrouhlé bez
nepravidelností
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Placement
 Comfort of the patient and operator
 Anaesthesia
 Checking of proximal contacts – dental tape
 Punching the holes
 Lubrication the dam
 Selecting the retainer
 Testing the stability of the retainer
 Positioning of rubberdam
 Applying of the napkin
 Attaching the frame
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Placement
 Passing the septa with and without the tape
 Inverting the dam interproximally –
interdental adaptation
 Inverting the dam faciolingually – inversion
 Confirmingya properla applied rubber dam
 Removal of the rubber dam (cut the with
scissors)
 Removing of the retainer
 Wiping the lipes
 Examining the dam (no remnants)
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Modes of placement
 Rubber first
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Modes of placement
 Retainer first
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Modes of placement
 Rubber and retainer together
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Modes of placement
 „One second placement“
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Interdental adaptation – inverting the rubber dam interdentally
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Inverting the rubber dam
faciolingually
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Dentap tape
Wedjet
Additional methods and factors
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Modifications
 Optidam
 Optradam
 Minidam
 Dermadam
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