Posterior_Direct_Restorations Salvatore_compressed

FIG 4-16 (a) The floss should never be positioned in the middle of the septum. This could break the dam. (b) The floss must be inserted between the dam and the tooth. (c) If the dam will not fit completely, the floss should not be withdrawn but passed from the other end, repeating the same procedure on the adjacent tooth. (d) If the septum still will not fit, the floss should be removed gently and the procedure started again. (e) The septa of the dam are stretched. (f) Floss is inserted between dam and tooth. (g) Pressure is applied axially.

(h) If the dam will not fit through, another end of the floss is used between the dam and the adjacent tooth. (i and j) The floss has passed into the interproximal space. Now it can be removed. (k to p) Withdraw the floss toward the two ends, not towards the loop.

To pass the septa into the posterior sectors where the contacts are tighter, the septa first must be stretched considerably (see Fig 4-16e). The floss must be positioned between tooth and dam (see Figs 4-16b and 4-16f) or medially and distally but not in the middle of the septum (see Fig 4-16a); otherwise, the dam will break. Firm, steady force should be applied cervically (see Fig 4-16g)—horizontal movements should not be used—until the floss passes through. This process is repeated on the other side (see Figs 4-16c, 4-16d, and 4-16h) without removing the first

section of floss. Once the dam is fitted (see Figs 4-16i and 4-16j), the floss is withdrawn horizontally (see Figs 4-16k to 4-16o), and only then is tension on the dam released (see Fig 4-16p).

The dam should be thoroughly inverted by tucking it in at the neck of the tooth (Figs 4-17a and 4-17b). This allows greater visibility and access to the cervical areas. This can be done with spatulas or pointed instruments (Figs 4-17c to 4-17f). An air jet may help.