Abstract

Despite the growing popularity of intraoral scanners, dental professionals continue to face the challenge of obtaining precise imaging of preparation margins. Deep margins, bleeding, or the presence of saliva during scanning procedures can compromise the accuracy of digital scans. Rubber dam isolation presents a practical solution to enhance the quality and efficiency of digital imaging. By creating a clean and dry field around the preparations and margins, it prevents interference from fluids (e.g., saliva and blood), allowing for clearer visualisation and more accurate capture of critical details during intraoral scanning. In addition, deep margin elevation enables the repositioning of subgingival margins to a more favourable location. This case report describes the use of rubber dam isolation in combination with deep margin elevation, performed prior to intraoral scanning with the dam in place. This approach was applied in the restoration of upper left premolars with an inlay and an onlay. A female patient in her mid-30s presented with upper left premolars showing secondary caries beneath extensive restorations and gingival inflammation at the margins. The treatment plan involved replacing the existing restorations with milled hybrid ceramic indirect restorations. The restorations and caries were removed. Under rubber dam isolation, deep margin elevation was performed on the distal wall of the upper left first premolar. Fibre-reinforced posts were placed, followed by composite resin core build-ups. Rubber dam isolation was maintained to facilitate scanning. The restorations were fabricated and cemented under isolation. At the one-year follow-up, the restorations were functional, well adapted and the periodontal tissues remained healthy.