Posterior_Direct_Restorations Salvatore_compressed
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FIG 4-15 (a) After fitting the dam on the frame, the clamp wings can be inserted in the dam. (b and c) Insert one wing in the hole along its full length. (d and e) Use the thumb and finger of one hand to compress the clamp wing while stretching the dam with the middle finger of the other hand until the hole stretches far enough to accommodate the other wing. (f) View from the opposite side showing the wing/dam locking action (small orange arrows) and the action of the middle finger (large yellow arrow). (g) The wing is inserted in the hole, and the tension of the middle finger is loosened. (h) View of the clamp in the dam. (i to m) The forceps is used to grasp the clamp, open it, and position it on the tooth. (n to s) The dam can be passed over the wings using a spatula or a pointed instrument. (t to v) Once the dam has been passed under the wings, the holes must be arranged over the appropriate teeth.
(w) In anterior sectors, septa usually will slot easily into the interdental spaces due to their intrinsic tension. (x) This is convenient because it allows the operator to concentrate on posterior septa, which sometimes require a little more effort.
VIDEO: APPLYING A DAM USING THE “DAM AND CLAMP TOGETHER” TECHNIQUE
Once the clamp engages with the dam (see Figs 4-15a to 4-15h), the forceps is used to grasp it (see Figs 4-15i and 4-15j) and apply force to open it (see Fig 4-15k). Once the clamp has passed over the equator of the tooth (see Fig 4-15l), it can be gently released to slide over the tooth surface until it settles in a stable position (see Fig 4-15m). A small spatula (see Figs 4-15n to 4-15q) or a pointed probe (see Figs 4-15r to 4-15t) is generally used to tuck the dam under the wings. Once the dam has been tucked under the wings (see Fig 4-15u), the rest of the isolation is carried out by first arranging the holes over the corresponding teeth (see Figs 4- 15v and 4-15w) and then fitting the interdental septa, starting with the ones that fit into position by themselves (see Figs 4-15x to 4-15z) before using dental floss for the others (Fig 4-16).
