General Info

Check out kits (exam and rubber dam) from 8N 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 for rubber dam and retraction cord packing (IAN for Mn, local infiltration for Mx) - review your local anesthetic landmarks.

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

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 and Mn molars; pack cord from MB line angle to ML line angle Instructor check with cord in sulcus and the tooth is well isolated Required to make ONE impression Use of the contour strip on Mx incisor

Demonstration
Various matrix systems - copper band

Isolation of Operating Field Rationale

Access Visualization Patient protection Bonding procedure

Patient Protection
Soft tissue around the tooth that you are working on cheek, lip, TONGUE TONGUE will move during procedure

Isolation of Operating Field Methods

Rubber dam Cotton roll Cotton roll holder Dry angles Hygro formic Mouth mirror

Rubber Dam
It is a MUST for all operative procedures It is NOT an option - unless you get prior approval from the instructor Please review the protocol (Dr.Hildebrandt first semeter Operative Dentistry) before coming to the clinic.

Top 7 Reasons Why I am not Using Rubber Dam

1. It saves me a lot of time.

Top 7 Reasons Why I am not Using Rubber Dam

2. Patient likes it better without rubber dam.

Top 7 Reasons Why I am not Using Rubber Dam

3. DENTIST do not use it.

Top 7 Reasons Why I am not Using Rubber Dam

4. The instructor do not seem to care whether I use it or not.

Top 7 Reasons Why I am not Using Rubber Dam

5. It is a PITA to put it on.

Top 7 Reasons Why I am not Using Rubber Dam

6. I just like to PO the instructor (Dr. Lee!!!!)

Top 7 Reasons Why I am not Using Rubber Dam

7. Think about the fact that I can finish up the procedure 30 min faster. It gives me time to have one more drink at Sally or I can have one more glass of wine before dinner at home.

Top 7 Reasons Why I am not Using Rubber Dam

1. It saves me a lot of time.
Myth: it saves time on constantly trying to keep the operating area free of saliva, blood. I do not have to worry about the cheek and tongue.

Top 7 Reasons Why I am not Using Rubber Dam

2. Patient likes it better without rubber dam.
Myth: The patient may not like it anymore if you cut his/her tongue/cheek.

Top 7 Reasons Why I am not Using Rubber Dam

3. DENTIST do not use it.
Myth: They do not have to take board exam, they have an assistant, they have more experience.

Top 7 Reasons Why I am not Using Rubber Dam

4. The instructor do not seem to care whether I use it or not.
Myth: You are the learner, not the instructor.

Top 7 Reasons Why I am not Using Rubber Dam

5. It is a PITA to put it on.
Myth: Practice make it perfect.

Top 7 Reasons Why I am not Using Rubber Dam

6. I just like to PO the instructor (Dr. Lee!!!!)
Myth: you are doing a good job helping out your future colleagues in getting rid of ME.

Top 7 Reasons Why I am not Using Rubber Dam

7. Think about the fact that I can finish up the procedure 30 min faster. It gives me time to have one more drink at Sally or I can have one more glass of wine before dinner at home.
Myth: TRUE?

Cotton Rolls

Placement of Cotton Rolls

Other ways to place a cotton roll?

Cotton Rolls Holder

Mn Arch

Dry Angle

Hygro formic
Mn Arch

Saliva Ejector

Access - Class V (Buccal)

Access - Class V (Lingual)

How to control the tougue?

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 in the sulcus perfectly, why the impression still do not turn out

Retraction Cord Placement

ISOLATION (no saliva and no blood) Use of a hemostatic agent to control bleeding (hemodent - aluminum chloride, ViscoStat - ferric sulfate) Applied steady pressure to push the cord into sulcus (sometime it may take a few seconds); do not release the pressure until the cord stay in the sulcus Pressure down gingivally (at angle angle slightly toward the root) and backward. Keep the area dry until you are ready to pull the cord out to inject the impression material into the sulcus

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

Angle the packing instrument slightly toward the root

Occasionally it is necessary to hold the cord with one instrument while packing with the second

Contour Strip

Contour Strip

Contour Strip