Controlling the Field

In dentistry today, the foundation of almost everything we do from a restorative aspect rests on adhesive dentistry. Whether it’s bread and butter restorative, crown and bridge, or even orthodontic brackets, the foundation is quality and reliable bonding.

As all dentists know, the enemy of adhesive dentistry is contamination.  Whether it is excess water, saliva, blood, or crevicular fluid, contamination negatively impacts bond strength and the long-term viability of the restoration.

Every day thousands of adhesive procedures are performed by dentists; this requires a delicate dance of perfection while also playing a game of “beat the clock.” When bonding is taking place, often the most difficult part of the procedure is controlling the field. Many patients have limited opening, excessive saliva, or are unable to stay open very long, impacting the control of the field.

To increase the odds of success, the most important step is to stop contamination before it starts. Rubber dams are the most common way to perform isolation, but they can be cumbersome, difficult to place, and uncomfortable for the patient. In all my years of clinical practice, I’ve never had a patient ask to have a rubber dam placed. Often clamps get in the way or saliva begins to seep in despite our best efforts to get a good seal. Cotton rolls and other absorbent products are probably the most commonly used materials to achieve isolation, but as we all know they are far from perfect and often only minimally effective.

A Solution for Controlling the Field

Wouldn’t it be great if a solution existed that would keep the patient open, isolate the field, remove fluids in real time, offer retraction, and provide bright illumination, all while being comfortable and easy on both the patient and the team? Well I’m happy to tell you that this product exists and it is called Isolite, made by Zyris.

The Isolite mouthpiece is a single-use flexible device made of a latex-free polymer. This means it is comfortable for the patient and easy to place for the assistant.  It contains a bite block that the patient closes on, eliminating muscle fatigue while giving the team adequate interocclusal clearance to work. On either side of the bite block are flanges that retract the tongue and the cheek to increase access to the target area.

Once in place, the patient simply closes into the bite block and clear access to the field is attained. The mouthpiece is then attached to the high-volume evacuation connector, meaning there is a constant flow of negative pressure to evacuate fluids. Even excessive handpiece water spray is quickly and continuously removed from the field. There is a control that allows the assistant to reduce the amount of vacuum in case that is needed. The mouthpiece also contains an incredibly bright and tiny LED array that provides incredible illumination from every angle. The smart folks who designed the system even thought to include a curing mode for the light so it can be changed to orange during the curing process, meaning there is no chance of accidental premature setting of any photopolymerized chemistry.

A couple of years ago, I fractured tooth #14 while eating lunch. One of my associates immediately volunteered to prep the tooth for a crown. The problem was no dental assistant could stay and help that night. His response? “No problem. I’ll just use the Isolite so I can do it by myself.”  He completed the preparation in less time than I expected. I left the office with no jaw fatigue and no stress. I was a fan of Isolite before that day, but became an even bigger fan after being a patient.

If you are looking for a way to work more efficiently while also providing better clinical outcomes, Isolite is something you should investigate. As someone who not only uses it, but has also been a patient with the device, I highly recommend it.

Zyris
zyris.com
800-560-6066

From Decisions in Dentistry. March/April 2025;11(2):24.