ISOLATION OF THE ISOLATION OF THE OPERATING FIELDOPERATING FIELD

Isolating the working area includes Isolating the working area includes

1.Isolation from moisture like saliva, blood 1.Isolation from moisture like saliva, blood and gingival crevicular fieldand gingival crevicular field2. Isolation from soft tissues like lips, 2. Isolation from soft tissues like lips, cheeks, gingiva and tonguecheeks, gingiva and tongue

Isolation from moistureIsolation from moisture

Direct methodsDirect methods 1. Rubber dam1. Rubber dam 2. cotton rolls & cotton roll holder2. cotton rolls & cotton roll holder 3. gauze pieces3. gauze pieces 4. absorbent wafers4. absorbent wafers 5. Suction devices.5. Suction devices. 6. Gingival retraction cord6. Gingival retraction cord

Indirect methodsIndirect methods

1.comfortable position of the pt. and relaxed 1.comfortable position of the pt. and relaxed surroundingssurroundings

2. local anaesthesia2. local anaesthesia3.drugs3.drugs anti sialogoguesanti sialogogues anti anxiety drugsanti anxiety drugs muscle relaxantsmuscle relaxants

Rubber damRubber dam

Introduced by Introduced by Dr.S C .Barnum (1864)Dr.S C .Barnum (1864) Purpose #Purpose # Isolation of operating site from moistureIsolation of operating site from moisture Retraction of soft tissueRetraction of soft tissue Increases accessibility and visibilityIncreases accessibility and visibility Improves efficiency of operatorImproves efficiency of operator Protection of pt. and operatorProtection of pt. and operator

Use of rubber dam should be avoided inUse of rubber dam should be avoided in Asthmatics and mouth breathersAsthmatics and mouth breathers Partially erupted and malpositioned teethPartially erupted and malpositioned teeth Psychological reasonsPsychological reasons

Armamentarium Armamentarium A. rubber dam sheetsA. rubber dam sheets 5”x5’’ or 6’’x6’’ square5”x5’’ or 6’’x6’’ squareB. Rubber dam clamps (retainer)B. Rubber dam clamps (retainer) winged/winglesswinged/winglessC. Rubber dam retainer forcepsC. Rubber dam retainer forcepsD. Rubber dam holder ( frame)D. Rubber dam holder ( frame) U shaped and could be an adult or U shaped and could be an adult or paedodontic one made of metal or plasticpaedodontic one made of metal or plasticE. Rubber dam punchE. Rubber dam punchF. Rubber dam template/stampF. Rubber dam template/stampG. Dental flossG. Dental floss

Cotton rolls and cotton roll holderCotton rolls and cotton roll holder

Moisture absorbents and aid in minimally Moisture absorbents and aid in minimally retracting soft tissuesretracting soft tissues

When used with LA provide acceptable dryness.When used with LA provide acceptable dryness. loose cotton can be rolled into rollsloose cotton can be rolled into rolls prefabricated also available( small & medium prefabricated also available( small & medium

sizes) sizes)

Gauze pieceGauze piece

Available in 2x2 inch or larger sizes.Available in 2x2 inch or larger sizes.Performed same function as cotton rolls.Performed same function as cotton rolls.Can be used as throat screens when Can be used as throat screens when minute instruments are being used to minute instruments are being used to avoid accidental aspiration.avoid accidental aspiration.

Absorbent pads/wafersAbsorbent pads/wafers

Available in different shapesAvailable in different shapesUsed inside the cheeks to cover the Used inside the cheeks to cover the parotid ductsparotid ducts

Evacuation systemsEvacuation systems

High volume evacuatorHigh volume evacuator Adv: removes shavings of tooth and Adv: removes shavings of tooth and restorative materialrestorative material Toxic material readily removedToxic material readily removed Decreases treatment timeDecreases treatment time

Low volume evacuator Low volume evacuator BBasically saliva ejectors. Can be left in asically saliva ejectors. Can be left in

mouth during operative proceduremouth during operative procedure Available in disposable plastic tips, autoclavable Available in disposable plastic tips, autoclavable

metallic tipsmetallic tips

Gingival retraction cordGingival retraction cord

Ready made cotton or synthetic fibers Ready made cotton or synthetic fibers woven in the form of cordswoven in the form of cordsTypes Types ::

BraidedBraided Non braidedNon braided PlainPlain Impregnated Impregnated

Uses :Uses :Provides access and visibility Provides access and visibility Protects gingiva from abrasionProtects gingiva from abrasionRestricts excess restorative material from Restricts excess restorative material from pushing into the sulcuspushing into the sulcus

Drugs:Drugs:

Anti sialogoguesAnti sialogogues anti cholinergic agents( atropine)anti cholinergic agents( atropine)Anti anxiety drugs Anti anxiety drugs (barbiturate sadatives – diazepam)(barbiturate sadatives – diazepam)Muscle relaxantsMuscle relaxants

Isolation from soft tissuesIsolation from soft tissues

1.1. Retraction of cheeks, lips and tongueRetraction of cheeks, lips and tongue

2.Retraction of the gingiva2.Retraction of the gingiva a. physico mechanical means a. physico mechanical means b. chemical meansb. chemical means c. electrochemical meansc. electrochemical means d. surgical meansd. surgical means

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