Call Girls ITPL Just Call 7001305949 Top Class Call Girl Service Available
Â
Isolation Techniques for Operative Dentistry
1. ISOLATION OF THE OPERATIVE
FIELD
DR ASHWINI M PATIL
Reader
Navodaya dental college
Raichur
2. The goals of operative field
isolation are
ďMoisture control
ďRetraction
ďHarm prevention
3. Following components of oral environment
need to be controlled during operative procedure
ď§
ď§
ď§
ď§
ď§
ď§
ď§
ď§
ď§
Saliva
Tongue
Mandible
Lips & cheek
Gingival tissue
Buccal & lingual vestibule
Floor of the mouth
Adjacent teeth and restoration
Respiratory moisture
4. Advantages
Patient related:
A. Provides comfort to the
patient
B. Protect patients from
swallowing or aspirating
foreign bodies
C. Protect patients soft
tissues by retracting them.
Operator related:
A. A dry clean operative field
B. Infection control
C. Increased accessibility to
operative site
D. Improved properties of
dental materials
E. Improved visibility & less
fogging of mirror
F. Prevents contamination of
tooth preparation.
5. Materials can be used
1. Rubber Dam
2. Cotton rolls & cellulose wafers
3. Throat shields
4. High volume evacuators & saliva ejector
5. Mirror & evacuator tip retractor
6. Mouth props
7. Air Water syringe
8. Cheek retractor
9. Drugs
6. Rubber Dam Isolation
ďśIn 1864, S.C.Barnum, a NY city dentist
introduced the rubber dam.
ďśIt is a flat thin sheet of latex/non-latex that is
held by a clamp and a frame, that is preferred
to allow the tooth/teeth to protrude through
the perforations, while all other teeth are
covered.
7. Rubber Dam Isolation
A.
B.
G.
Advantage
Act as a raincoat for the tooth.
Complete,long term moisture
control.
C. Maximizes access and visibility.
D. Clean dry field while working.
E. Protect lips,cheeks & tongue by
keeping them aside.
F. Reduces risk of cross contamination
esp. to root canal system
Prevents accidental swallowing or
aspiration of foreign bodies.
Improves the properties of dental
materials
Disadvantage
A. Takes time to be applied.
B. Communication with the patient
can be difficult.
C. Incorrect use may damage
porcelain crowns/gingival
tissues.
D. Insecure clamps can be
swallowed or aspirated.
H.
8. Contraindication:
ď§ Asthmatic patients.
ď§ Epilepsy and other motor disabilities.
ď§ Allergic to latex
ď§ Mouth breathers
ď§ Presence of some fixed ortho app.
ď§ A recently erupted tooth that does not retain
a clamp
ď§ Extremely malpositioned teeth
ď§ Third molar (in some cases)
9. Armamentarium
ď Rubber dam sheet.
ď Rubber dam clamps.
ď Rubber dam forceps.
ď Rubber dam frame.
ď Rubber dam punch.
Accessories
ď Lubricant/Petroleum jelly.
ď Dental floss.
ď Liquid dam.
ď Rubber dam Napkin.
10. Rubber Dam Sheet
ďź It is made of latex or non-latex.
ďź Available in 2 sizes- âś 5â*5â
⡠6â*6â
ďź New material should be used.
ďź Available in varying thickness.
ďź Light and dark sheets are available for colour contrast.
ďź Has a shiny & dull side, dull side will be facing the
occlusal side.
11. Rubber Dam Frame
ďźThe rubber dam frame maintains the border
of the dam in position.
ďźSupport the edges of the rubber dam.
ďźRetract the soft tissues.
ďźAvailable in metal and plastic.
12.
13. Rubber Dam Punch
ďźRubber dam punch is used to make the holes in
the sheet through which the teeth can be
isolated.
ďźThe working end is designed with a plunger on
one side and a wheel on other side.
ďźThis wheel has holes of different sizes on the flat
surface facing the plunger.
ďźThe punch must produce a clean cut every time.
15. Rubber Dam Clamps
ďźThese are used to secure the dam to the
teeth, that are to be isolated.
ďźThese also minimally retract the gingiva
ďźSubdivided into >Winged
>Wingless
17. Rubber Dam Template
ďźIt is an inked rubber stamp which helps in
marking the dots on the sheet according to
position of the tooth.
ďźHoles should be punched according to arch
and missing teeth.
19. Accessories
⢠Dental Floss: It is used as flossing agent for
rubber dam in tight contact areas.
⢠Rubber Dam napkin: This is a sheet of absorbent
material placed between the rubber dam and
skin.
⢠Lubricant: A lubricant is applied in the area of
punch holes facilitates the passing of dam septa
through proximal contacts.
37. RUBBER DAM APPLICATION TECHNIQUES.
âŻClamp first technique.
âŻWing technique
âŻRubber first technique
âŻBracket technique
38. CLAMP FIRST TECHNIQUE
Advantages:
⯠It is two handed procedureore
⯠It can be implemented with molar and premolar(single bracket), winged or wingless clamp
⯠Excellent operative field visibility during placement
Disadvantages:
⯠Inserting the clamp into the mouth before the dam is dangerous since it might be displaced (fasten
it with ligature)
⯠The clamp is severely strained during placement
⯠It cannot be used with double bracket clamps
39.
40. WING TECHNIQUE
Advantage:
⯠It is two handed procedure
⯠It is safe procedure for the clamp engaged within the sheet hole; if it gets disengaged from the
plier there is no risk of falling into the oral cavity (swallowing or inhaling)
⯠It is minimally invasive technique ; the patient does not feel the dentistâs hands in his/her mouth
Disadvantages:
⯠It can be implemented with winged clamps only
⯠Limited visibility on the target tooth
41.
42. RUBBER FIRST TECHNIQUE
Advantages:
⯠It is a clamp safe procedure when oral cavity is protected by the rubber sheet(no risk of
swallowing or inhaling)
⯠Suitable for every clamp type
Disadvantages:
⯠Invasive for the patient especially in posterior region
⯠Limited visibility of the tooth to be clamped
43.
44. BRACKET TECHNIQUE
Advantages:
⯠It is two handed procedure
⯠it is safe; the clamp is engaged within the sheet hole and it wonât fall into oral cavity should it
unfasten from the plier(swallowing or inhaling)
âŻCompatible with winged or wingless (wingless is better) premolar and molar (single bracket
clamp)
⯠Excellent field visibility during clamping
Disadvantages:
⯠Not compatible with anterior clamps(double bracket).
53. Cotton rolls
⢠Cotton rolls, gauze & cellulose wafers
absorbents are helpful for short period
of
isolation of the teeth especially where
rubber dam application is not possible.
⢠Usually placed in buccal & lingual sulcus
specially where salivary gland ducts exit, to as
to absorb saliva.
54. Throat Shield
⢠Throat shield is important specially when the
maxillary tooth is being treated.
⢠An unfold gauze is stretched over the tongue
and posterior part of the mouth.
⢠Avoid aspiration of restorations.
55. High volume evacuators & saliva ejector
⢠It is used to remove water from airrotor with
high suction speed.
⢠Also helps in retracting the soft tissues.
58. Mirror & evacuator tip retractor
⢠A secondary function of the mirror and
evacuator tip is to retract the cheek, lip &
tongue
59. Mouth prop
⢠Mouth prop is also used to establish &
maintain a suitable mouth opening, thus help
in tooth preparation of posterior tooth.
â˘It is placed on the opposite to treatment
side.
â˘Provides sufficient mouth opening for
longer times.
60. Cheek retractor
⢠They are used to expand the mouth opening.
⢠This is usually use when working on the
gingival border of upper & lower front teeth
and for the adjustment of orthodontic bands.
61. Air water syringe
⢠By air water syringe an air blast can be useful
to dry tooth and soft tissue during
examination or used during procedure.
62. Drugs
⢠The use of drugs to control salivation is rarely
indicated in restorative therapy, and is
generally limited to atropine.
⢠Contraindicated for nursing mothers, and
patients with glaucoma.