Rubber dam sizes
5x5, 6x6
Where is the dull side facing and where the shiny side?
Dull side: occlusal
Shiny side: gums
Benefits of thicker rubber dam
- more effective in retracting tissue
- more R to tearing
- better sealing at cervical area
Composition of clamps
2 jaws and 4 prongs connected with 1 bow
Passive Vs Active Clamps
Passive Clamps:
- flat
- no anesthesia needed
- placed above gingival margin
- cause minimal gingival trauma
Active Clamps:
- narrow, curved
- anesthesia needed
- placed below gingival margin
- can displace gingivae
Winged Clamps Vs Wingless Clamps
Winged Clamp
- endo use
- interference w/ wedge and matrix
- more retraction
Wingless Clamp
- restorative use
- less retraction
- no interference w/ wedge and matrix
How many bows do anterior and posterior teeth have?
Anterior: 2
Posterior: 1
Extended bow clamp
- distal extention
- preparation of the distal surface of a clamped tooth
Serrated clamp
serrated wings for retention on broken down tooth
S-G (Silker –Glickman ) clamp
-anterior extention
-clamp itself is placed on a tooth proximal to
one being treated
-for severely broken down tooth
Clamps with long guard extension
- hold cotton wool in sulcus
- protect the cheek and tongue
Non-metallic clamp
- bulky
- dont fit teeth very well
Cervical retracting clamps
- used in conjunction with a major anchor clamp
- have small gripping power and so retention is provided mainly by impression compound
- have limited life
- single-bowed or double-bowed
- jaws are movable even after attaching the clamp to the tooth
Punch
- has a rotating metal table disk with 5 holes of varying sizes
- plunger should be well-centered in the cutting hole
Hole size depends on:
- tooth cervical diameter
- rubber dam elasticity
- clamped/non clamped tooth
Ivory Vs Stokes clamp forceps
Ivory clamp forcep:
- prevents clamp rotation
- it limits the use of these forceps to teeth that are within a range of normal angulation
Stokes clamp forcep:
- rotation of clamp
- has notches near beak tips
Floss uses:
- to tie the clamp and prevent the patient from aspirating or swallowing it
- For testing the interproximal contacts
- For passing the dam interproximally
- For making ligatures when needed
- For inverting the dam
Floss uses:
- to tie the clamp and prevent the patient from aspirating or swallowing it
- testing the interproximal contacts
- passing the dam interproximally
- making ligatures when needed
- inverting the dam
What is single tooth isolation used for?
- fissure sealants
- class I and V restorations
- endodontics
What is multiple tooth isolation used for?
- class II restorations
- bonding indirect restorations
- multiple restoration and quadrant dentistry
What are the rules for multiple tooth isolation?
General rule: at least 1 tooth posterior and 2 anterior to the one being treated
Incisors: P to P
Canine: M1 to opposite I2
Premolars: 2 teeth distally to opposite I2
Molars: opposite I2 to as D as possible
Clamp first
- winged or wingless clamps
- no M3
- tightened w/ floss
- easier than clamp and dam together
- improved visibility
- reduces the risk of traumatizing the gingival tissues
Clamp and rubber dam together
- M3
- limited visibility
- winged or wingless clamps
- solves the difficulty of trying to pass the dam over a previously placed clamp
Clamp, rubber dam and frame all together
- winged clamp only
- limited space for stretching the rubber dam
