Assessment of treatment field isolation during scaling, root planing and rinsing

Aim: Intensive application of highly concentrated antimicrobials during scaling and root planing may be hazardous if swallowed in quantity. This study evaluates two dental isolation systems for fluid leakage in conjunction with a sham treatment of scaling and root planing. Materials and methods: Eight volunteers were randomly assigned to wear a conventional rubber dam (RD) and a combined suction and isolation device (IsoLite® system [IL]) alternatively on contralateral maxillary and mandibular quadrants. RD was cut between the canine and the first molar and was fixed on the first molar with a rubber dam clamp and with a tissue adhesive (Histoacryl) on the gingiva. IL was applied as recommended by the manufacturer. Ultrasonic instrumentation with corresponding irrigation water was used for 5 min as sham treatment, i.e. no actual therapy. The irrigation liquid was collected and the difference between the amount of liquid applied and that collected during treatment was determined. The volunteers then reported on their comfort during treatment. Results: Neither of the devices offered complete isolation. Mean leakage with both systems was generally low, i.e. approximately 10% (of the applied irrigant). More leakage was recorded in the maxilla than in the mandible, for both systems. Both devices were deemed moderately comfortable to wear. Conclusion: RD and IL isolated the working field to a similar degree. Since RD represents the highest isolation standard currently available, the use of IL must also be considered sufficient to prevent noxious amounts of antiseptic rinses from leaking into the mouth.