rubberdampptshow-130719061005-phpapp01.ppsx

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RUBBER DAM

Presented by : Cheng Yung Yew P11132



Goals of Isolation

• Moisture Control

• Retraction and Access

•

Harm Prevention• Local Anesthesia



Definition - Ruer Dam

• A small late! or non-late! sheet

• used to isolate a tooth or teeth from the oral environment and to "revent mi#rationof fluids or forei#n o$ects into or out of the o"erative field

• "rovidin# a dr%& visile and clean o"erative field'



Ruer Dam Isolation

• ()*+& ,e .or/ Cit% 0 1'C' Barnum& introduced ruer dam

• Ensures a""ro"riate dr%ness of the teeth

• Isolatin# one or more teeth from oral environment

•

Prevent "ul"al contamination from oral fluids



Advanta#es of Ruer Dam

1. A dr%& clean o"eratin# field

2. Im"roved access and visiilit%

3. Im"roved "ro"erties of dental materials

4. Protection of "atient and o"erator

5. 2"eratin# efficienc%



Disadvanta#es of Ruer Dam

1. Lo usa#e amon# "rivate "ractitioners

2. 3ime consumin#

3. Patient o$ection

4. Conditions "recludin# use of ruer dam 3eeth that have not eru"ted sufficientl%

1ome third molars

E!tremel% mal"ositioned teeth Patients ith asthma 4reathin# difficult thru no

se5



Materials and Instrument

I. Ruer Dam Material

II. Ruer Dam Holder 4frame5

III.Ruer Dam Retainer 4clam"5

IV. Ruer Dam PunchV. Ruer Dam Retainer 6orce"s

VI. Ruer Dam ,a"/in

VII.LuricantVIII.Modelin# Com"ound

IX. Anchors



I. Ruer Dam MaterialDam material availale in 7!7 inch or *!* inc

h sheets3hic/nesses or ei#hts

o thin 48'(7mm5& medium 48'9mm5& heav% 48':mm5&su"er heav% 48':7mm5

Has a shin% and a dull sideoDull side less li#ht reflective "laced facin# th

e occlusal side of the isolated teeth



II. Ruer Dam Holder 4 .oun#;s frame5Maintains the orders of ruer dam in "osit

ionU-sha"ed metal frame

1mall metal "ro$ections

An o"tional ,ec/ 1tra" ma% e "laced ehind the "atient;s nec/ attached to 9 hoo/s



III.Ruer Dam Retainer 4clam"5Consists of + "ron#s and 9 $as& connected %

a oUsed to anchor the dam to most "osterior toot

h to e isolated

Used to retract #in#ival tissue

Availale in different si<es and sha"es

=in#s "rovide e!tra retraction of ruer dam

Disadvanta#e > interfere ith "lacement of matri!ands& ed#es











I?' Ruer Dam PunchA "recision instrument havin# a rotatin# meta

l tale 4dis/5 ith * holes of var%in# si<es& anda ta"ered& shar"-"ointed "lun#er

Plun#er should e centered in the cuttin# hole avoid chi""in# of holes % "lun#er ti"



V. Ruer Dam Retainer 6orce"sUsed for "lacement and removal of retainer f

rom tooth



VI. Ruer Dam ,a"/inPlaced eteen ruer dam and "atient;s s/i

nAdvanta#es >Prevents s/in contact ith ruer to reduce "ossi

le aller#ic reactions

Asors an% saliva see"in# at corners of mouth

Acts as cushion

Convenient method i"in# "atient;s li" on removal of the dam



VII.LuricantA""lied in area of "unched holes to facilitate

the "assin# of dam throu#h "ro!imal contactsCocoa utter& "etroleum $ell% a""lied to co

rners of mouth to "revent irritation

?III' Modelin# Com"ound1ometimes used to secure retainer to tooth

Prevent retainer movement durin# o"erative"rocedure



IX. Anchors 42ther than Retainers5 Pro!imal contact ma% e sufficient to anchor

the dam on the tooth farthest from the "osterior retainer

3o secure the anchor further& a a!ed dental ta"e 4or floss5& or a small "iece of ruer dam material& can e "assed throu#h the "ro!imal contact'



Hole 1i<e and Position

• Holes must e "unched % folloin# archform

• 7-* holes in cuttin# tale of ruer dam "unch

• 1maller holes incisors& canines @ "remolars

• Lar#er holes molars& "osterior anchor tooth



• Guidelines in Positionin# the Holes > -1. Punch an identification hole in u""er left co

rner of ruer dam 4o"tional52. =hen o"eratin# on the incisors and mesial

surfaces of canines& isolate from first "remolar to first "remolar'



3. =hen o"eratin# on "osterior teeth& isolate anteriorl% to include the lateral incisor on the

o""osite side of arch from the o"eratin# site'

4. Isolation of minimum of : teeth is recommended e!ce"t hen endodontic thera"% is in

dicated'5. 3he distance eteen holes is eual to the

distance from the center of one tooth to thecenter of ad$acent tooth& measured at levelof #in#ival tissue "revents rin/les of thedam eteen teeth'





*' =hen a cervical retainer is used for isolation of a Class ? lesion& a heavier ruer dam

usuall% recommended for etter tissue retraction' Hole for the tooth should e "unched sli#htl% fa

cial to arch form

3he farther #in#ivall% the lesion e!tends& the farther the hole must e "ositioned from arch form'

Hole should e sli#htl% lar#er



7. =hen a thinner ruer dam is used& smallerholes must e "unched& ecause thin dam h

as #reater elasticit% to seal around the teeth'

8. 6or ine!"erienced o"erator& a ruer stam"that im"rints "ermanent and "rimar% arch f

orms on ruer dam is availale'9. A "lastic tem"late can e also used to mar/

hole "osition'





Placement of Ruer Dam

• Before "lacin# the ruer dam dental chair ad$usted for o"timal "atient comfort

• Usuall%& administerin# anesthetic "recede

s a""lication of ruer dam• Ruer dam and retainer can e "laced s

euentiall% "rovides ma!imal visiilit%

hen "lacin# retainer& reduces ris/ of im"in#in# on #in#ival tissue



• Alternative "lacement > -

A""l%in# Dam and Retainer 1imultaneousl%1. reduce ris/ of retainer ein# salloed

2. this a""roach ease the "assin# of the dam over

a "reviousl% "laced retainer A""l%in# Dam Before Retainer

1. 3here is no need of mani"ulate dam over retainer

2. Reduction in visiilit% of underl%in# #in#ival tissue& hich ma% im"in#ed on % retainer





A""lication of Ruer Dam Isolation

•

13EP ( > 3estin# and Luricatin# the Pro!imal Contacts

• 13EP 9 > Punchin# the Holes

• 13EP : > Luricatin# the Dam

• 13EP + > 1electin# the Retainer• 13EP 7 > 3estin# the Retainer;s 1tailit% and Retenti

on

• 13EP * > Positionin# the Dam over the Retainer

• 13EP > A""l%in# the ,a"/in

• 13EP ) > Positionin# the ,a"/in



• 13EP > Attachin# the 6rame

• 13EP (8 > Attachin# the ,ec/ 1tra" 42"tional5

•13EP (( > Passin# the Dam 3hrou#h PosteriorContact

• 13EP (9 > A""l%in# Com"ound 42"tional5

• 13EP (: > A""l%in# the Anterior Anchor 4If needed5

• 13EP (+ > Passin# the 1e"ta 3hrou#h the Contacts ithout 3a"e

• 13EP (7 > Passin# the 1e"ta 3hrou#h the Contacts ith 3a"e



• 13EP (* > 3echniue for Usin# 3a"e 42"tional5

• 13EP ( > Invertin# the Dam Inter"ro!imall%

• 13EP () > Invertin# the Dam 6aciolin#uall%

• 13EP ( > Usin# a 1aliva E$ector 42"tional5

• 13EP 98 > Confirmin# a Pro"erl% A""lied

Ruer Dam• 13EP 9( > Chec/in# the Access and ?isiilit

%

• 13EP 99 > Insertin# the =ed#es



Removal of Ruer Dam Isolation

• 13EP ( > Cuttin# the 1e"ta

• 13EP 9 > Removin# the Retainer

•

13EP : > Removin# the Dam• 13EP + > =i"in# the Li"s

• 13EP 7 > Rinsin# the Mouth and Massa#i

n# the 3issue• 13EP * > E!aminin# the Dam



6actors affectin# Ruer Dam Placement• ?ariation ith A#e

• Errors in A""lication and Removal1. 2ff-Center Arch 6orm

2. Ina""ro"riate Distance eteen the Holes

3. Incorrect Arch 6orm of Holes4. Ina""ro"riate Retainer

5. Retainer-Pinched 3issue

6. 1hredded or 3orn Dam

7. Incorrect Location of Hole for Class ? Lesion

8. 1har" 3i"s on ,o'9(9 Retainer

9. Incorrect 3echniue for Cuttin# 1e"ta





Reference•

1turdevant;s Art and 1cience of 2"erativeDentistr% & 6ifth Edition 3heodore Roertson& Herald He%maan& Ed 1ift Cha"ter (8Ruer Dam Isolation (8>+*:-)*

• htt">FF---'%outue'comF-atchGvH7eCBC h*B.?c





.ou dont have to rush %our teeth - $ust theones %ou ant to /ee"

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