Çocuk Diş Hekimliği’nde İzolasyon Yöntemleri ve Konu Üzerine Yapılan Güncel Çalışmalar

Abstract

Pedodonti, 0–15 yaş arası bireylerin ağız ve diş sağlığını korumaya yönelik restoratif, endodontik, cerrahi ve koruyucu birçok tedaviyi kapsamaktadır. Bu tedavi işlemlerinin uzun vadeli başarısı, işlem sırasında kuru, temiz ve kontaminasyondan uzak bir çalışma alanının sağlanmasıyla doğrudan ilişkilidir. Bu nedenle, kullanılan izolasyon tekniğinin seçimi klinik başarı açısından kritik bir rol oynamaktadır. Özellikle pediatrik hastalarda seçilecek yöntemin etkinliği ve hastaya uygunluğu, tedavi sürecini doğrudan etkilemektedir. Bu anlatı derlemesi, pamuk rulolar, tükürük emiciler ve rubber dam gibi geleneksel izolasyon yöntemlerinin yanı sıra Isolite ve DryShield gibi modern sistemlerin etkinliğini değerlendirmektedir. Bu yeni nesil sistemler, entegre emme, aydınlatma ve ısırma desteği gibi fonksiyonları bir araya getirerek daha verimli ve entegre bir yaklaşım sunmaktadır. Klinik süreci hızlandırmakta, hasta konforunu artırmakta ve çocuk hastaların tedaviye uyumunu kolaylaştırmaktadır. Ayrıca, kısa dikkat süresi, artmış salivasyon ve sınırlı ağız açıklığı gibi çocuklara özgü davranışsal ve anatomik özellikler izolasyon tekniği seçiminde mutlaka dikkate alınmalıdır. Bireyselleştirilmiş ve hasta merkezli bir yaklaşım ön planda tutulmalıdır. Modern sistemlerin klinik uygulamalara entegrasyonu, pedodontik tedavilerin etkinliğini ve hasta memnuniyetini artırmada önemli katkılar sağlayabilir.

Keywords

• Çocuk diş hekimliği
• rubber dam
• hasta konforu

Isolation Techniques in Pediatric Dentistry and Recent Studies on the Topic

Abstract

Pediatric dentistry involves a wide range of restorative, endodontic, surgical, and preventive treatments aimed at maintaining the oral health of individuals aged 0–15 years. The long-term success of these procedures is strongly associated with maintaining a dry, clean, and uncontaminated working field during dental interventions. For this reason, the choice of isolation technique plays a critical role in achieving optimal clinical outcomes. The effectiveness and patient compatibility of the selected isolation method directly influence the success of the treatment, especially in pediatric patients who often present unique challenges in terms of both anatomy and behavior. This narrative review focuses on evaluating commonly used traditional methods such as cotton rolls, saliva ejectors, and rubber dams, as well as modern isolation systems like Isolite and DryShield. These newer systems combine suction, lighting, and bite block functions, offering a more integrated and efficient approach. They have been shown to significantly improve clinical workflow and enhance the comfort and cooperation of pediatric patients during treatment. Furthermore, behavioral traits like short attention span, increased salivation, and limited mouth opening must be considered when selecting an isolation strategy. A personalized and patient-centered approach should be prioritized. Incorporating advanced systems can contribute to more effective, time-efficient, and stress-free pediatric dental procedures, ultimately leading to improved patient compliance and satisfaction.

Keywords

• Pediatric dentistry
• rubber dams
• patient comfort

References

1. Gupta R, Tak JJ, Jaswanth JS. Recent advances in isolation in dentistry. IOSR J Dent Med Sci. 2023;22(6):32-6.
2. American Academy of Pediatric Dentistry Council on Clinical Affairs. Policy on patient safety. Pediatr Dent. 2022;44:80–2.
3. Roberson TM, Heymann HO. Operative dentistry: principles of cavity preparation. In: Gürgan S, editor. Art and science of operative dentistry. Ankara: Güneş Tıp Kitabevleri; 2011. p. 463–92.
4. Accorinte MLR, Reis A, Loguercio AD, de Araújo VC, Muench A. Influence of rubber dam isolation on human pulp responses after capping with calcium hydroxide and an adhesive system. Quintessence Int. 2006;37:205-12.
5. Bahcall JK, Olsen FK. Clinically enhancing the connection between endodontic and restorative treatment for better case prognosis. Dent Today. 2007;26:98-103.
6. Baum L, Phillips RW, Lund MR. Textbook of operative dentistry. Philadelphia: Saunders; 1995.
7. Tarçın B, Gümrü Tarçın B, Korkut B. Restoratif uygulamalarda izolasyon yöntemleri ve izolasyonun önemi. Türkiye Klinikleri J Restor Dent. 2015;1(3):28-33.
8. Dean JA, Avery DR, McDonald RE. Dentistry for the child and adolescent. 9th ed. St Louis: Mosby; 2011.

9. Christensen GJ. Using rubber dams to boost quality, quantity of restorative services. J Am Dent Assoc. 1994;125(1):81–82. doi:10.14219/ jada.archive.1994.0019
10. Cochran MA, Miller CH, Sheldrake MA. The efficacy of the rubber dam as a barrier to the spread of microorganisms during dental treatment. J Am Dent Assoc. 1989;119:141-4.
11. Barnum S. History of the discovery of the dam. Can J Dent Sci. 1877;4:88-9.
12. American Association of Endodontists. Use of dental dams in endodontics [Internet]. 2024 [cited 2026 Apr 14]. Available from: https://www.aae.org/specialty/wp-content/ u p l o a d s / s i t e s / 2 / 2 0 2 4 / 0 6 / D e n t a l D a m s _ PositionStatement_updated.pdf
13. Eskibağlar M, Eskibağlar BK, Gündoğar M, Özyürek T. Diş hekimliği pratiğinde rubber dam ve uygulama yöntemleri. Selcuk Dent J. 2021;8:875-80.
14. Bhuva B, Chong BS, Patel S. Rubber dam in clinical practice. Endod Pract Today. 2008;2(2):131-41.
15. Ballal NV, Khandelwal D, Saraswathi MV. Rubber dam in endodontics: an overview of recent advances. Int J Clin Dent. 2013;6:319-30.
16. Sikri VK. Textbook of operative dentistry. 4th ed. New Delhi: CBS Publishers & Distributors; 2016.
17. Jamir Y, Rao D, Panwar S, Samaddar K, Remi R. Isolation in paediatric dentistry: recent advances. Int J Appl Dent Sci. 2023;9:518-24.
18. Ammann P, Kolb A, Lussi A, Seemann R. Influence of rubber dam on objective and subjective parameters of stress during dental treatment of children and adolescents: a randomized controlled clinical pilot study. Int J Paediatr Dent. 2013;23:110-5.
19. Alhareky M. Effectiveness of the Isolite system vs. rubber dam technique while placing pit and fissure sealants in pediatric patients [doctoral dissertation]. Tufts University; 2013.
20. Shukla N, Akram Z, Kumar PGN et al., Khairnar MR, Jadhav SK, Priyadarsini S. Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques - a systematic review & meta-analysis. Evid Based Dent. 2025 Jun;26(2):112.
21. Sharma D, Choudhari S, Vanza H, Mittal S, Ahuja V, et al. The impact of rubber dam association with physiological stress parameters on children aged 7–10 years undergoing pit and fissure sealant treatment: an in vivo study. Cureus. 2024;16:e58615.
22. Saha A, Kamatham R, Mallineni SK, Nuvvula S. A cross-sectional survey on children perception of isolation methods for restorative procedures and influence of cognitive development. SRM J Res Dent Sci. 2016;7:219-21.
23. Rahul S, Saikiran KV, Elicherla NR et al., Anchala K, Singaraju A, et al. Evaluation of child’s behavior during pit and fissure sealant administration using rubber dam and MiniDam: a randomized clinical trial. J Indian Soc Pedod Prev Dent. 2024;42:119-25.
24. Bagher SM, Sabbagh HJ. A literature review of clinical efficiency, patient satisfaction, and future preference of Isolite and DryShield dental isolation systems among pediatric patients. J Clin Pediatr Dent. 2023;47.
25. Lyman T, Viswanathan K, McWhorter A. Isolite vs cotton roll isolation in the placement of dental sealants. Pediatr Dent. 2013;35:95E–99E.
26. Collette J, Wilson S, Sullivan D. A study of the Isolite system during sealant placement: efficacy and patient acceptance. Pediatr Dent. 2010;32:146-50.
27. Alhareky MS, Mermelstein D, Finkelman M, Alhumaid J, Loo C. Efficiency and patient satisfaction with the Isolite system versus rubber dam for sealant placement in pediatric patients. Pediatr Dent. 2014;36:400-4.
28. Bagher SM, Allaf H, Khogeer LN, Felemban O. Patient satisfaction and preference with DryShield vs rubber dam isolation among pediatric patients. J Res Med Dent Sci. 2021;9:82–90.
29. Mattar RE, Sulimany AM, Binsaleh SS, Al-Majed IM. Comparison of fissure sealant chair time and patients’ preference using three different isolation techniques. Children (Basel). 2021;8:444.
30. Siddalingappa D, Reddy V, Nayak AS, Urala AS, Pentapati KC. Efficiency and Patient-reported Outcomes for Isolite System: A Systematic Review of Randomized Controlled Trials. Int J Clin Pediatr Dent 2025; 18: 331-338.
31. Mahima S, Karuna YM, Shenoy R, Sudha K, Maimoona TM, et al. Evaluation of Anxiety Levels in Children While Using Rubber Dam and OptraDam Isolation Techniques. Int J Clin Pediatr Dent 2023; 16: 287-291.