Flowable wings

9 Mar 2016 - 39066

Several clinal procedures need rubber dam placements. It is not easy; especially in the situation where the Root canal treatment has been done on a tooth prepared with vertical preparation or feather edge. It is most difficult when the target is in good isolation without soft tissue damage.

This technique suggests that flowable composite can be used to place temporary wings, (which is good to stabilize the rubber dam) and can be easily removed after treatment.

The temporary wings are also helpful when fixing the Rubber dam in restorative dentistry.

Here’s the step by step

Fig. 1

Clean the tooth by Air polishing with glycine powder for 5 seconds, subsequent use the sonic instrument to reactivate the dentine. If there is a build up reactivate the composite too.

Fig. 2

By sonic instrumentation (diamond coated tip), obtain a spot of reactivated dentin. Verities flow (Kerr) (the flowable used in this technique) is self adhering, it needs “fresh” tissue.

Fig. 3

You need a spot of tissue (dentin and/or composite) reactivated to allow the self adhering process.

Fig. 4

Air dry the tooth’s surface, and place the Vertise flow on the tooth, letting it flow on the gengiva. Wait for 5 to 10 seconds to achieve the specific adhesion required. Light cure for 40 seconds. (If you wait 20 seconds as constructor says, the self adhering process will be completed and you will need to cut with a bur the wings…).

Fig. 5

Fit the dam between the gum and the flowable wing. This is possible because of the soft tissue resilience.

Fig. 6

Flowable wings from different angles.

Fig. 7

Isolation is mandatory before root canal treatment; can be difficult to isolate at the same time many feather edge prepared tooth.

Fig. 8

The same technique is used to fix the Ivory 27N. Wings are placed on the premolar and canine.

Fig. 9

Wings detail.

Fig. 10

Liquid Dam can be used to fill gap between teeth and rubber dam.

Fig. 11

Lateral view.

Fig. 12

Detail of cavity access on lateral incisor.

Fig. 13

Wings can be useful in case of cementation on indirect restorations.

Fig. 14

It is good to drive the dam in the proper position also using wings on the close teeth.

Fig. 15

In edentulous areas rubber dam tends to rise. In this case a wing placed in the mesial 36 can be useful to hold the rubber dam in a proper position.

Fig. 16

This isolation allows to treat 36 and 37 at the same time.

Fig. 17

Isolation of palatal lesions.

Fig. 18

The flowable composite adheres by itself, giving a proper but reversible bonding values to be able to remove it afterwards.

 

Conclusions

Flowable wings is not the same as the classical technique of adhering composite to create tooth equator to place clamps, but rather to withstand the rubber dam with perfect seal by itself. Bing very respectful with the soft tissues and the hard ones. Self etching flowable materials, give a perfect traditional bonding for this purpose.

Bibliography

Dentista moderno numero 7 Luglio 2014 pag 58