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 perparation or feather edge. It is most difficult when the target is in good isolaltion without soft tissue damage.
This tecnique suggests that flowable composite can be used to place temporary wings, (which is good to stabilise the rubber dam) and can be easily removed after treatment.
The temporary wings are also helpful when fixing the Rubber dam in restorative dentistry.
Technique 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 instrument (diamond coated insert), 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 tooths 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 gengiva and Flowable wings. This is possible because of gengiva 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 reeth 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 good 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 mantain the Rubber dam in a proper position.
Fig 16.- This isolation allows to treat the 36 and 37 at the same time.
Fig 17.- Isolation of palatal lesions.
Fig 18.- Flow adheres by itself, giving a proper but reversible bonding values to be able to remove it afterwards.