Isolation and Retraction

The main isolation options are rubber dams for maximum moisture control, all-in-one isolation systems like Isolite and OptraDam that combine retraction and isolation in a single device, and cotton roll isolation for shorter or lower-risk procedures. Rubber dams remain the gold standard for endo and bonded restorations requiring strict moisture control.

Retraction cord is physically packed into the sulcus to mechanically displace the gingiva before impression taking; retraction paste is injected into the sulcus and displaces tissue through a combination of hemostasis and chemical action. Paste is faster to apply and better tolerated by patients, while cord provides more predictable displacement in deeper sulci.

All-in-one isolation systems like Isolite and OptraDam are preferred when rubber dam clamp placement is difficult, for procedures requiring simultaneous retraction and illumination, or when patient cooperation makes traditional rubber dam application impractical. They are particularly effective for quadrant dentistry and multi-unit cases.

Hemostatic retraction pastes typically contain aluminum chloride or aluminum sulfate, which cause temporary vasoconstriction and tissue shrinkage. They are applied via a syringe tip directly into the sulcus, left for approximately 60–90 seconds, then rinsed thoroughly before impression taking to avoid interference with impression material accuracy.

Independent panels of practicing dentists use products in their own offices for approximately 4 weeks, rating on criteria including field visibility, tissue displacement predictability, ease of application, and patient comfort. Products scoring 4.3 or above earn the DPS Best Product designation.