Rubber dam usage related to restoration quality and survival

The effects of rubber dam or cotton roll isolation on the initial quality and later survival of 644 amalgam and 149 anterior enamel-bonded composite resin restorations were evaluated over periods of up to 15 and 10 years, respectively. All restorations were placed by one operator and their quality assessed at the time of finishing, using seven clinical characteristics. The influence of six other clinical parameters on the survival of the restorations was also evaluated. There were no clinically-significant differences present in the initial high quality of the restorations, or in their later survivals, which could be directly related to the use or otherwise of rubber dam. Overall, the restoration survivals were excellent. However, there were significantly more amalgam restoration failures, from bulk fracture, in patients with severe bruxism.