8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 1/57

General Info

Check out kits (exam and rubber dam) from8N dispensing

Bring your own impression mixing guns. Will be working in groups of 3 (you make

your own arrangement) - operator, assistant,patient/volunteer.

Highly recommend using local anesthetic forrubber dam and retraction cord packing (IANfor Mn, local infiltration for Mx) - review yourlocal anesthetic landmarks.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 2/57

Chair Assignment

Bench 1 (10) - Chair 13 - 16

Bench 2 (9) - Chair 17 - 19

Bench 3 (9) - Chair 20 - 22

Bench 4 (10) - Chair 23 - 29 Bench 5 (10) - Chair 23 - 29

Bench 6 (10) - Chair 30 - 35

Bench 7 (8) - Chair 30 - 35

Bench 8 (9) Chair 36 - 38

Bench 9 (9) - Chair 39 - 41 Bench 10 (8) - Chair 42 - 44

Overflow chairs - Chair 45 - 47

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 3/57

Requirements

Three rubber dam - Mx and Mn posterior(retainer on 1st or 2nd molar), Mx anterior(first premolar to first premolar; no retainer)

Two retraction cords - most posterior Mx andMn molars; pack cord from MB line angle toML line angle

Instructor check with cord in sulcus and thetooth is well isolated

Required to make ONE impression

Use of the contour strip on Mx incisor

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 4/57

Demonstration

Various matrix systems - copper band

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 5/57

Isolation of Operating Field

Rationale

Access

Visualization

Patient protection

Bonding procedure

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 6/57

Patient Protection

Soft tissue aroundthe tooth that you

are working on -cheek, lip,TONGUE

TONGUE will 

move duringprocedure

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 7/57

Isolation of Operating Field

Methods

Rubber dam

Cotton roll

Cotton roll holder

Dry anglesHygro formic

Mouth mirror 

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 8/57

Rubber Dam

It is a MUST for all operativeprocedures

It is NOT an option - unless you getprior approval from the instructor

Please review the protocol

(Dr.Hildebrandt first semeter OperativeDentistry) before coming to the clinic.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 9/57

Top 7 Reasons Why I am not

Using Rubber Dam1. It saves me a lot of time.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 10/57

Top 7 Reasons Why I am not

Using Rubber Dam2. Patient likes it better without rubber

dam.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 11/57

Top 7 Reasons Why I am not

Using Rubber Dam3. DENTIST do not use it.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 12/57

Top 7 Reasons Why I am not

Using Rubber Dam4. The instructor do not seem to care

whether I use it or not.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 13/57

Top 7 Reasons Why I am not

Using Rubber Dam5. It is a PITA to put it on.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 14/57

Top 7 Reasons Why I am not

Using Rubber Dam6. I just like to PO the instructor (Dr.

Lee!!!!)

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 15/57

Top 7 Reasons Why I am not

Using Rubber Dam7. Think about the fact that I can finish up

the procedure 30 min faster. It gives

me time to have one more drink atSally or I can have one more glass ofwine before dinner at home.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 16/57

Top 7 Reasons Why I am not

Using Rubber Dam1. It saves me a lot of time.

Myth: it saves time on constantly trying tokeep the operating area free of saliva,blood. I do not have to worry about the

cheek and tongue.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 17/57

Top 7 Reasons Why I am not

Using Rubber Dam2. Patient likes it better without rubber

dam.

Myth: The patient may not like it anymoreif you cut his/her tongue/cheek.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 18/57

Top 7 Reasons Why I am not

Using Rubber Dam3. DENTIST do not use it.

Myth: They do not have to take boardexam, they have an assistant, theyhave more experience.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 19/57

Top 7 Reasons Why I am not

Using Rubber Dam4. The instructor do not seem to care

whether I use it or not.

Myth: You are the learner, not theinstructor.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 20/57

Top 7 Reasons Why I am not

Using Rubber Dam5. It is a PITA to put it on.

Myth: Practice make it perfect.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 21/57

Top 7 Reasons Why I am not

Using Rubber Dam6. I just like to PO the instructor (Dr.

Lee!!!!)

Myth: you are doing a good job helpingout your future colleagues in getting

rid of ME.

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 22/57

Top 7 Reasons Why I am not

Using Rubber Dam7. Think about the fact that I can finish up

the procedure 30 min faster. It gives

me time to have one more drink atSally or I can have one more glass ofwine before dinner at home.

Myth: TRUE?

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 23/57

Cotton Rolls

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 24/57

Placement of Cotton Rolls

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 25/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 26/57

Other ways to place a cotton

roll?

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 27/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 28/57

Cotton Rolls Holder

Mn Arch

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 29/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 30/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 31/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 32/57

Dry Angle

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 33/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 34/57

Hygro formic

Mn Arch

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 35/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 36/57

Saliva Ejector

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 37/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 38/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 39/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 40/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 41/57

Access - Class V (Buccal)

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 42/57

Access - Class V (Lingual)

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 43/57

How to control the tougue?

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 44/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 45/57

Retraction Cord Placement

Common Problems

I cannot get the cord into the sulcus, I need a

smaller cord The cord keep on poping out of the sulcus

I followed all the protocol and the cord is inthe sulcus perfectly, why the impression still

do not turn out

R i C d Pl

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 46/57

Retraction Cord Placement ISOLATION (no saliva and no blood)

Use of a hemostatic agent to controlbleeding (hemodent - aluminum chloride,ViscoStat - ferric sulfate)

Applied steady pressure to push the cord

into sulcus (sometime it may take a fewseconds); do not release the pressure untilthe cord stay in the sulcus

Pressure down gingivally (at angle angleslightly toward the root) and backward.

Keep the area dry until you are ready to pullthe cord out to inject the impression materialinto the sulcus

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 47/57

As the cord is placed

subgingivally, the

instrument must be pushed slightly

toward the area

already tucked into

 place

If the force of the

instrument is

directed away from

the area previously packed, the cord

already packed will

 be pulled out

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 48/57

Angle the packing instrument slightly toward the root

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 49/57

Occasionally it is necessary to hold the cord with

one instrument while packing with the second

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 50/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 51/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 52/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 53/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 54/57

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 55/57

Contour Strip

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 56/57

Contour Strip

8/3/2019 10 Isolation and Retraction Cords

http://slidepdf.com/reader/full/10-isolation-and-retraction-cords 57/57

Contour Strip