Isolation in endodontics
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The document discusses isolation in endodontics, focusing on the use of rubber dams. It defines a rubber dam as a thin latex sheet held by a clamp and frame, with teeth protruding through perforations. The main advantages of rubber dams are moisture control, maximum accessibility and visibility, and protection of tissues. Potential disadvantages include time to apply and possible damage to tissues. Contraindications may include latex allergy or asthma. The document outlines the components of a rubber dam kit and provides step-by-step instructions for applying and removing a rubber dam.
Isolation in endodontics
- 1. Ashraf RefaiSamir BDS MSc DD HMD Associate Professor of Endodontics Al-Azhar University ashraf_refai@hotmail.com Ashraf Samir Refai www.arefai.edublogs.org www.idclinics.com +201001434323
- 3. Endodontic procedures can not be expressed properly unless the moisture in the mouth is properly controlled
- 4. The goals of isolation are… Moisture control Retraction Harm prevention
- 5. What needs to be controlled during Endodontic procedures? Saliva Tongue Mandible Lips & cheek Gingival tissue Buccal & lingual vestibule Floor of the mouth Adjacent teeth and restoration Respiratory moisture
- 6. Patient Related Advantages • Provides comfort to the patient • Protect patients from swallowing or aspirating foreign bodies • Protect patients soft tissues by retracting them.
- 7. Operator Related Advantages • A dry clean field • Infection control • Increased accessibility • Improved properties of materials • Improved visibility & less fogging of mirror • Prevents contamination of root canal preparation
- 8. Classification of the Methods Used to Obtain Isolation 1.Moisture Isolation a.Direct Methods b.Indirect Methods 2.Soft Tissue Isolation a. Retraction of the lips, cheek and tongue b.Retraction of the gingiva
- 9. Direct Methods of Moisture Isolation 1. Rubber dam 2. Cotton rolls & gauze 3. Absorbent cellulose wafers 4. Suction devices 5. Gingival retraction cord
- 10. Indirect Methods of Moisture Isolation 1.Comfortable patient position & relaxed surroundings 2. Local anesthesia 3.Drugs
- 11. Classification of the Methods Used to Obtain Isolation 1.Moisture Isolation a.Direct Methods b.Indirect Methods 2.Soft Tissue Isolation a. Retraction of the lips, cheek and tongue b.Retraction of the gingiva
- 12. Retraction of the Lips, Cheek and Tongue 1.Rubber dam 2.Cotton rolls and holder 3.Tongue guards 4.Throat Shield 5.Tongue depressor 6.Cheek and lip retractors 7.Mouth mirrors 8.Mouth props
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- 14. Retraction of the Gingiva 1.Physico mechanical means a.Rubber Dam b.Retraction cord c.Teflon tape 2.Chemical means 3.Electrochemical means a.Electrocautery b.Laser 4.Surgical means
- 15. Rubber Dam What is it? • It 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. In 1864, S.C.Barnum, a NY city dentist introduced the rubber dam.
- 16. Advantages of Rubber Dam Isolation 16
- 17. Advantages of Rubber Dam Isolation •Act as a raincoat for the tooth (Niqab)
- 18. Advantages of Rubber Dam Isolation •Long term moisture control
- 19. Advantages of Rubber Dam Isolation •Maximum accessibility and visibility
- 20. Advantages of Rubber Dam Isolation •Clean dry field
- 21. Advantages of Rubber Dam Isolation •Protects lips, cheek and tongue
- 22. Advantages of Rubber Dam Isolation •Prevent accidental swallowing and aspiration of foreign bodies
- 23. Advantages of Rubber Dam Isolation •Improves the performance of materials used
- 24. Disadvantages of Rubber Dam Isolation 24
- 25. Disadvantages of Rubber Dam Isolation •Takes time to be applied
- 26. Disadvantages of Rubber Dam Isolation •Communication with the patient is difficult
- 27. Disadvantages of Rubber Dam Isolation •Possible damage to crowns and gingival tissues
- 28. Disadvantages of Rubber Dam Isolation •Insecure clamp maybe swallowed or aspirated
- 29. Possible Contraindications for Rubber Dam Isolation 29
- 30. Possible Contraindications for Rubber Dam Isolation • Asthmatic patients
- 31. Possible Contraindications for Rubber Dam Isolation Latex Allergy
- 32. Possible Contraindications for Rubber Dam Isolation Mouth Breathers
- 33. Possible Contraindications for Rubber Dam Isolation Malposed, tilted teeth (i.e Wisdom teeth)
- 34. Components of the Rubber Dam (Armamentarium) 34
- 35. Armamentarium 1. Rubber dam sheet 2. Rubber dam clamps 3. Rubber dam forceps 4. Rubber dam frame 5. Rubber dam punch 6. Rubber dam Template 7. Scissors Accessories 8. Lubricant 9. Dental floss 10.Rubber dam Napkin 1 2 3 4 56 7 8 9 10
- 36. Rubber Dam Sheet • Material: latex or non-latex • Aailable in rolls or sheets • Sizes- 5”x5” or 6”x6” • Thickness: Light, Medium, Heavy • Comes in different colors
- 37. Rubber Dam Clamps • Functions • Secures the dam to the teeth • Retract the gingiva • Types: • Winged • Wingless
- 38. Rubber Dam Clamps Wingless Clamp Winged Clamp
- 39. Rubber Dam Clamps or Bow or Hole JawBeaks
- 40. Rubber Dam Clamps Winged Clamp
- 41. Rubber Dam Frame • Functions: • Maintains the border of the dam in position • Support the edges of the rubber dam • Retract the soft tissues
- 43. Rubber Dam Forceps • Function: • Used to place and remove clamp on the tooth
- 45. Rubber Dam Punch • Function: Makes holes in the sheet through which the teeth can be isolated • Parts: • Rotating disc with different sized holes • Sharp pointed plunger
- 46. Rubber Dam Punch
- 47. Rubber Dam Template or Stamp • Marks the correct position of the tooth to be isolated on the rubber dam. • Holes should be punched according to arch and missing teeth.
- 49. 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.
- 50. Accessories
- 51. Application of Rubber Dam
- 52. Testing & lubricating the proximal contacts
- 56. 5.Testing the Retainers Stability & Retention
- 57. Positioning the Dam Over the Retainer
- 60. Applying the Anterior Anchor (Optional)
- 61. Passing the Septa Through the Contacts
- 62. Invert the Dam Interproximally
- 63. Inverting the Dam Faciolingually
- 64. Confirming a Properly Placed Rubber Dam
- 65. Checking for Access & Visibility
- 66. Inserting the Wedges (Optional)
- 67. Removal of Rubber Dam
- 70. Remove the Dam
- 71. Wiping the Lips
- 73. Examine the Rubber Dam
- 74. Ashraf RefaiSamir BDS MSc DD HMD Associate Professor of Endodontics Al-Azhar University ashraf_refai@hotmail.com Ashraf Samir Refai www.arefai.edublogs.org www.idclinics.com +201001434323