Endodontic instruments Endodontic Al Azhar University Gaza Lama El Banna Faculty of Oral and Dental Medicine

1. Rubber Dam
• Dam is Not Religion.
• RD is a Mean and Not a Value ,
isolation can be achieved without RD,
hence RD is just one type of isolation.
• RD it is Just a Tool that help us to get a
Moisture Free environment.
• RD it is Not a Goal in itself ,
Dry environment is The Goal.

3. separation of a tooth or group of teeth from
oral tissues and saliva,
by use of a dental dam, cotton rolls, or any
other means of isolation ,
to improve access, visibility, and control moi
sture contamination while restorative
or operative dental procedures are
performed.

4. Goals of isolation
• Moisture control
• Retraction , Accessibility and Visibility
• Harm prevention
• Safe and Aseptic field
• Prevent accidental swallowing of instrument and
restorative materials

5. Types of isolation
• Direct (Physical)(Complete vs Partial)
• Indirect (Chemical)

7. ABCDE’s of RD
• Adequate access and visibility in operating field
• Better Pt protection and management
• Complete moisture control in operating field
• Decrease operating time
• Enhancement of safety and aseptic operating field

32. Advantages
Pt Operator
Provide comfort to pt
Protection from swallowing or
aspirating foreign bodies
Protect soft tissue by retracting them
Dry & clean operating field (long term)
Infection control (protection)
Accessibility & Visibility (Max.)
(effciency))
Improved dental material properties
Prevent contamination of tooth
preparation
Less fogging of mirror
Pt comfort Operator efficiency
(Access , Visibility , Illumination, less fogging)
Pt protection Operator Protection
Prevent soft tissue injury Prevent contamination
by retract them by dry & clean operating field
Improve dental material properties

33. Disadvantages
• Time consuming
• Pt communication
• Pt objection
• Incorrect use may damage gingival tissue or porcelain
crown
• Insecure clamp may be swallowed or aspirated

34. Contraindication
• Asthmatic pt
• Allergic pt to latex
• Mouth breather pt
• Extremely malposed teeth
• Third molr

35. Armamentarium
Basics Accessories
RD sheets
RD clamps
RD forceps
RD frame
RD template
Dental floss
Lubricant
Wadgets
Wooden wedges
Orthodontic elastics
Gingival barrier
Modeling compound
Napkin
Scissor

36. Sheet
• Size
• Surface
• Latex or non
• Color
• Thickness

37. Frame• Used to maintain the border of RD in position

38. Punch• Used for making holes on the dam

39. Forceps• Used for placement and removal of clamp from tooth

40. Template• Used for marking of teeth position on the dam

41. Clamps• Used to secure the RD to the most posterior tooth to be
isolated and to retract the gingiva

43. Winged Wingless
Double arched
(Butterfly)
Better
retraction&
Visualization
Interfere
with
matrix
&wedge

44. PassiveActive

46. General Rules for Isolation
• L.A … Pre-flossing
• Mark /Punch … Lubricate
• Clamp selection … Clamp testing
• Dam … Frame
• Flossing … Inversion

47. Specific Rule in Isolation

48. Practical
• Floss Ligature types (Single , Double , Surgeon knot)
• Methods of RD application (Clamp>RD) (RD>Clamp) (Clamp + RD)
• Method of secure RD on frame (Simple , RD pocket ,Envelope)
• Single tooth isolation (Winged VS Wingless) .. Clamp rocking .. Flossing
• Quadrant dentistry isolation .. Inversion (Types) .. Flossing
• Anterior teeth isolation(Clamped OR Clampless) ..Inversion(Types)..Flossing
• Marking holes U- shape VS V-shape hard palate
• Cl III isolation .. Clamp stability .. Flossing
• Split Dam isolation (Remaining teeth , Bridges , Pediatric , Anterior ,
Predictable Cl II , Fixed Ortho. Appliance)
• Teflon Floss .. Retraction cord use .. Teflon tape use