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Insulation tips and tricks


Insulation tips and tricks

Nowadays are increasingly numerous clinical procedures that require field proper isolation. The need to have control of operations caused the rubber barrier became, over time, the common denominator of various branches of our profession, especially if we talk about endodontics, adhesive restorations or prostheses.

In recent years, the prosthesis has undergone incredible changes, starting with the new materials and new perspectives were opened after spreading the adhesive cementation, then get to the revaluation of vertical finishing areas proposed both contextually to periodontal surgery as the BOPT (Biologically Oriented Preparation Technique - Preparation Technique Biologically Oriented). This technique provides for the preparation of the natural vertical pillar to allow the adaptation of mucous to the profiles and shapes determined by the prosthetic restorations, enabling thus extend the use of vertical preparation also not committed to the teeth of periodontal mode.

The dissemination of such preparation is the cause that drove the search for a "trick" to correctly position the rubber barrier during canalares treatments in those vertically prepared pillars, with smooth walls, no lines and therefore well unfavorable positioning and stabilization of a hook.
Everything is complicated when the goal is to isolate more elements and, in the context of treatment, whether to prevent damage to the gingival tissues.

One solution could be to stabilize the barrier with the aid of Flowable Compound fins applied to the pillars. Thus, it is possible to obtain a valid insulation to keep the latex sheet in position. Our goal is to be able to position the fins rapidly with a bond strength to maintain a stable field and at the same time, which also allows them to be easily removed at the end of treatment.

The membership of the fins obtained with an adhesive three step etch-and-rinse (adhesive, primer, bonding, separate) or simplified adhesive systems has two exactly opposite problems between them: the first is that working without barrier and near periodontal groove, control of the camp definitely lies on the edge, and the longer it takes for membership, the more you run the risk of contamination, who hesitates in rapid deployment of material. The second problem is that if, by contrast, managed to maintain adequate control of the field, accession, although in the absence of the barrier may result effective too, with the risk of being necessary to cut the fins, an option that will prefer to avoid, above all, prepared in proteticamente elements. For these reasons a self-adhesive compound is preferable, the Kerr Vertise Flow, it does not require particular adhesion or adhesive. The manufacturer's protocol predict place it in the cavity (prepared above and dried for at least 5 seconds) first stretching a thin layer (less than 0.5 mm), which no longer act on dental tissue for 15-20 seconds, and that will polymerize, and then stratify in greater thicknesses. The material was used for an indication other than those suggested by the manufacturer and a modified protocol, allows us to obtain the degree of "membership" ideal for the proposed isolation technique.

Source: Dentista Hoje, written by: Giuseppe Chiodera Ombretta Papini
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