The opinions within this web page are not ours.
Authors have been credited for the individual posts where they are.
- www.rxroots.com Photos courtesy: Ananya Bhooshan : Fred : Marga|
First rubber dam case
From: "Ananya Bhooshan"
Sent: Friday, July 14, 2006 4:17 PM
Subject: [roots] first case finsihed under Rubber dam
Here's my first case under dam. Though I have strted few this is the one I finished first.
All hand files. and GG for coronal flaring.
2 canals and 2 visits.
CaOH in between.
Obturated with std cones
ZnOE as sealer and
lateral and warm vertical and an IRM Temporary.
Hope you can appreciate the clamps in the wire film. Taking the radiograph while dam is on is pretty difficult for me
or is that we have to remove the dam for taking IOPA? - Ananya
photos by Ananya Bhooshan
That's what I'm talking about! Nicely done. Now we're talking some serious endo.
One small step, and soon we'll have all of India doing the same - Guy
Well done Ananya, which tooth did you clamp? Was it the tooth you were working on?
I will leave discussion of this to the experts but typically I will clamp the molar I am working on and if caries
doesnt go into the interproximal then I will place a single hole in the dam. If the caries is interproximal or the
restorations are and need to be removed then I will carry the dam to three teeth.
Here is an example of what happened this week. I placed the dam on the 2nd premolar for the endo with a single hole
and then realized I wanted all the amalgam out and removed the dam, replaced it with one punched with three holes
(1st molar to 1st premolar). ( You can see the difference in the images on the 2nd Jpeg.)
One other question was how many canals (it looks like 2) did you find. I find that almost all molars have three canals
and that often in third molars the canals in the mesial root come of one orifice with the canals branching Buccal and
Lingual. I typically hate IRM filling material because patients disappear and it washes out and then the coronal
leakage is an issue. I always try to place a bonded core (usually resin ) but I know that some love amalgam, at the
Now the good things. I like your length control, but I thought that the taper (hand files I guess) was a little weak.
I like how the canals dont look transported and you seemed to have done a decent job with the removal of all decay.
In closing, I want to compliment you on showing us your case. You will learn alot from this process, and it will help
you improve as a clinician. You are to be commended for taking the constructive criticism here on dam placement and
instead of signing off Roots and saying "those Rooters are jerks for pushing rubber dam down my throat " (not literally -
GAG ..:) ) you have taken up the cause and started doing endodontics by the standard of care. I am proud of you.
It is easy to make excuses but the real clinician striving for success will accept change as a positive and necessary
step on the pathway to perfection.
I am proud of you........may many more in India and in other countries where rubber dam is not the norm, learn from your
efforts. As I am fond of saying........CLAP CLAP CLAP...... - Dr Glenn Van As
photos by Dr Glennn Van AS
Hi Ananya, Wow, what a difference, yes, I do appreciate the clamp!! Nicely done. I have attached some pictures from
one of my presentations, how to place a rubber dam when the tooth has little or no retention, maybe they are useful.
Keep up the good work. - Marga
We can all learn something from this. I own nearly 100 r.d. clamps in about 40 or 50 styles. Until marga's post,
I've never seen or used a silker glickman clamp! That one is pretty wild. - Gary
Dr Glenn, I did clamp the adjacent molar since there was a cervical decay which I restored prior to the access prep.
I din;t want to disturb it so I thought of doint it and placing that itself was time consuming since I am a novice
I don't have my own practice and the materials that is suppplied with is what I can use. Many in our part use just ZnOE
for post RCT filling. I insisted to use IRM, These will be changed to Amalgum or composite by the other dentist and
post/crown later on. We charge usually 20-30 dollars for a molar and can not provide the composite in that go.
i am in short supply of the dam sheets. and its embarassing to use the gloves. I just got a pack of 20 sheets from
Hygenic. no one seems to deal with them here. Hope some one starts business in S Asia soon - Ananya