ISOLATION

BY :ASMI PATEL
[805]
DEFINATION :

Separation of tooth or group of teeth from oral tissues and saliva by

use of dental dam , cotton rolls or other means to improve
access ,visibility and control moisture contamination during
restrorative or operative dental procedure known as isolation
 CONTENTS
1.Dam Sheet
4.Rubber Dam Fram1.Isolation
2.Rubber Dam introduction
3.Rubber e
5.Rubber Dam Clamp
6.Rubber Dam Punch
7.Rubber Dam Forceps
8.Napkin
9.Lubricants
10.Hole positioning guide
 Isolation
•The goals of operating field isolation are:
A. Moisture control
B. Retraction and access
C. Patient safety

• Different methods of isolation:

A. Rubber Dam
B. Cotton rolls and Wafers
C. Suction devices
 Cotton
rolls

Gauze Absorbent cellulose

pieces wafers

Suction devices
RUBBER DAM
 Introduction
-Given by Sanford Barnum, in 1864
-Reasons for use of rubber dam:
A. Prevention of salivary and bacterial contamination
B. Elimination of the risk of aspiration and swallowing of
instruments
C. Prevention of spillage of irrigating solution’s in oral cavity
ADVANTAGES :
1. Improved access and visibility
2. Optimisation of dental material properties
3. Protection of the patient and the operator
4. Operating efficiency
DISADVANTAGES :
5. Time consumption
6. Patient denial
7. Latex allergy
8. Insufficiently erupted tooth
9. Malpositioned tooth
10.Some 3rd molars
 RUBBER DAM KIT

RUBBER DAM SHEET RUBBER DAM

LUBRICANT RUBBER DAM
SHEET NAPKIN PUNCH

RUBBER DAM SHEETS

FRAME FORCEPS
CLAMPS HOLE POSITIONING
GUIDE
 RUBBER DAM SHEETS
• 15 x 15 cm or 6 x 6 inches
•Available in 5 different thicknesses:
a. Thin
b. Medium
c. Heavy
d. Super heavy
e. Extra heavy
• They are also available in different colours
• Material used : Latex, Latex-free sheets also available for
patients with latex allergies
• It has two side a shiny side and matte/dull side, and the dull
side should always face the operator to avoid reflection of
light in eyes while operating
• Shelf life- 1 year
• During summers they might stick with each other, and to
prevent that,
1. Sprinkle powder between them
2. Store them in refrigerator
 RUBBER DAM FRAME
• Support the edges of the sheet and retract the soft tissue
• It can be metal or plastic
• Available in 2 designs:
a. Young’s design, they are ‘U’ shape
b. Nygaard Ostby design
• Advantages of plastic frame: They are useful when
radiographs are to be taken with entire assembly, as they
are radioluscent they do not interfere with the imaging
• But they cannot be autoclaved, rather they have to be
disinfected
• All frames have points and pegs to which rubber sheet is
stretched.
 RUBBER DAM CLAMP
• Also known as retainer
• Used to anchor the dam to the tooth to be isolated
• Comprises of 4 prongs, 2 jaws, connected by a bow
• 2 main groups according to jaw design:
1. Bland : Winged
Wingless
2. Retentive : Winged
Wingless
• To be secure a clamp must fit around the tooth below the level of
maximum crown width
• The points of the jaws of the clamps must all contact the crown below
this level in 4 areas, 2 on facial surface and 2 on lingual surface, this is
called ‘4 point contact’.
• It prevents tilting and rocking of the retainer
• This is achieved by selecting those clamps in which the length of clamp
jaws relate to the mesiodistal width of root. The jaws should not extend
the mesial and distal line angles of tooth because:
1. They may interfere with placement of matrix and wedges
2. Gingival trauma is more likely to occur
3. Complete seal around the anchor tooth is more difficult to achieve
•Correct placement of clamp is achieved when:
1. When the bow is to the distal
2. All 4 points of jaws are in contact with the tooth
3. The clamp is gripping the crown of the tooth below its maximum convexity
 ALTERNATION TO CLAMPS:
• Employs area beneath interdental
contacts for retention
• These include:
I. Wedges inserted below contact points
II. Rubber strip passed under tension
through contact point and released to
lie beneath the contact area
III.Ligatures of dental floss tied around
neck of tooth
 RUBBER DAM PUNCH
•Precision instrument with rotating metal table
• Used to produce clean cut holes in rubber sheet
• 2 types of holes are made:
a. Single hole, e.g. Dentsply single hole punch
b. Multi-hole, e.g. Ivory pattern punch
• Should be regularly checked for wear and tear,
because of 2 problems:
1. Blunting of sharp cutting edge to the anvil holes,
usually due to prolong use
2. Damage to punch point and anvil as a result of
incorrect alignment
• Size of hole depends on:
1. whether or not tooth is to be clamped
2. Cervical diameter of tooth
3. Elasticity of rubber dam being used
 RUBBER DAM FORCEPS
•They are needed to stretch jaws of
clamps open in a controlled manner
during placement and removal
• There are 3 widely used designs:
a. Ash/stokes pattern
b. Ivory pattern
c. University of washington pattern
• They have a sliding ring between the
hinge and forceps handle which can
hold the forcep open and so hold the
clamp under tension
 RUBBER DAM NAPKIN
Made up of an absorbent material, can be
a paper or cloth
Available in small/large size
Following are it’s advantages:
1. Prevents direct contact between
rubber sheet and skin to reduce possibility
of allergy
2. Absorbs saliva seeping at the corners
of the mouth
3. Acts as a cushion
4. Provides a convenient method of
wiping patient’s lips after dam removal
 LUBRICANTS
•Water soluble
• Rubber dam lubricant is commercially available,
WINK
• Instead of that, one can also use, shaving foam or
soap slurry
• Cocoa butter/ vaseline should not be used as
lubricant; as they are oil based and cannot be rinsed
easily after rubber dam placement, they can rather
be used to apply as a non-irritant at corners of
mouth
• Applied at in the areas of punched holes facilitate
the passing of dam septae through proximal
contacts
 HOLE POSITIONING GUIDE

a.Template: They are available to guide the

marking of dam. These templates are
approximately the same size and shape as
unstretched dam itself
b.Rubber dam stamp: PTeeth as a guide:
The cusp tips of posteriors and incisal
edges of anteriors can be visualized
through the dam, and the centers of teeth
are marked on the dam with a pen
c. Provides a convenient method to mark the
dam for punching
THANK YOU