Ahlers Marcus Oliver
Department of Restorative Dentistry and Preventive Dentistry, School of Dental Medicine, University Clinic Hamburg-Eppendorf, Hamburg, Germany.
Quintessence Int. 2003 Mar;34(3):203-10.
The application of the rubber dam (dental dam) is indicated in endodontics and for restorative dental treatments involving the acid-etch technique. The frequency of the technique's use varies significantly according to individual circumstances, and is generally too low given its advantages. One possible reason for many dentists' reluctance to use it could be frustrating results in the past with technically difficult applications. Such conditions arise, for example, when the taut rubber dam sheet exerts too much pull on the rubber dam clamps, causing them (and the entire rubber dam) to come loose. Particularly susceptible here are clamps attached to molars. This undesired tension results from stretching the rubber dam material--a necessary step--for attaching the sheet to the traditional rubber dam frame. As an alternative, a new easy-to-use rubber dam frame (Safe-T-Frame) has been developed that offers a secure fit without stretching the rubber dam sheet. Instead, its "snap-shut" design takes advantage of the clamping effect on the sheet caused when its two mated frame members are firmly pressed together. In this way the sheet is securely attached, but without being stretched. Held in this manner, the dam sheet is under less tension, and hence, exerts less tugging on clamps--especially on those attached to molars. Even in cases where there are no distinct anatomic undercuts, this lack of tension in the sheet eases isolation procedures and permits the use of standard rubber dam clamps. As a further benefit, the frame's raised edging provides a barrier around the sheet, which prevents small amounts of fluids from escaping. This contributes to greater patient comfort.
橡皮障(牙用障)适用于牙髓病治疗以及涉及酸蚀技术的牙修复治疗。该技术的使用频率因个体情况差异很大,鉴于其优势,其使用频率总体偏低。许多牙医不愿使用橡皮障的一个可能原因是过去在技术难度较大的操作中效果不尽人意。例如,当拉紧的橡皮障片对橡皮障夹施加过大拉力时,就会出现这种情况,导致橡皮障夹(以及整个橡皮障)松动。此处特别容易出现这种情况的是附着在磨牙上的夹子。这种不希望出现的张力是由于在将橡皮障片附着到传统橡皮障框架时拉伸橡皮障材料这一必要步骤导致的。作为替代方案,已开发出一种新型易用的橡皮障框架(安全T型框架),无需拉伸橡皮障片就能实现稳固贴合。相反,其“卡扣式”设计利用了两个配对框架部件紧密压合时对橡皮障片产生的夹紧效果。通过这种方式,橡皮障片得以稳固附着,且不会被拉伸。以这种方式固定后,橡皮障片所受张力较小,因此对夹子的拉扯力也较小——尤其是对附着在磨牙上的夹子。即使在没有明显解剖倒凹的情况下,橡皮障片缺乏张力也简化了隔离操作,并允许使用标准橡皮障夹。此外,该框架的凸起边缘在橡皮障片周围形成一道屏障,可防止少量液体逸出。这有助于提高患者的舒适度。