Isolation Of Dental Operating Field Question And Answers

Isolation Operative Dentistry Important Notes

1. Components of rubber dam

• Rubber Dam Sheet
• Rubber dam clamp/ retainer
• Rubber dam frame
• Rubber dam punch
• Rubber dam retainer force
• Dental floss
• Template

Isolation Operative Dentistry Long Essays

Question 1. Enumerate various methods of Isolation. Describe in detail about rubber dam.

Answer:

Methods of Isolation:

• Direct method
  
  • Rubber dam Cotton rolls
  • Gauze piece Absorbent
  • wafers Suction devices
  • Gingival retraction cord
• Indirect Method
  • Local anesthesia Drugs
  • Anti sialogogues
  • Anti-anxiety
  • Muscle relaxants

Rubber Dam – By Dr. S.C. Barnum

Purpose:

• Control of moisture
• Retraction
• Protects soft tissues
• Improves quality of treatment

Contraindications:

• Asthmatic patients
• Allergy to latex
• Mouth breathers
• Extremely malpositioned tooth
• Third molar

Components:

1. Rubber Dam Sheet:

• Square sheets
• Size – 5″x 5” or 6″ x 6″

Thickness:

• Thin – 0.006″
• Medium – 0.008″
• Heavy -0.010″
• Extra heavy- 0.012″
• Special heavy – 0.014″

Color:

• Green/blue
• The dull side faces the operator

2. Rubber Dam Clamps/Retainers:

To secure the dam to the teeth

Parts:

• 2 jaws
• Bow – connecting jaws
• 4 prongs – 2 on each jaw

Read And Learn More: Operative Dentistry Short And Long Essay Question And Answers

• Rests on line angle

Types:

• Winged or wingless retainer
• Large, small, universal

3. Rubber Dam retainer forceps:

• Hold the retainer
• Facilitates its placement and removal

4. Rubber Dam frame:

• U shaped frame
• Types – metal or plastic
• Has minute projections on its outer surface to secure the dam

5. Rubber Dam punch:

• For making holes in the dam
• Depending on the applied tooth, the sizes of the holes vary

6. Rubber Dam Template:

• Used to transfer the markings to the sheet

7. Dental Floss:

• To prevent accidental aspiration of the clamp

 

 

Placement:

Comfortable position of the patient
↓
Selecting the appropriate clamp and sheet
↓
Punching a hole in the sheet
↓
Applying lubricant
↓
Holding clamp through forceps
↓
Placement of rubber dam

• The clamp is placed first and then the sheet is passed over it
• Placement of sheet and then securing it with clamp
• Both are placed together

Removal:

Removal of clamp
↓
Stretching of sheet
↓
Cut all interseptal rubbers
↓
Remove the remaining

Question 2. Discuss importance of isolation and various methodds used to achieve the same.

Answer:

Importance Of Isolation:

• Isolation helps for following

1. Moisture control

• It refers to excluding sulcular fluid, saliva, and gingival bleeding from the operating field

2. Retraction and access

• It provides maximal exposure of the operating site

3. Harm prevention

• Prevents harm to the patient during the operation
• Small instruments and restorative debris can be aspirated or swallowed
• Provides patient comfort and operator efficiency

Direct Method:

1. Cotton rolls:

• Moisture absorbent
• Provide minimal retraction

Types:

• Manual and prefabrication
• Stabilized by cotton roll holder

Site of placement:

• Maxillary anteriors – Either side of labial frenum
• Mandibular anterior
• Lingual sulcus
• On either side of labial frenum
• Maxillary posterior – Adjacent vestibules
• Mandibular posterior
• Buccally – vestibule
• Between tongue and teeth
• Moistened it before removal to avoid tearing off of gingiva

2. Gauze pieces:

• Size – 2″ x 2″

Uses:

• To isolate larger areas
• As throat screens

Advantages:

• Better tolerated
• More acceptable
• Less adhesion to dry tissues

3. Absorbent wafers:

• Made of cellulose
• Covers parotid ducts

4. Evacuators:

Type:

• High vacuum
• Low vacuum
• High vacuum
  • Removes debris from the working site
  • Removal of toxic material
  • Decreases treatment time
• Low volume [Saliva ejectors)
  • Used along with operative procedures

Types:

• Disposable plastic tips
• Autoclavable metallic tips

5. Gingival retraction cord:

• Inserted into gingival sulcus
• Retracts gingiva

Types:

• Braided and non-braided
• Plain and impregnated

Effects:

• Improved accessibility and visibility
• Protects gingival from abrasion
• Restricts placement of restoration into sulcus
• Everts gingival tissue

Indirect Method Of Isolation:

• It includes

1. Anaesthetic agents

2. Antisialogogues

• Chemical agent is administered orally 1-2 hours prior to the procedure

Effect:

• Causes temporary dry mouth by acting on sympathetic nervous system

Drug of choice:

• Atropine 0.1-1 mg

Contraindicated:

• Nursing mothers
• Patients with glaucoma

Advantage:

• Useful in hypersalivation

Disadvantages:

• Tachycardia
• Dilatation of pupils
• Urinary retention
• Sweat glands inhibition.

Isolation Operative Dentistry Short Essays

Question 1. Gingival Retraction/ Gingival tissue management.

Answer:

Gingival Retraction:

Methods:

1. Physicomechanical:

• Rubber dam
  • Heavy, extra heavy, and special heavy sheets provide adequate mechanical displacement of gingival tissue
• Wooden wedges – Used interdentally
• Gingival retraction cords
  • Displaces gingival laterally and apically

Placement:

• Anesthetize the area
• Select appropriate cord
• Pack the cord with cord tucking instrument, around the tooth
• Place it for 5 minutes
• Remove the cord after moistening it to avoid gingival abrasion
  • Rolled cotton twills
    • Laterally displaces gingival
    • Combined with ZOE

2. Chemical means:

Chemical used:

• Trichloroacetic acid
• Sulfuric acid

Advantage:

• Hemostatic

Disadvantage:

• Caustic
• Irritant

3. Chemico mechanical method:

Chemical used:

• Vasoconstrictors – Epinephrine
• Astringents – Tannic acid
• Tissue coagulant – Silver nitrate

4. Rotary curettage (Gingettage):

• Removes a minimal amount of gingival epithelium with the help of a high-speed handpiece and bur.

5. Electrosurgical method:

• Alternating electric current energy is used at a high frequency

Actions:

• Cutting
• Coagulation
• Fulguration
• Desiccation

Question 2. Advantages of Rubber Dam.

Answer:

Advantages of Rubber Dam:

• Maximizes access and visibility
• Protection of soft tissues
• Provides clean and dry field
• Avoids contamination
• Prevents aspiration of foreign bodies
• Improves efficiency
• Improves properties of dental material
• Protection of patient and dentist

Isolation Operative Dentistry Short Answers

Question 1. Gingival retraction cord.

Answer:

Gingival retraction cord:

• Inserted into the gingival sulcus
• Retracts gingiva

Types:

• Braided and non-braided
• Plain and impregnated

Effects:

• Improved accessibility and visibility
• Protects gingival from abrasion
• Restricts placement of restoration into the sulcus
• Everts gingival tissue

Question 2. Affected and infected Dentin.

Answer:

Affected and infected Dentin:

1. Infected Dentin

• Irreversible denatured collagen
• Infiltrated with bacteria
• Notremineralizable
• Should be removed
• Darker
• Softer
• Lacks sensation
• Indistinct cross bands
• Stained with:
  • 0. 2% propylene glycol
  • 10% acid red solution
  • 0. 5% basic Fuschia

2. Affected Dentin

• Reversible denatured collagen
• Not infiltrated
• Remineralize
• Left behind while the cavity
• preparation
• Lighter
• Harder
• It is sensitive
• Distinct cross bands
• Cannot be stained with any solution

Isolation Operative Dentistry Viva Voce

1. Thinner rubber dam can pass through contacts easily
2. A thicker rubber dam is more effective in retracting tissues and more resistant to tearing
3. The jaws of the retainer should not extend beyond the mesial and distal line angles of the tooth
4. The bow of the retainer should be tied with dental floss
5. The tip of the saliva ejector must be smooth and of non-irritating material
6. Gingival cord placement should not harm gingival tissue
7. Atropine used for isolation is contraindicated in nursing mothers and patients with glaucoma