RUBBER DAM PLACEMENT

  1. Placement of Rubber Dam
  2. Before placement of rubber dam, following procedures should be done:
    • Thorough prophylaxis of the oral cavity.
    • Check contacts with dental floss.
    • Check for any rough contact areas.
    • Anesthetize the gingiva if required.
    • Rinse and dry the operated field.
  • Methods of Rubber Dam Placement.
  • Method I: Clamp placed before rubber dam
  • Select an appropriate clamp according to the tooth size.
  • Tie a floss to clamp bow and place clamp onto the tooth
  • Larger holes are required in this technique as rubber dam has to be stretched over the clamp. Usually two or three overlapping holes are made.
  • Stretching of the rubber dam over the clamps can be done in the following sequence:
  • – Stretch the rubber dam sheet over the clamp
  • – Then stretch the sheet over the buccal jaw and allow tosettle into place beneath that jaw
  • – Finally, the sheet is carried to palatal/lingual side andreleased.
    This method is mainly used in posterior teeth in both adults and children except third molar.

Method II: Placement of rubber dam and clamp together

  • Select an appropriate clamp according to tooth anatomy.
  • Tie a floss around the clamp and check the stability.
  • Punch the hole in rubber dam sheet.
  • Clamp is held with clamp forceps and its wings are insertedinto punched hole.
  • Both clamp and rubber dam are carried to the oral cavityand clamp is tensed to stretch the hole.
  • Both clamp and rubber dam is advanced over the crown.First, jaw of clamp is tilted to the lingual side to lie on thegingival margin of lingual side.
  • After this, jaw of the clamp is positioned on buccal side.
  • After seating the clamp, again check stability of clamp.
  • Remove the forceps from the clamp.
  • Now, release the rubber sheet from wings to lie around thecervical margin of the tooth.
  • Method III: Split dam technique: This method is split dam technique in which rubber dam is placed to isolate the tooth without the use of rubber dam clamp. In this technique, two overlapping holes are punched in the dam. The dam is stretched over the tooth to be treated and over the adjacent tooth on each side. Edge of rubber dam is carefully teased through the contacts of distal side of adjacent teeth.

Split dam technique is indicated:

• To isolate anterior teeth
• When there is insufficient crown structure
• When isolation of teeth with porcelain crown is required. In such cases placement of rubber dam clamp over the crown margins can damage the cervical porcelain.
• Dam is placed without using clamp.
• Here two overlapping holes are punched and dam is stretched over the tooth to be treated and adjacent tooth on each side.

REFERENCE- NISHA GARG TEXTBOOK OF ENDODONTICS

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