Rubber Dams and Pit/Fissure Sealant Flashcards
What are the three main reasons for use of rubber dams?
- Moisture control
- Protects and retracts soft tissue
- Improves vision for operative site
- Protects airway
When are rubber dams mandatory?
During endodontic procedures
What are some reasons for not using rubber dam?
- Time
- Patient doesn’t like
- Allergy
What is an alternative method of anchoring rubber dam?
With Wedjet and ligature
What instrument do you use to invert the dam around necks of teeth to complete isolation?
Flat plastic
What is ligaturing?
Passing floss through mesial and distal contacts, looping around lingual surface at gingival margin
What types of clamps are used for posterior teeth and what is the purpose of clamps?
Premolar clamp 1, 2 and molar clamp 56
Used for retention of rubber dam -construct the cervical area of the dental crown to hold the rubber dam
What are some advantages and disadvantages of winged clamps?
Advantages:
- More rapid placement of dam
- less chance of tear dam when stretching over clamp
- less chance of popping of the tooth
Disadvantages:
- Can obscure teeth- hard to identify tooth
- Must stretch dam
- Clamp can slip off
What are some advantages and disadvantages of wingless clamps?
- Clamp can be placed rapid, accurately not obscured vision
- less projection on clamp- better access to tooth
Disadvantages:
- Stretching dam over clamp
- Clamp must be secured by floss
- Difficulty access mouth by dam and fingers
What type of clamp is this?
Wingless
What type of clamps are these?
Hu-friendly pattern clamps-winged
What are the basic instruments required for rubber dam set up use?
Artery forceps, hole punch, supporting frame, clamps x3 minimum, rubber dam forceps, scissors, dam, template, floss, interproximal carver or flat plastic
What is this wedge used for?
To tie down anterior dam
What are the basic steps in applying the rubber dam?
- Hole punch appropriate teeth in dam using template
- Choose appropriate sized clamp- attach floss to clamp- at least 15cm of floss
- Deliver assembled dam and clamp the tooth
- Use flat plastic to flip dam off wings- ensure sealed
- Position most anterior hole over tooth and lock down with floss
- Ligaturing- floss through mesial and distal contacts looping around lingual surface at gingival margin
- Make a slip knot with floss- pull tight
- Use flat plastic to invert the dam around necks of teeth to complete and seal for isolation
For a pit and fissure sealant of buccal pit, what handpiece tip do you need?
Low speed with bristle brush
What sealant do use for a pit and fissure sealant, and tip?
Helioseal fissure sealant and fine black cannula
Before you begin sealing, you are required to clean the pit and fissure with a paste. What paste and describe the process?
Pumice- make a slurry paste.
Using a mixing spatula, add 2 drops of water, scoop powder over with spatula to make slurry.
Helps the pumice stick to the brush better.
How do you ensure you add the paste to tooth without it spinning off the brush?
Turn off water supply
Foot pedal on minimum speed (to the left)
What instrument do you use to check the margins of fissure sealant?
Sickle probe
Describe the process of pit and fissure sealant
- No tooth prep with burs
- Clean pit and fissures with bristle brush and slurry pumice paste on low speed
- Wash off paste and dry
- Acid etch for 15 secs- wash and dry
- Bleed off 1-2 mm of sealant onto tissue, and place sealant into the fissure (release air bubbles)
- Remove excess with mycrobrush or air from triplex
- Light cure for 20 secs
