Isolation Flashcards
What are the 3 main reasons to use Isolation
- Moisture Control 2. Retraction 3. Harm Prevents
How does Isolation assist in Moisture control
- Excludes Sulcular fluid, saliva, and blood 2. Prevents spray of handpick and debris from being swallowed
How does Isolation assist in retraction?
- Provides maximal exposure
How does Isolation assist in harm prevention
- Provides patient comfort, and prevents harm while increasing operator efficiency
Define Rubber Dam Isolation
Used to define operating field by isolating 1 or more teeth from oral environment. It eliminates saliva and retracts soft tissue
5 Advantages of Rubber Dam Isolation
- Prevent Pulpal contamination from fluid - Increases performance 2. Retracts soft tissue, dark color dam provides non reflective background for better contrast 3. Provides dry optimal condition for placing material 4. Protects patient from aspiration and swelling. Protects soft tissue irritation. Effective infection control of dental office 5. Increase productivity, decrease conversation, keeps mouth open
Rubber Dam Material
5x5 or 6x6 Thin: .006 in, Med: .008 in, Heavy: .101 in, Extra Heavy, .012 in Dark material preferred Thinner material easier to pass contact
What does the Frame do in Rubber Dam isolation
Maintains borders of Dam - U Shaped
What does the Punch do in Rubber Dam isolation
Precision instrument with rotating table & sharp pointed plunger
What does the retainer forceps do in Rubber Dam isolation
Used for placement and removal of retainer
What does the Napkin do in Rubber Dam Isolation
Placed between rubber dam and skin: 1. improves patient comfort 2. absorbs seeping saliva 3. Cushions 4. Convenient to wipe patients lips on removal of Dam 5. Comfort for long appointments
What does lubricant do in Rubber Dam Isolation
Applied in area of punched holes to facilitate passing contact
Steps in Rubber Dam placement - 9 steps
- Anesthesia 2. Retainer Selection 3. Pre-Framing 4. Placement 5. Passing Dam through posterior contact 6. Applying anterior anchor 7. Passing dam through contacts 8. Inverting the Dam 9. Ligature Placement (if necessary)
Name the parts of the retainer
- Hole
- Jaw
- Prong
- Bow
How many line angles should the retainer contact?
4
What are the 3 reasons the jaw should not extend beyond the mesial and distal line angles?
- They can interfere with matrix/wedge placement
- Ginigival trauma is more likely to occur
- Complete seal around anchor tooth is more difficult to achieve
What is the purpose of wings on the retainer
They are for extra retraction of the dam
What are the 2 placement techniques for rubber dam
- Retainer first, then rubber dam
- Retainer and dam applied simultaneosly
What can be used as an anterior anchor
Wedjet, dental tape, piece of rubber dam
What can be used to pass the dam through the contacts?
dental floss
What can be used to invert the rubber dam after placement
dental tape or air-water syringe with IPC
When would you use ligatures in RD placement
Teeth with short crown
It is unnecessary if enough teeth are isolated.
Use a surgeon’s knot to tie
What are the four steps in RD removal
- Cut RD at interproximal areas
- Remove retainer
- Remove rubber dam
- Check for any remaining pieces in interproximal areas
What is the benefit of Light-Cured Resin Barriers
they isolate and protect soft tissue by focusing heat away from the tooth and ginigiva for added comfort
What is optragate?
a lip and cheek retractor
How is Retraction cord used?
Used in direct restorations involving subgingival areas
Used in indirect involving gingival margins
It is used without dam to control sulcular seepage, hemmorhage
Improved access and visibility helps prevent abrasion
What are the dimensions that should be used for retraction cord
It should extend approximately 1 mm beyond gingival width
Ultrapak Cord (Ultradent)
Braided Cord
Size 000-2
Dampen with Water or Hemodent
Leave in until finished
Hemostatic
Retraction cord w/hemodent
Buffered Aluminum Chloride
Viscostat Clear: 25% Aluminum Chloride
Expasil: Kaolin and Aluminum Chloridge
Hemodent
Good Hemostasis
Buffered with Aluminum Chloride
Used with cord or as a liquid
Localized action
Viscostat
Excellent Hemostasis
20% ferric sulfate
Stains composite
Viscostat Clear
Good hemostasis
25% aluminum chloride
No stain
Less effective than viscostat
scrub and rinse
Expa-syl
Excellent Hemostasis
Kaolin & Aluminum Chloride
Selective
EXPENSIVE!
Decreased Tissue Trauma
Learning Curve
What are the steps in rebonding after contamination (6)
- Control Field
- Rinse and Dry
- Apply etch and rinse
- Apply primer
- Apply adhesive and polymerize
- Apply and Polymerize resin
