4. Isolation of the Working Field Flashcards
An Effective Infection Control Barrier
Literature shows a significant reduction of ____ (90-98% decrease) in the treatment area with the use of a rubber dam
microrganisms
Disadvantages of rubber dam
1. Initial placement is time consuming 2. Possible patient objection 3. Latex allergy - may required non-latex dam 4. Some situations make rubber dam application impossible -- \_\_\_\_ teeth -- \_\_\_\_ teeth 5. \_\_\_\_ sufferers 6. \_\_\_\_ reasons
partially erupted
extremely malpositioned
asthma
psychological
Types of Rubber Dam
Latex
5” x 5” or 6” x 6”
Thin, Medium, Heavy, Extra heavy thickness
Non-latex
Shiny side, dull side
Dull is less light reflective and faces away from the ____ surface (outside)
Thick dams \_\_\_\_ More effective in tissue \_\_\_\_ More resistant to tearing Especially recommended for \_\_\_\_ isolation
Thin dams
Pass through the ____ easier
Less resistant to tearing
occlusal preferred retraction class V contacts
Types of Rubber Dam
Light or Dark colored ____ is preferred for contrast
Scented vs Unscented
Rubber Dam Material
Shiny side – faces towards ____ Dull side – faces away from teeth
Dull is less light reflective
dark
teeth
Rubber Dam Clamp
- Prong: four-point contact
Prevents ____ or tilting of the clamp
Rocking movement could cause injury to tooth or tissue
Inverted prongs
For ____ teeth
When ____ necessary
rocking
partially erupted
gingival retraction
Rubber Dam Clamp Types
Winged Clam
Anterior and lateral wings
Provides extra ____ of the rubber dam
Can be placed on the rubber dam prior to seating the clamp on the ____ or on the tooth prior to placing the ____
____ may interfere with placement of matrix bands, band retainers, wedges
Wingless clamp
No anterior and lateral wings
Placed on the tooth ____ to seating the rubber dam
Does not interfere with placement of matrix bands, band retainers, wedges
retraction anchor tooth rubber damn wings prior
WINGLESS CLAMPS
W1
universal clamp for ____
W2A
larger ____ that W1 cannot accommodate
W56 universally used for maxillary and mandibular \_\_\_\_ small molars W26N universal for maxillary and mandibular molars when \_\_\_\_ is not applicable
W8A for smaller \_\_\_\_ and large \_\_\_\_ good for \_\_\_\_ molars 212 UNC used for cervical tissue retraction for \_\_\_\_ must be supported by \_\_\_\_
premolars
premolars
molars
W56
molars premolars max third Class V compound
WINGED CLAMPS 14A used for \_\_\_\_ good for \_\_\_\_ teeth good for \_\_\_\_ molars careful: abusive to \_\_\_\_ attachment last \_\_\_\_
14
same as 14A, but smaller
used for small ____ and ____
90N
similar to 212, but with ____ for clamp forceps
usually used for ____
molars partially erupted tapering gingival resort
molars
premolars
holes
endodontics
Rubber Dam Punch
An instrument with rotating metal punch template with \_\_\_\_ varying sizes of holes with a plunger
____ holes for the incisors, canines, and premolars
The ____ holes for the molars
The largest hole is for the posterior tooth with the ____ already in place
6
smaller
larger
clamp
Selection of teeth to isolate
Isolation of more teeth is preferred for better visualization and access
Anterior teeth
Often includes all ____ anterior teeth AND the first ____
Posterior teeth
At least one tooth ____* (if possible) to the tooth being restored and extended to the ____ of the adjacent quadrant
*____ teeth distal for premolars
-best to isolate distally with a ____ if possible
6 premolars distal lateral incisor 2 molar
Endodontic procedures
____ tooth isolations routinely used for endodontic treatment
single
Before Rubber Dam Placement :
Select teeth to isolate
Test the interproximal contacts with floss
Mark occlusal contacts in Maximum Intercuspation (MIC)
Select the ____ of the tooth if a ____ restoration is being done
Punch the holes for isolation using the template Select the proper clamp(s), tie floss on bow(s) Lubricate the rubber dam
____ lips and corners of the mouth
shade (color)
bonded
lubricate
Punching Rubber Dam Holes
Punched holes correspond to the ____ areas of the teeth
CEJ
Punching Rubber Dam Holes
Maxillary anterior punched holes:
____” from the top of the rubber dam in order to cover the lips, but not cover the nose
Mandibular anterior punch holes:
____” from the bottom of the rubber dam in order to cover the lips
1
1 1/2
Placement of the rubber dam
Order of Placement:
Wingless Clamp: Place ____,
then rubber dam
Winged: Placement of rubber dam and clamp ____ or place ____ then rubber dam
Both Winged and Wingless: Place ____, then ____
Place clamp first onto the ____ then lower onto the buccal/facial
Confirm 4-point contact from the prongs
Check stability
PULL FLOSS THROUGH HOLE
clamp together clamp rubber dam clamp lingual
