Rubber Dam Placement Research Articles

The influence of dental operating microscope in locating the mesiolingual canal orifice.

The purpose of this study was to evaluate the influence of using the dental operating microscope (DOM) for detection of the mesiolingual (ML) canal orifice in extracted maxillary molars compared with unaided vision (no loupes or headlamps). Using a clinical simulation model system, we mounted 39 maxillary molars in a dentoform and placed them into a mannequin. After rubber dam placement and preparation of standard access, 2 attempts were made to locate the ML canal with unaided vision. Then the teeth were examined by using a DOM. Finally, all teeth were sectioned, stained, and evaluated with the DOM for actual presence of an ML canal. ML canal orifices were detected in 20 of the teeth with a sharp explorer and mirror. In the remaining teeth, 12 ML canal orifice were located by using the DOM. Qualitative nonparametric comparisons were used. The results of this study indicate that the DOM provides increased opportunity for the dentist to detect canal orifices.

Allergic Reaction After Rubber Dam Placement

In the last few years allergic reactions to natural rubber latex (NRL) have increased in dental practice affecting both the dental team and patients. Some case reports discuss the potential risks of hypersensitivity to NRL products. An adverse patient reaction after dental rubber dam placement is reported. About 1 min after the isolation of the tooth with a rubber dam the patient presented signs and symptoms of hypersensitivity. Oxygen and intravenous hydrocortisone were administered and the patient kept under observation. After 2 h she had stable vital signs and no more allergics symptoms. It is unclear whether components of the NRL dam or the cornstarch powder incorporated with the rubber dam was responsible for the allergic reaction. Dentists must be aware of the health problem and be prepared for an adequate management in dental practice.

Using Rubber Dams to Boost Quality, Quantity of Restorative Services

Rubber dam use for restorative dentistry is far too low. If practitioners realized rubber dam's advantages and increased treatment quality, its use would be irresistible. Few other dental procedures offer both an increase in operating speed and treatment quality. To save the most time, competent auxiliary staff should be taught to place rubber dams before the clinical procedure begins. (Additional information on rubber dam placement by auxiliary staff is available from Dr. Christensen.)

A simplified method of rubber dam placement

3. 4. 5. Stretch the rubber dam loosely over the frame. Punch only two holes in the dam approximately 2 cm apart. Make a straight scissors cut between the holes. Place a winged clamp on the posterior tooth. Stretch the dam over the clamp and carry the dam anteriorly over the canine or from the first premolar to the first premolar to isolate the anterior segment. Advantages of this simplified placement method are as follows: 1. Rapid and easy placement can be done by an assistant. 2. Removal is simplified should anesthetic reinjection become necessary, should a medical emergency require immediate clearing of the airway, or for the end of the appointment. 3. There are no interproximal rubber septa to become entangled in the bur or diamond instrument. 4. The rubber is less likely to tear when stretched over the clamp. 5. Moisture is easily controlled by standard high-volume suction even though the dam is not sealed around the neck of each tooth.

Provisional restorations for traumatically injured teeth requiring endodontic treatment

The acid-etch-composite resin technique is used to retain a provisional restoration during the course of endodontic treatment. As described, the use of a gutta percha cone during the buildup and bonding to adjacent teeth provides the following: (1) good esthetics during endodontic treatment, (2) good support for rubber dam placement, (3) good entry to the canal, (4) good coronal seal for medication within the canal, and (5) good function as required by the provisional crown.