THE ADVANTAGES OF COFFERDAMS TODAY AND THE IMPORTANCE OF LEVEL 4 INSULATION

Аннотация

Isolation of the working field is of great practical importance in dental treatment. The cofferdam is one of the most effective methods of isolation. It is a 15x15 cm latex veil made of rubber wood. The cofferdam kit includes: latex veil, frames, clamps, clamping forceps, perforator and template. Keywords: clamp, cofferdam, supragingival margin, gingivectomy. ПРЕИМУЩЕСТВА КОФФЕРДАМОВ СЕГОДНЯ И ВАЖНОСТЬ ИЗОЛЯЦИИ 4-ГО УРОВНЯ Аннотация. Изоляция рабочего поля имеет большое практическое значение при лечении зубов. Коффердам является одним из самых эффективных методов изоляции. Это латексная вуаль размером 15x15 см, изготовленная из каучукового дерева. В комплект коффердама входят: латексная вуаль, рамки, зажимы, зажимные щипцы, перфоратор и шаблон. Ключевые слова: зажим, коффердам, наддесневой край, гингивэктомия. The main reason to use a cofferdam is the need to ensure the dryness of the working field, because ingress of saliva containing microorganisms can infect periapical tissues during endodontic treatment, and also reduces the adhesion of composite materials when filling teeth. The advantages also include improved visibility of the working space, the exclusion of foreign, toxic substances on the soft tissues of the oral cavity. It is also important that the general well-being of the patient when using a cofferdam improves, as the patient feels that the treatment takes place outside the oral cavity, irritation from choking becomes less, the contents of the oral cavity remains normal. While there are many advantages, the cofferdam still has its disadvantages: it requires additional time for installation, the patient may have an allergic reaction to latex, the dental service becomes slightly more expensive. Cofferdam can affect the visible color of the teeth and thus make it difficult to choose the right shade of composite, but an experienced dentist will choose the color before placement. Dentist will match the color before the cofferdam is placed. Despite the disadvantages, there are many more advantages to the cofferdam, making it the most reliable method of isolation available today. 676 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 3 Although in modern dental practice, not many doctors use the cofferdam, citing the time required to apply and remove it, but once you start working with it, it is impossible to give it up. Cofferdam provides protection for the doctor and medical staff from cross-infections. Dental treatment becomes easier, better and more effective. Relevance. When it comes to quality restoration and adhesion, good insulation immediately comes to mind. This is a mandatory procedure, which, however, is not always easy to accomplish. The need to work in dry conditions in the oral cavity was recognized many decades ago, and the idea of using a rubber sheet to insulate a tooth dates back more than 150 years! The use of cofferdam was first described in 1864 in New York City by Dr. Sanford Christie Barnum, who demonstrated the benefits of isolating a tooth with a piece of rubber. Adhesive procedures were not known at the time, so the question becomes, “Why did he choose to work with a cofferdam?” Objective. What does good isolation imply? Good isolation can be achieved by mechanically shielding from the from the environment of the teeth to be worked on. In this case, they will remain dry and clean throughout the procedure. The first thing to aim for is a good inversion, i.e. tucking the edges of the cofferdam around the cusp of the teeth into the gingival sulcus and keeping it there until the end of the work. In other words, it is necessary to place the cofferdam outside the boundaries of the preparation area. Materials and Methods. For this we need kits and tools for cofferdam clamps, forceps for placing the clamps, punch, cofferdam template, frame, multifunctional floss set. Good insulation also includes: 1. A dry working field; 2. A large working field; 3. maximum tissue retraction; 4. Minimal interference with restorative procedures. To find new solutions to improve and accelerate the inversion of the of the cofferdam, various technologies and materials have been developed. The main purpose of isolation is to “separate” the teeth from the oral cavity to keep fluids and surrounding tissues out of the working field. The weak points in cofferdam isolation are the perforation holes. Immediately after applying the cofferdam, it is necessary to place it under the gingival margin into the gingival furrows. This process is called inversion. In other words, inversion is the tucking of the edge of the cofferdam perforations around the necks of the teeth into the gingival furrows to hold it in this position until it is the end of the work. An important rule is that the cofferdam should be 677 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 3 positioned passively around the tooth neck. If the material is stretched, inversion is almost impossible to achieve. The elastic properties of rub