QUIZ 1: Isolation and Matrices

What is the purpose of isolation?

Controls moisture

Retracts tissue

Provides additional patient comfort

May prevent aspiration/swallowing of dental materials

Improves bonding of adhesives

What are the benefits of retracting tissue in isolation?

Better access

Protect against trauma

What can happen with poor isolation?

Poor isolation may lead to poor outcomes

Majority of procedures in dentistry are technique sensitive

Completing procedures with poor isolation can result in failed restorations/recurrent caries

What are the types of isolation?

Rubber dam

Isovac/dryshield

Cotton rolls

Dry angles

Optragate

Cord

What is the rubber dam used for?

Considered the gold standard of isolation

Can be used for both maxillary and mandibular arches

What are the advantages of rubber dams?

Great to use when only 2 handed dentistry is available

Provides better visibility

Retracts soft tissue --> improves access

Prevents aspiration/swallowing of materials

What are the disadvantages of rubber dams?

Takes time to be applied correctly

Communication with patient may be challenging

Insecure clamps can be aspirated / swallowed

May not be able to use on patients that breathe through their mouth or have respiratory issues

What materials are required for rubber dams?

Rubber dam

Punch

Forceps

Retainers (clamps)

Youngs Frame

Floss

Plastic instrument

What are the steps to apply a rubber dam?

1. Anesthetize the patient (optional)

2. Use template to mark hole location

3. Punch the holes

4. Retainer is selected, ligated, and positioned on forceps

5. Place the retainer on most posterior tooth

6. Stretch the rubber dam over the clamp

7. Ligate at the anterior tooth

8. Place holes over top of teeth

9. Floss the interproximal spaces to expose teeth

10. Invert the rubber dam with plastic instrument

11. Place the frame

What are the advantages of Isovac/Dryshield?

Helpful when an assistant is not available

Easy to Use

Efficient

Works as a bite block

Multiple sizes

Can be used for both

maxillary and mandibular arches

Connects to your high volume

suction

What are the disadvantages of Isovac/Dryshield?

Loud

Some patients dislike

What are the benefits of cotton rolls?

absorbent, used as an adjunct

helpful for a brief period of time --> may need to be replaced to maintain isolation

helps retract tongue, lip, and cheek

can be used for mx (buccal) and md arch (buccal and lingual)

What are cotton roll holders?

assist in keeping cotton rolls in place in the md arch?

What is the function of dry angles/shields?

blocks the parotid gland

protects and retracts buccal tissue

can be used for mx and md arches

silver backing on some products provide additional reflection of light on teeth

What are the functions of the optragate?

retracts lips --> helpful for those with strong lips

anterior teeth

improves visibility

What is the function of a gingival retraction cord?

used for retraction of gingival tissue away from the tooth

helpful in getting a better apical margin

What are situations in which gingival retraction cards are beneficial for?

Class V restoration

What is a matrix?

device applied to a prepared tooth before placing restorative material in the tooth

What are the functions of a matrix?

Used to assist in the shaping/contouring the restoration

Separates teeth while placing restorations

Helps provide additional isolation

Prevents material overflow / overhangs

Why do we use a matrix on Class II and III preparations? (interprox)

Class II and Class III preparations (interprox have areas of tooth structure that need a wall (marginal ridge) built back up

Matrix controls the placement and contouring of restorations

Prevents overhangs if placed correctly

What are the things to look for in a matrix?

Rigid

Allows for building of proximal contact and other anatomical features

Adapts to the tooth

Will prevent excess material

Can be removed easily after placement of restoration

What are the types of matrices?

Matrix Band/Toffelmire

T-band

Matrix systems

Mylar strip

What are Toffelmire Matrix Band indicated for?

Class II restorations --> interproximal

MO

DO

MOD

How are Toffelmire Matrix Bands used?

Can be positioned on buccal or lingual aspects of tooth

Stable when placed correctly

Holder easily separates from band for easy removal

What are the materials needed with Toffelmire Matrix Bands?

Matrix band --> many styles and thicknesses

Toffelmire holder

Wedge

Burnisher

Forceps

What are T Bands indicated for?

Class II restorations --> interproximal

MO

DO

MOD

What are the characteristics of T Bands?

Fast and easy to assemble

Not as stable

Used more in pediatrics

What are the indications for Matrix System?

Class II and III restorations

What are the benefits of Matrix Systems?

helps create tight contacts

designed to help with anatomy/contour

What are Mylar Strips typically used for?

Composite restorations

Class III and IV restorations (anterior teeth)

What materials do you need with Mylar Strips?

wedge and forceps