Considerations for Operative Dentistry and Class II Review Flashcards
(43 cards)
Why should you isolate the operating field with a rubber dam?
◦ Better visualization
◦ Better access
◦ Prep walls dry and clean
◦ Your materials work better
- Improved properties- direct contact of varnish/liner/base with cavity walls
- Moisture affects bond as well as materials ability to set up
◦ Prevents injury to patient soft tissues
◦ Prevents aspiration and swallowing of debris
◦ Fewer aerosols
What are the componenets of a dental dam set up?
- rubber sheet
- clamp
- frame
- punch
- forceps
What side of the rubber sheet faces the operator and which side faces the patient?
- shiny side against patients tongue, palate
- dull side faces the operator
What are the parts of a rubber dam retainer (clamp)?
- bow
- jaws
- forceps holes
- points
What cases are more important to use a rubber dam: composite or amalgam?
Composite
- bonding requires uncontaminated surfaces
- wet field = recurrent caries or failed bond
What can a wet field cause during a composite restoration?
recurrent caries or failed bond
How do you isolate the teeth during a class II procedure?
one tooth posterior, two teeth anterior to tooth you’re working on
How do you isolate the anterior teeth during a procedure?
◦ Canine to canine
◦ Or can clamp on one premolar, ligate between incisors or incisor/canine
What teeth do you isolate in a pediatric case?
only isolate teeth necessary
What teeth do you isolate in an endo case?
a single tooth
What are the steps for placing a rubber dam?
- Prep work
◦ punch holes in rubber
◦ check contacts for floss shredding
◦ mark occlusion BEFORE placing dam - Place clamp on tooth
- Place dam over entire clamp
- Stretch dam through contacts (Floss)
- Invert dam
◦ Delicately blow air around cervical area and push rubber into sulcus with plastic instrument - Ligate anterior tooth
If the rubber dam does not work to isolate what are other options?
Antisialogogue medications (RARELY USED)
◦ Atropine and Banthine
Absorbents
◦ Cotton Rolls
◦ Dry Shields
◦ 2x2 gauze
◦ Cotton pellets
Suction
◦ High evacuation suction
◦ Saliva ejector
◦ Svedopter
◦ Isovac (bolded)
What are the different absorbents we can use?
- cotton rolls
- dry shield
- 2x2 gauze
- cotton pellets
What is the least effective absorbent?
2x2 gauze (works better as a throat pack
What can cotton pellets be used for?
◦ Remove moisture from inside preparation
◦ Remove moisture when patient is sensitive to air and water spray
What is a dry shield?
◦ Blocks parotid, retracts and protects cheek
◦ Wet when removing to avoid “cotton roll burn”
How do you place and remove a cotton roll?
◦ Placed in vestibule
◦ Wet when removing to avoid “cotton roll burn”
What are the different types of suction?
◦ High evacuation suction
◦ Saliva ejector
◦ Svedopter
◦ Isovac
What are the pros of the high evacuation suction?
◦ Very effective at picking up debris
◦ Can be used to retract tissue
◦ Vented is better- reduces sucking up of tongue and mucosa
What are the cons of the saliva ejector?
◦ Ineffective at removing debris
What is a svedopter?
old fahioned isovac
What are some additional tools that can be used to isolate the operating field?
- retraction cord
- bite block
- anterior lip retractors
If caries are in the E1/E2 layer what is the treatment?
- REMINERALIZE
If caries are in the D1 layer what is the treatment?
restore surgically or attempt
to remineralize
- caries extends only to first third of dentin
