Transcript Isolation Instrument
Isolation Instrument
Dr. Abdulaziz Nasser Maher
Environment of the Dental Operatory Microbial exposures in the dental operatory involve : 1. Airborne contamination .
(i.e.,
2. Digital contamination of surfaces .
hands soiled with saliva that repeatedly contact operatory equipment and surfaces and return to the patient's mouth during treatments). •
Environment of the Dental Operatory Airborne Contamination High-speed handpiece :
•
Create airborne contaminants from :
Bacterial residents in the dental unit water spray system .
• Microbial contaminants from saliva, tissues, blood, plaque, and fine debris cut from carious teeth . Airborne contaminants exist in the form of spatter, mists, and aerosols.
• •
Aerosols
Invisible particles ranging from
50 - 5
um that can remain suspended in the air and breathed for
hours
. •
Environment of the Dental Operatory Mists
Become visible in a beam of light, • Consist of droplets estimated to approach or exceed 50 um . • Heavy mists tend to gradually settle from the air after
5 15
minutes .
• Both aerosols and mists produced by the cough of patient unrecognized active pulmonary or pharyngeal tuberculosis (
TB
) are very likely to
transmit
the
infection
.
with •
Environment of the Dental Operatory Spatter
Consists of particles generally larger than
50
visible splashes.
um and are even Spatter has a distinct trajectory, usually falling within
3 feet
of the patient's mouth . Spatter or splashing of mucosa is considered a potential route of infection for dental personnel by blood borne pathogens .
• • •
(a) Mask (b) Safety glasses (c) Face shields Protective gloves Non-permeable barriers
Isolation Instrument complete and partial isolation
Rubber Dam equipment (punch, forceps, holder & clamps ).
Saliva ejector.
Cotton roll holder.
.1
.2
.3
complete isolation
Rubber Dam Advantages
Dry clean operating field Better access and visibility Protection of Patient and Operator Increased operating efficiency Improves the properties of dental materials indirectly.
Disadvantages
Time consumption Objectionable to some patients
Rubber dam punch
• •
Functions
Used to make holes of different sizes in the RD sheet .
Punch stylus pierces a hole in the rubber dam sheet.
Anisworth Design (Hygenic) Ivory Design
Rubber Dam sheet MATERIAL
Sizes :
5 X 5
inch and
6 X 6
inch sheets.
Available in 5 different thickness :
Thin 0.15 mm (0.006 inch) Medium 0.20 mm (0.008 inch) Heavy 0.25 mm (0.0010 inch) Extra Heavy 0.30 mm (0.012 inch) Special Heavy 0.35 mm (0.014 inch) The rubber dam has shiny and dull side.
Rubber Dam frame and clamp
• •
Rubber dam holder ( frame)
is used to secure the borders of RD in stretched condition.
Young ´ s rubber dam holder is U shaped metal frame with small projections to hold the dam.
• • •
Rubber dam retainer or clamp
Used to anchor the rubber dam to the most posterior tooth to be isolated.
It consists of 4 prongs and
2
jaws connected by a bow.
Prongs make four point contact with the tooth.
Retainer W56 W7 W8 W8A W27 Hyg B-6 Rubber dam retainer or clamp Appropriate Teeth
most molars
Retainer
W4 mandibular molars W2 maxillary molars W maxillary molars - A distal extension-mandibular molars - D anterior teeth
Appropriate Teeth
most premolars small premolars wingless active distal extension
Rubber dam retainer or clamp
Rubber dam clamp forceps Functions and features
1.Used to place and remove rubber dam clamps on and from a tooth Work with a spring action when handles are squeezed together • 2. Beaks fit placement into the holes of the rubber dam clamp for secure • 3. Sliding ring allows forceps to lock when placing the clamp and to be released when removing the clamp 4. Handle shaped to allow a firm palm-grasp by the operator • • •
Ivory Design Stoke type
Rubber Dam
Unfavorable Conditions for Dam Placement
Insufficiently erupted teeth Some third molars • • Extremely malpositioned teeth Asthmatic patients • Latex allergy • •
Rubber Dam
Rubber Dam
partial isolation Cotton roll holder
Saliva ejector
used for both complete and partial isolation