In October 2018, national medical examination center to release the new medical exam outline, the physician qualification examination in 2019 countries will adopt the new outline, practical skills in the diagnosis and treatment for "foundation" of increased the use of "dental floss guidance" and "rubber isolation", oral practice skills examination will become more and more better to joint our clinical diagnosis and treatment,Today we will learn the clinical application of rubber dam isolation.

What is a rubber dam

First of all, we need to understand what is the rubber dam technology, using the elasticity of the rubber cloth, perforated in the neck of the tooth as a barrier, so that the crown of the tooth is treated and the mouth is isolated from a wet method.

The role of rubber dam

        1. strong moisture isolation, avoid chemical stimulation, protect mucosa and other oral soft tissue

        2. prevent infection

        3. Prevent the swallowing and sucking of small instruments

        4. Keep the surgeon's vision clear

        5. easy to micro root canal treatment, prevent oral mirror fog

        6. save time, improve work efficiency

Composition of rubber dam

        Blanket: there are 5 kinds of thickness, thick or extra thick blanket is more commonly used, thin (0.15mm), (0.20mm), thick (0.25mm), extra thick (0.30mm), super thick (0.35mm)

        Punch flier: 5 kinds of commonly used hole diameter: 0.5~ 2.5mm, rubber dam holes must have neat edges and appropriate size, remove the residual rubber dam sheet in the hole after use.

        Rubber dam clamp: according to the applicable tooth position, anterior teeth (butterfly clamp), premolars, molars (beak length is different), used to fix the rubber dam sheet set on the isolated teeth, more commonly used in clinical.

        Rubber dam forceps: when installing or removing rubber dam sheet, open the clamps.

        Rubber dam bracket: Hold and stretch sheet, "U" shaped or annular, stainless steel or plastic, partially foldable.

Install rubber dam

        There are four installation methods of rubber dam, but the wing method is commonly used clinically, and the installation steps of the wing method are as follows:

          Preparation before installation: to prepare the isolated teeth, first remove calculus and hyperplasia gums to form a good closure, floss to check the adjacent surface, remove the sharp filling body, and correct the suspension of the filling body. Partial anesthesia.

          Drilling: first use the positioning template to locate the drilling site, the size of the hole depends on the size of the tooth, molar should have a larger hole to prevent the rubber dam sheet from tearing when placing clamps.

          According to the position of the tooth, choose the rubber dam clamp, the rubber dam clamp wing through the rubber dam sheet hole, with the rubber dam clamp to open the rubber dam clamp, together with the rubber dam sheet clamped in the tooth neck, the clip lunge is located in the far, the flat shovel end of the filling device or fingers will push the rubber cloth above the wing to the lower tooth neck.

          The beak of the rubber dam clamp should be located below the high point of the tooth shape, and there are four points of contact with the tooth. For teeth that cannot smoothly enter the adjacent surface contact area, floss can be double folded in the tongue to form a ring to press the rubber dam sheet into the contact area, and then extract floss from the buccal side to prevent the displacement of the rubber dam sheet.

          After the rubber dam clamp is in place, the free part of the blanket is supported outside the mouth with the rubber dam bracket.

Remove rubber dam

After treatment, remove the rubber dam clamp with the rubber dam forceps first, and then remove the rubber dam bracket and blanket together.