The effect of different isolation techniques on rubber dam leakage in a dental simulator

This study aimed to evaluate the sealing effectiveness of three different gingival barrier materials used in combination with rubber dam isolation in a dental simulator environment and to compare their performance with conventional rubber dam isolation. In this in vitro experimental study, four isolation systems were evaluated using a phantom simulator model: conventional rubber dam, rubber dam + OpalDam Green Barrier, rubber dam + SDI Gingival Barrier, and rubber dam + FlexDam Gingival Barrier. Measurements were performed on maxillary and mandibular first molars and maxillary and mandibular central incisors. Each isolation system was applied ten times in each tooth region, resulting in a total of 160 applications. Isolation quality was assessed by measuring the residual volume of 10 mL distilled water remaining in the isolated area after a five-minute evaluation period. Data were analyzed using the Kruskal–Wallis H test and Dunn’s post-hoc test ( p < 0.05). Significant differences among the isolation systems were observed in both posterior (H = 26.100, p = 0.001) and anterior (H = 29.222, p = 0.001) tooth regions. In posterior teeth, the median residual fluid volumes were 8.08 mL for conventional rubber dam, 9.85 mL for OpalDam Green Barrier, 9.85 mL for SDI Gingival Barrier, and 9.73 mL for FlexDam Gingival Barrier. In anterior teeth, the corresponding median values were 8.58, 9.85, 9.80, and 9.45 mL, respectively. Conventional rubber dam demonstrated the lowest median residual fluid volume in both regions. OpalDam Green Barrier and SDI Gingival Barrier demonstrated consistently high residual fluid volumes across both regions, whereas FlexDam Gingival Barrier showed high sealing performance in posterior teeth but greater variability in anterior teeth. Under standardized simulator conditions, adjunctive gingival barriers may improve the predictability of cervical sealing compared with conventional rubber dam isolation alone. Their use may be beneficial when cervical adaptation is challenging; however, these laboratory findings should be confirmed under clinical conditions before being generalized to patient care.