20 Most Important Points on the Retainer

20 Most Important Points on the Retainer

1. The retainer secures the dam to the tooth and helps in soft tissue retraction.

2. The rubber dam retainer/clamp has four prongs and two jaws connected by a bow.

3. Most rubber dam clamps are now manufactured from stainless steel as this resists corrosion much better than plated steel

4. Specific retainers are designed for certain teeth. However, teeth that are rotated, partially erupted, fractured, unusual crown form or with severe carious involvement require special clamps

5. Properly selected retainer should contact the tooth in four areas. Thus, it prevents rocking/ tilting of retainer.

6. It shouldn’t extend beyond the medial and distal line angles of the tooth because:

I. It may interfere with matrix and wedge placement.

II. Gingival trauma may occur.

III. Complete seal around the anchored tooth becomes difficult.

7. Some retainers have processes which are gingival directed. They help to anchor the partially erupted tooth and provide additional soft tissue retraction.

8. Retainers are available in two forms; wingless and winged.

9. The advantage of a winged clamp on a molar tooth is that both clamp and dam can be placed on the tooth simultaneously.

10. Wings allow a more rapid, efficient means of applying dam. In addition, it gives broader buccolingual deflection of the dam.

11. When a wingless clamp is used on a molar tooth, it is normal to place the clamp first, and place the dam over it.

12. Most of the anterior teeth can be isolated with a small winged clamp but if stability is a problem, a wingless clamp is almost always successful.

13. Winged retainer has 2 wings-Anterior and lateral. They provide extra retention and allow the attachment of the dam to the retainer before its placement.

14. Wing may interfere with the placement of the matrix band, band retainers and wedges. Sometimes, anterior wing can be cut away, if not required. However, generally in such condition wingless retainers are preferred.

15. Bow is tied with dental floss of approximately 12 inches in length before the retainer is placed in the mouth.

16. For maximum protection floss is tied with both holes. Floss allows retrieval of the retainer/ its broken parts, if it is accidentally swallowed or aspirated.

17. Jaw is sometimes re-contoured according to the shape of the tooth by grinding with mounted stone.

18. In case of treatment of anterior teeth except class-V restoration, a retainer is usually not required.

19. Wedges or strips of rubber dam can be used to retain the dam instead of a clamp in the front of the mouth.

20. This is especially useful in the anterior region, when it is necessary to use a split-dam technique.