1. Dr. Abdulaziz Nasser Maher
Isolation Instrument
Dr. Abdulaziz Nasser Maher

2. Environment of the Dental Operatory
Microbial exposures in the dental operatory involve :
1. Airborne contamination .
2. Digital contamination of surfaces .
(i.e., hands soiled with saliva that repeatedly contact operatory equipment and surfaces and return to the patient's mouth during treatments).

3. 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 um that can remain suspended in the air and breathed for hours.

4. 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 minutes.
Both aerosols and mists produced by the cough of patient with unrecognized active pulmonary or pharyngeal tuberculosis (TB) are very likely to transmit the infection.

5. Environment of the Dental Operatory
Spatter
Consists of particles generally larger than 50 um and are even visible splashes.
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 .

6. (a) Mask (b) Safety glasses (c) Face shields
Protective gloves
Non-permeable barriers

7. Isolation Instrument complete and partial isolation
Rubber Dam equipment (punch, forceps, holder & clamps ).
Saliva ejector.
Cotton roll holder.

8. complete isolation

9. Rubber Dam Advantages Disadvantages 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

10. Anisworth Design (Hygenic)
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

11. Rubber Dam sheet MATERIAL Available in 5 different thickness :
Sizes : 5X5 inch and 6X6 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 ( 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.

12. 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.

13. Rubber dam retainer or clamp
Appropriate Teeth
W56
most molars W4
most premolars W7
mandibular molars W2
small premolars W8
maxillary molars W-
wingless
W8A
- A
active
W27
distal extension-mandibular molars
- D
distal extension
Hyg B-6
anterior teeth

14. Rubber dam retainer or clamp

15. 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 into the holes of the rubber dam clamp for secure placement
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

16. Rubber Dam Unfavorable Conditions for Dam Placement
Insufficiently erupted teeth
Some third molars
Extremely malpositioned teeth
Asthmatic patients
Latex allergy

17. Rubber Dam

18. Rubber Dam

20. partial isolation Cotton roll holder

21. Saliva ejector used for both complete and partial isolation

22. Thank you for your attention!