Use Of Rubber Dam Research Articles

Work experience influences treatment approaches in endodontics: a questionnaire survey among dentists in Western Norway

Objectives: To collect information on endodontic treatment procedures among dentists in the public dental service (PDS) in Western Norway and relate this information to their work experience.Materials and methods: A survey comprised of 35 questions related to personal information, frequency of endodontic treatment, endodontic procedures and treatment principles was distributed electronically to 187 dentists in PDS in two counties of Western Norway.Results: The response rate was 74%, and 130 dentists participated. Among them, 57.0% had completed their education less than 13 years ago, and almost all were below 39 years old (95%). The majority (81.0%) had graduated in Norway. Stepwise caries excavation in primary and permanent teeth and direct pulp capping in primary teeth were more frequently performed by dentists with less than 13 years from graduation. Routine use of rubber dam was high among the responders (87%). However, use of rubber dam and master-cone radiograph uptakes were more frequent among the younger dentists. The majority used rotary instrumentation systems, and almost all participants followed the current guidelines for use of antibiotics in endodontics.Conclusions: In general, dentists in PDS follow the current endodontic treatment guidelines. However, it seems that the more recently graduated dentists perform more endodontic procedures and tend to adhere more to the taught principles regarding rubber dam use and radiograph uptakes.

The secrets of isolation in the cervical area

It is often presumed that, since its introduction in 1864, the use of rubber dam in multiple dental procedures has increased. However, its use is not as widespread as one might expect. There still seem to be many obstacles that prevent clinicians from adopting it as a standard of care. Furthermore, it appears very difficult to scientifically prove the impact of its use on the final outcome of a given procedure. The fundamental idea of isolating the operatory field and preventing contamination is simple; the practical execution of it is more demanding. In this article, the authors not only focus on the essential criteria for predictable isolation, they also present an isolation strategy that can be translated into a step-by-step procedure. It is suggested that by adopting this strategy, clinicians can eliminate the most commonly experienced obstacles and optimize the full potential of isolation, even in extremely difficult clinical situations.

Once Resin Composites and Dental Sealants Release Bisphenol-A, How Might This Affect Our Clinical Management?-A Systematic Review.

(1) Background: Bisphenol A (BPA) based dental resins are commonly used in preventive and reparative dentistry. Since some monomers may remain unpolymerized in the application of dental resin, they dissolve in the saliva. (2) Methods: The literature search was carried out in Pubmed, Cochrane and Embase databases. Randomized controlled trials, cohort studies and case-control studies that evaluated BPA levels in human urine, saliva and/or blood were included. (3) Results: The initial search had 5111 results. A total of 20 studies were included in the systematic review. Most studies showed an increase of the levels of bisphenol A 1 h after treatments with composite resins and dental sealants. One week after treatments the levels were decreased. (4) Conclusions: Some clinical precautions should be taken to decrease the release of BPA, namely the use of rubber dam, the immediate polishing of all resins used, or the use of glycerin gel to avoid non-polymerization of the last resin layer, and mouthwash after treatment. Another preventive measure in addition to the above-mentioned is the use of the smallest possible number of restorations or sealants, a maximum of four per appointment. These measures are even more important in children, adolescents and pregnant women.

Endodontic infection control routines among general dental practitioners in Sweden and Norway: a questionnaire survey

Objective: The purpose of this study was to investigate endodontic infection prevention and control routines among general dental practitioners in Sweden and Norway.Materials and methods: A questionnaire was sent by email to 1384 general dental practitioners employed in Sweden and Norway. The participants were asked questions concerning different aspects of infection prevention and control during endodontic treatment; use of rubber dam, sealing of rubber dam, antibacterial solutions, and use of hand disinfectant and gloves.Results: The response rate was 61.4% (n: 819). 96.9% reported routinely using rubber dam during endodontic treatment. 88.3% reported always, or sometimes, sealing the area between rubber dam and tooth. Most disinfected the endodontic operative field, but the antibacterial solutions used varied. 11.9% did not use gloves at all during treatment, and 10.5% did not use hand disinfectant during treatment.Conclusions: Most of the general dental practitioners took measures to establish and maintain aseptics during endodontic treatment, which infers an awareness of the importance of endodontic infection prevention and control. But the results were self-reported and there may be a gap between claimed and actual behaviour. Further studies using observation methodologies are needed to assess how infection control routines are performed in everyday clinical practice.

The teaching of posterior composites: A survey of dental schools in Oceania

ObjectiveTo investigate current teaching and operative techniques of posterior composite restorations in dental schools in Oceania (Australia, New Zealand, Fiji and Papua New Guinea). MethodsA 24-item validated questionnaire including closed and open questions was mailed to the Heads of Department of Operative/Restorative Dentistry in 16 dental schools. Responses were compiled in Excel and analyzed. ResultsThe response rate of this study was of 94% (n = 15). All respondent schools taught the use of posterior composites for occlusal and occluso-proximal cavities in premolars and molars. The mean percentage of preclinical teaching devoted to composites was greater than for amalgam (39% vs 29%). This proportion was anticipated to be 3:1 for posterior composite/amalgam in five years’ time. Most posterior restorations placed by students are composites (average 64%, ranging from 10 to 100%), with amalgam representing 19.5% of the restorations placed (ranging from 0%–50%). Slot-type cavities were the preparation techniques most commonly taught (80%) and most schools (67%) teach the mandatory use of rubber dam for moisture control. The most common contraindication to composite placement (67% of the schools) was a history of adverse reaction to composites. The phase down of teaching and use of amalgam in Oceania is expected to occur within 8–10 years. ConclusionsDespite minimally invasive approaches becoming increasingly common worldwide, the use of amalgam is still taught in Oceania. Future studies should assess whether the clinical teaching of posterior composites is in keeping with material development and trends in mainstream dental practice.

Impact of different restorative treatments for deep caries lesion in primary teeth (CEPECO 1) \u2013 study protocol for a noninferiority randomized clinical trial

BackgroundDue to the lack of evidence to determine the best treatment for deep cavitated caries lesions in primary molars, the search for an effective restorative technique, which results in a minimal discomfort to patients, and reduce the time needed for the treatment, becomes relevant. The objective of this randomized clinical trial was to evaluate if high-viscosity glass ionomer cement (HVGIC) restorations is noninferior to restoration with calcium hydroxide cement associated with HVGIC for treatment of deep lesions in primary molars, as well as the impact of the treatments on cost and discomfort of the patient.MethodsA non-inferiority randomized clinical trial with two parallels arms (1:1) will be conducted. Children with 4 to 8 years will be selected at Clinic of Pediatric Dentistry at Ibirapuera University. 108 teeth will be randomized into two groups: (1) Calcium hydroxide cement associated with HVGIC and (2) HVGIC restoration. Primary outcome will be considered the pulp vitality and to be evaluated after 6, 12, 18 and 24 months by two calibrated examiners. Survival of restorations will also be evaluated in the equal intervals. The duration of dentals treatment and the cost of all materials used will be considered for estimating of cost-efficacy of each treatment. Individual discomfort will be measured after each dental procedure using the Wong-Baker’s Facial Scale. For the primary outcome, Kaplan-Meier survival and the long-rank test will be used to comparison between the groups. Cox regression will be performed to assess the influence of variables on the outcome. For all analyzes, the significance level is set at 5%.DiscussionBased on the philosophy of ART, our hypothesis is that the HVGIC restoration is a possible approach to restore the deep caries lesion with pulp vitality without the use of rubber dam and anesthesia.Trial registrationClinicaltrials.gov registration NCT02903979. Registered on June 9th 2016.

Attitudes of Libyan Patients towards the Use of Rubber Dam in Endodontic Treatment in Benghazi

Aims: this study investigated the attitudes of adult patients in Benghazi towards the use of rubber dam (RD) and evaluated time needed for rubber dam application and duration of use. Methodology: A self-administrated questionnaire was designed and distributed to 200 patients receiving endodontic treatment by: (a) General Dental Practitioners (GDPs) (b) Endodontists. Patients were kindly requested to fill the questionnaire directly after the treatment. Data were entered into a database and subsequently analyzed using SPSS. Results: The majority of patients (77% and 70%) whom were treated by endodontists and GDPs respectively reported they would prefer RD to be used at their next appointment, and most had a positive attitude of the experience. A statistically significant association between age and gender was found among the GDPs' patients (P<0.05). 87.9% and 65.6% of patients whom were treated by endodontists and GPDs respectively reported that the operators sufficiently explained the purpose of rubber dam to them, a statistically significant difference between the two groups of patients (P<0.001) was reported. The mean time needed for rubber dam placement was 4.28 min for GDPs and 1.10 minutes for endodontists, which was statistically significant. A significant difference between the two groups of patients with regards to their opinions toward the benefit of using the rubber dam was noticed (P< 0.05). Prolonged RD use exhibited association with a negative opinion of the experience of RD. Conclusions: Patients generally showed a positive attitude towards the RD. Moreover, some patients showed a negative attitude because of time taken by inexperienced operator in placement of rubber dam.

Undergraduate dentistry students' perception of difficulties regarding endodontic treatment.

The present study aimed to identify students' perceptions of endodontic treatment at a Brazilian university through a survey, which analysed student profiles and their difficulties in 2016. One hundred and two students who had experienced endodontic, laboratory or clinical procedures answered a survey based on their experiences, regarding their perceptions, experience and self-confidence levels. Results demonstrated that there was no significant difficulty among students regarding anaesthesia, rubber dam use, chamber access, working length determination, instrumentation, root filling and temporary restoration procedures during endodontic treatment. However, problems were observed regarding radiographic examination (mainly in separating root canals) and the choice of intracanal medication. The present study also raised a question regarding dental education: how can endodontic education be improved by addressing students' perceived difficulties? Evaluating the major student difficulties during root canal therapy can help the improvement of teaching strategies during preclinical and clinical teaching.

Dental Dam Application for Endodontics in Dogs-A Novel Clamp Kit.

Although rubber dams are widely used in endodontic treatment in humans with well-known advantages, their use in veterinary medicine is uncommon. The use of a dental rubber dam provides better control of cross-infection, prevents soft tissue contact of chemicals, and improves treatment efficiency. The purpose of this article is to describe a new line of clamps specifically designed for dogs and to review the procedure and materials used for isolating the operative field in endodontic patients. This new design of clamps, better adapted to canine tooth anatomy with different sizes and conformations, has been successfully used in dogs by the authors with good clinical results. The clamps allow for better adaptation to the tooth without injuring the gingiva or the furcation and provide increased retention of the dam for more effective isolation. Given the proven benefits in humans, the authors expect that the widespread use of a rubber dam with clamps specifically designed for canine dental anatomy will improve clinical outcomes in endodontics.

The longevity of posterior restorations in primary teeth.

Data sourcesSciVerse Scopus, ISIS Web of Science, Cochrane library, Medline/PubMed. Studies published from 1996 to 2017 in English were considered.Study selectionTwo independent reviewers screened the literature. Randomised clinical trials, non-randomised clinical trials with parallel groups or single group, retrospective studies) evaluating different posterior restorations (class I, class II restorations and crowns) with different materials (amalgam, compomer, composite, glass ionomer cement, stainless steel crown) placed in primary teeth by reporting different outcomes measures (survival rate, success rate, annual failure rate).Data extraction and synthesisTwo independent reviewers extracted data. Risk of bias was assessed using the Cochrane tool. A qualitative analysis was conducted.ResultsThirty-one studies were included. Seven different materials were used for restorations: amalgam (six studies), compomer (nine studies), composite (six studies), conventional glass ionomer cement (five studies), metal-reinforced glass ionomer cement (MRGIC) (four studies), resin-modified glass ionomer cement (ten studies), and stainless steel crown (SSC) (three studies). When considering the annual failure rate (AFR), composite showed the lowest (1.7-12.9%) and MRGIC showed the highest (10.0-29.9%). For the success rate, SSC presented the highest (96.1%) and MRGIC presented the lowest (57.4%). Class I restorations and restorations placed under the use of rubber dam revealed better results in both AFR and success rate. The main reason for failure was secondary caries.ConclusionsThere is a large variation in longevity of posterior restorations in primary teeth. Secondary caries is the main reason causing failure.

Ten-year follow-up on adoption of endodontic technology and clinical guidelines amongst Danish general dental practitioners

Objective: The aim of this study was to re-assess the adoption of certain endodontic technology and central treatment principles of root canal treatments as advocated by guidelines presented by the European Society of Endodontology.Material and methods: The questionnaire included the same questions in 2003 and 2013. The general dental practitioners (GDPs) anonymously reported how frequent (‘often’, ‘occasionally’, and ‘never’) they used certain endodontic technology and adhered to central treatment principles. The statistical analyses were performed using Chi-squared test and Goodman–Kruskal’s γ-coefficient as an association measure.Results: The overall response rate of the 2013 group was 46.5% (n = 531). The frequencies of GDPs reporting often use of rubber dam, apex locator and rotary NiTi instruments were significantly higher (p < .0001) than in 2003, as well as reporting the use of composite resin for coronal sealing (p < .019). Adoption was significantly influenced by the factors gender (p = .601) and time since graduation (p = .361), and the cluster analyses revealed the neglected use of rubber dam to be associated with no established postoperative recall system.Conclusions: After 10 years, there was a higher frequency of GDPs who had adopted certain endodontic technologies. However, progress towards high-quality root canal treatment might be obstructed as the majority of GDPs avoids consistent use of rubber dam, and routinely neglects recalls for postoperative controls of their endodontic treatments.

Undergraduate dental students' perception, educational satisfaction, and attitude regarding the use of rubber dam

Background and Objective: The rubber dam is used in dentistry to create saliva-free working environment during operative procedures. Despite its numerous advantages, utilization is poor in dental schools. We sought to determine undergraduate dental students' perception, educational satisfaction, and attitude regarding the use of rubber dam. Materials and Methods: This cross-sectional survey was carried out among 5th and 6th year undergraduate dental students. A structured questionnaire was developed that sought their perception, educational satisfaction, and attitude regarding the use of rubber dam. Data collected were analyzed using IBM SPSS version 21.0. P <0.05 was considered statistically significant. Results: One hundred and nine students participated in the study; 66 (60.6%) females and 43 (39.4%) males with a mean age of 23.4 ± 2.02. Most of the students, i.e., 73 (67%) were satisfied with their classroom experience with regard to the use of rubber dam but were least satisfied with their laboratory and clinical training. There was a statistically significant association between the students' satisfaction with their training in the use of rubber dam and the confidence to use the rubber dam on their patients (P = 0.001). Conclusion: The students agreed to the importance of rubber dam but were not satisfied with their hands-on clinical training. The use of rubber dam postgraduation may be influenced by the dental educator's method of training, motivation, and consistency in its use. Students who acquire competence and are confident in the use of rubber dam during their undergraduate training are more likely to continue to use the skills following graduation.

Experience and Practicality of Rubber Dam Use among Undergraduate Dental Students in Fiji

Background: Every dental school has the responsibility to teach its students the ideal techniques of isolation prior to the clinical procedure. Rubber dam is considered to be an essential tool for conservative dentistry; hence its preclinical training to dental students is of uttermost importance. Due to lack of previous study, this study aims to assess the experience of undergraduate dental students at Fiji National University (FNU) on use of rubber dam. Methodology: This is a cross-sectional quantitative study whereby 48 self-administrated questionnaires were distributed among the third, fourth and fifth year dental students at FNU. All the students in that respective year were also observed for the time taken to place rubber dam using an observation checklist. The data was analyzed using the Epi-Info software. Results: A 100% response rate was obtained. Among the 48 participants, 30 were females and 18 were males. 75% of the participants stated moisture control as the major advantage of rubber dam use. Difficulty in placing rubber dams was a main disadvantage highlighted by 35% of the student while 27% stated that placing rubber dam took up extra clinical time. The mean time taken to place rubber dam was 6 minutes to the nearest minute on adult patients. Students preferred to use cotton rolls for isolation during Glass Ionomer Cement (79%) and Amalgam (65%) procedures. Majority of the students felt that the training and teaching sessions on rubber dam are sufficient. The major problems identified by students while placing rubber dam were lack of appropriate clamps, patient acceptance and compliance. Conclusion: The level of knowledge among undergraduate students on the advantages and disadvantages of rubber dam is high. There are various factors in practice and training that could be emphasized to encourage students on future use of rubber dam. Among the undergraduate dental students there was still a high possibility that they might not practice routine placement of rubber dam after graduation. There is scope for further study on the rubber dam practice of general dental practitioners.

Factors associated with patients' satisfaction of rubber dam use during root canal treatment.

The use of rubber dam (RD) has been recommended in dental procedures including root canal treatment. The aim of the study was to identify factors that were associated with patients' satisfaction and acceptance of RD. This was a cross-sectional study, conducted from January 2015 to December 2016 at Kuwait University School of Dentistry. A pretested questionnaire was used by a face-to-face interview of patients after taking informed consent. The study was approved by the Institutional Ethics Review Board. The providers/operators who applied RD were grouped into three categories: undergraduate final year (7th year) dental students; general dentists and postgraduate students; and specialists. Mean age of the patients (n = 175) was 31.6 ± 13.0 years. About 55% had past experience, and 52% expressed a better experience during the current procedure compared with the previous one. A positive experience during the current procedure correlated significantly with the future intention of RD use (r = 0.244, P = 0.001). Time needed for RD application was short (4 min), irrespective of the operators. The duration of RD use during the procedure was significantly shorter among dental specialists compared with the other groups. Time for RD application was the only significant predictor for patient satisfaction, after controlling for other independent variables. Based on the positive influence of current RD use on the future intention, dentists should spend time needed to explain the importance, safety and effectiveness of RD use with their patients.

Current trends in technological armamentarium and treatment among Brazilian endodontists

Aim: To determine the current trends in technological armamentarium and endodontic treatment among Brazilian endodontists. Methods: A total of 279 endodontists answered a web-based survey questionnaire about their region of activity in Brazil and years as a specialist, average number of endodontic cases treated per month, number of visits to complete the treatment, use of rubber dam for isolation, type of irrigant, obturation technique and device used for this purpose, temporary filling materials, and greater difficulty encountered during treatment and technological armamentarium. A descriptive analysis, expressed in terms of frequency and percentage, was performed and the data were correlated using the chi-square test (p0.05). Results: Most of the respondents had up to 10 years as specialists. More than 50% of endodontists preferred to complete the endodontic treatment in a single visit. Ninety-nine percent of endodontists used rubber dam for isolation. NaOCl was the most widely used irrigant. Most of the respondents associated different techniques for root canal filling. Lateral condensation and Continuous wave of condensation were the isolated technique most reported. Filling devices (thermocompactors) were used by 53% of endodontists. Glass ionomer was the preferred temporary filling material. The answers for the use of technological armamentarium revealing that 94% of endodontists used an apex locator; 67.38% utilized magnification (loupe: 23.66%; microscope: 35.48%; microscope and loupe: 8.24%); 58% reported to digital radiography; and 47.31% used computed tomography as a complementary tool. About mechanized instrumentation, 44.44% endodontists employed rotary and reciprocating files. The difficulties encountered during endodontic treatment were classified as preparation &gt; access &gt; obturation &gt; anesthesia &gt; isolation. Conclusions: Most endodontists have implemented new technologies, such as mechanical instrumentation, apex locators, magnification, digital radiography, computed tomography, ultrasound, and obturation tools, in their clinical practice.

Rubber Dam: Is it a Popular Method of Field Isolation among Dentists in Karachi?

Objective: To find out the frequency of rubber dam usage among clinical students, interns and dental practitioners and the barriers they come across to place it routinely in their practices.&#x0D; Methods: An observational cross-sectional study was performed from October 2016 to January 2017 using non-probability convenience sampling. A questionnaire was meticulously designed based on questionnaires used in similar studies in the past. The target population in this study was clinical dental students, interns and the faculty members working in various teaching institutions in Karachi and involved in general dental practice. Data from completed questionnaire was analysed using SPSS version 20.&#x0D; Results: With the healthy response rate of 81%, this study shows that the majority (76%) of clinical students, interns and practicing dentists in Karachi, Pakistan continue to ignore the rubber dam placement in their routine practices. Total 89% of non-users did not use it as they find it time con- suming and 66% of them mentioned that it is difficult to place. Couple of other reasons for which more than 50% of respondents avoid using rubber dam are frequent tearing of the sheet and patient's fear or abhorring attitude towards placement of rubber dam.&#x0D; Conclusion: This study suggests that use of rubber dam is an unpopular method for isolation of op- erative site among clinical students, interns and clinicians working in Karachi.

Association of Failed Root Canal Treatment with Dentist and Institutional Volumes: A Population-based Cohort Study in Taiwan

IntroductionThe volume-outcome relationships in failed root canal treatments (RCTs) are rarely studied. Thus, we aimed to examine the association of failed RCTs with dentist and institutional volumes. MethodsAmbulatory dental claims (2005–2010) of 1 million beneficiaries randomly selected from the National Health Insurance Research Database of Taiwan were used. This study is a population-based cohort study using a marginal Cox proportional hazards regression model in which the outcome variables cluster around individual patients. A total of 458,557 teeth that received first-ever RCT from 2005 to 2010 and were followed up until the end of 2010 were identified as the tooth cohort. These teeth were aggregated to 244,368 patients, 10,901 dentists, and 7122 institutions for analysis. ResultsDentists in the second, third, and highest quartiles all showed a significantly lower hazard ratio of failed RCTs than those with the lowest case volume, and their adjusted hazard ratios (aHRs) were 0.93, 0.92, and 0.90, respectively. Medical institutions in the second, third, and highest quartiles also showed a significantly lower hazard ratio of failed RCTs than those with the lowest case volume, and their aHRs were 0.93, 0.89, and 0.81, respectively. Teeth with a history of periodontitis also exhibited a significantly higher aHR of failure events. The use of rubber dams significantly reduced the rates of failed RCTs. ConclusionsDentists and institutions with high care volumes tended to show good RCT outcomes. Such an effect was prominent and robust among dental institutions.

A Retrospective, Radiographic Outcomes Assessment of 1960 Initial Posterior Root Canal Treatments Performed by Endodontists and Dentists

IntroductionThe Air Force Dental Service has established evidence-based treatment standards for endodontics, including 3-dimensional filling of the canal system, cuspal coverage restoration of endodontically treated posterior teeth, and use of rubber dam. The purpose of this retrospective study was to determine the effect of these standards on outcomes of initial posterior root canal treatments (RCTs) completed by Air Force (AF) and civilian dentists with and without accredited postgraduate training. MethodsTreatment and follow-up radiographs of AF members who had an initial posterior RCT completed in 2011 were evaluated. A survey of all radiographs was performed to determine the (1) RCT obturation quality, (2) healing of periapical pathosis, and (3) presence and quality of cuspal coverage restorations. ResultsA total of 2262 RCTs were examined, with 1960 RCTs meeting inclusion criteria for at least 1 evaluation category. For RCT obturation quality, 1810 RCTs were evaluated, and 96.0% were considered adequate. For cuspal coverage restorations, 1856 RCTs were evaluated, and of these 2.7% were inadequately restored. Healing of periapical pathosis was 91.5% and 85.7% for AF and referred civilian providers, respectively. Survivability was 94.4% for endodontists, 95.3% for AF general dentists with additional training, 87.9% for AF general dentists without additional training, and 78.4% for civilian general dentists. Overall, survivability was 94.1% for a follow-up period ranging up to 47 months, with a mean of 27 months. ConclusionsIn this retrospective, radiographic analysis, evidence-based practices as followed in the Air Force Dental Service and accredited postgraduate training resulted in improved treatment outcomes.

Attitude and knowledge of isolation in operative field among undergraduate dental students.

Objective:The purpose of this study was to evaluate the general attitude of undergraduate dental students toward rubber dam use, specifically focusing on operative procedures before starting to serve community.Methods:Questionnaires were distributed to undergraduate clinical years' students of two private colleges; Al-Farabi Dental College, Riyadh, KSA and Buraidah Private Colleges, Qassim, KSA. Questions were asked about areas where the students used rubber dam in operative procedures, in which types of caries classes, and in which type of restoration they frequently used the rubber dam.Results:We found that students of both private dental colleges agreed with the opinions that proper isolation cannot be achieved for the restoration of operative procedures without using rubber dam and restoration placed under rubber dam have a greater longevity than those placed without.Conclusions:Within the limitations of the present study, it can be concluded that the perceptions of dental students on rubber dam need to be improved and strategies should be developed so that this valuable adjunct will comprise one of the indispensable elements of dental care.

Rubber dam isolation for restorative treatment in dental patients.

Successful restorations in dental patients depend largely on the effective control of moisture and microbes during the procedure. The rubber dam technique has been one of the most widely used isolation methods in dental restorative treatments. The evidence on the effects of rubber dam usage on the longevity of dental restorations is conflicting. Therefore, it is important to summarise the available evidence to determine the effects of this method. To assess the effects of rubber dam isolation compared with other types of isolation used for direct and indirect restorative treatments in dental patients. We searched the following electronic databases: Cochrane Oral Health's Trials Register (searched 17 August 2016), Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 7) in the Cochrane Library (searched 17 August 2016), MEDLINE Ovid (1946 to 17 August 2016), Embase Ovid (1980 to 17 August 2016), LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 17 August 2016), SciELO BIREME Virtual Health Library (1998 to 17 August 2016), Chinese BioMedical Literature Database (CBM, in Chinese) (1978 to 30 August 2016), VIP (in Chinese) (1989 to 30 August 2016), and China National Knowledge Infrastructure (CNKI, in Chinese) (1994 to 30 August 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform, OpenGrey and Sciencepaper Online (in Chinese) for ongoing trials. There were no restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (including split-mouth trials) assessing the effects of rubber dam isolation for restorative treatments in dental patients. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias of the included studies. We resolved disagreement by discussion. We included four studies that analysed 1270 participants (among which 233 participants were lost to follow-up). All the included studies were at high risk of bias. We excluded one trial from the analysis due to inconsistencies in the presented data.The results indicated that dental restorations had a significantly higher survival rate in the rubber dam isolation group compared to the cotton roll isolation group at six months in participants receiving composite restorative treatment of non-carious cervical lesions (risk ratio (RR) 1.19, 95% confidence interval (CI) 1.04 to 1.37, very low-quality evidence). It also showed that the rubber dam group had a lower risk of failure at two years in children undergoing proximal atraumatic restorative treatment in primary molars (hazard ratio (HR) 0.80, 95% CI 0.66 to 0.97, very low-quality evidence). One trial reported limited data showing that rubber dam usage during fissure sealing might shorten the treatment time. None of the included studies mentioned adverse effects or reported the direct cost of the treatment, or the level of patient acceptance/satisfaction. There was also no evidence evaluating the effects of rubber dam usage on the quality of the restorations. We found some very low-quality evidence, from single studies, suggesting that rubber dam usage in dental direct restorative treatments may lead to a lower failure rate of the restorations, compared with the failure rate for cotton roll usage. Further high quality research evaluating the effects of rubber dam usage on different types of restorative treatments is required.