Adequate retraction/isolation remains one of our most common clinical challenges. Adding to this is the increased use of clinical photography, both intraoral and extraoral, which requires that these soft tissue structures be well isolated.
Over the years, dentists and dental manufacturers have experimented with clinical tools to help create space between the teeth (our working field) and the tongue, cheeks, and lips. These tools have included the following:
- Patient-held or assistant-held curved cheek retractors
- Operator thumbs and forefingers
- Cotton rolls and Dri-Angles (Dental Health Products)
- Isolite (Zyris) or DryShield Isolation System (Solmetex)
- OptraGate (Ivoclar)
- Mirrors and/or air/water syringe tips
- Rubber Dam
All these have limitations, including expense, difficulty of use, inefficiency, patient discomfort, and ineffectiveness. Nearly all dentists desire a means of consistently retracting the tissues of the oral cavity that meets these standards:
- Is easy to use for assistant and dentist
- Stays in place, with clinician’s hands free, during the procedure
- Retracts cheeks, lips, and tongue simultaneously
- Is comfortable for the patient
- Is inexpensive and disposable
Ultradent Products Inc, recently introduced its own retraction device: the Ultradent Umbrella. I and several other Catapult product review board members had the opportunity to try the Umbrella in our offices for several weeks, and found it particularly convenient and effective.
Umbrella™
The Umbrella tongue, lip, and cheek retractor is ideal for a variety of procedures requiring clear access without compromising patient comfort, including but not limited to in-office whitening, scanning, impressions, bite registrations, surgical procedures, and more. It is designed to give you a clear treatment field while making patient comfort a top priority. It is easy to place, disposable, and naturally and gently helps the patient hold their mouth open without pulling or stretching their lips. A new, innovative tongue-retraction design allows the tongue to comfortably rest behind the tongue guard, keeping it back and away from the working area. Featuring anatomically placed/shaped bumpers, so clinicians can rest a hand on the patient’s mouth without causing discomfort, the Umbrella also provides relief and comfort to gaggers—it does not initiate the gag reflex for most.
Ultradent Products Inc
888-230-1420
Ultradent.com
The Umbrella is made of a flexible, disposable material with a springlike feature, allowing clinicians to press the placement tabs together for comfortable placement, then “springing” into the desired position when the tabs are released. An innovative tongue retraction feature keeps the tongue back and away from the working area. The labial component has bumpers that, when properly placed, provide ample separation within the vestibules. The device is designed so that the patient can remain still while the bite is checked.
The Umbrella was tremendously easy to use. Almost all clinical personnel in our offices had a chance to use the product and were surprised at how simple it was to slide into the patient’s mouth, often using 1 hand, and to achieve the desired retraction upon releasing the product and letting it pop into position. After the pop, no effort is required to maintain position, making the Umbrella one of the easiest, most convenient products among those listed.
In contrast to several retraction/isolation alternatives, the Umbrella is very comfortable for the patient. Bumpers near the labial vestibule have been designed so that little discomfort was reported, even when clinicians put excessive pressure on those areas as a fulcrum. Although there is a tongue retraction feature, which could gag the patient, very few Catapult product review clinicians said gagging prevented them from using the Umbrella.
Apart from second molars, our clinicians reported highly adequate retraction of the tongue, cheeks, and lips during use. A variety of clinical uses were exhibited by the various Catapult evaluators, including the following:
- Anterior restorations (82.35%)
- Posterior restorations (23.53%)
- Digital scanning (23.53%)
- Diagnostic photography, intraoral and extraoral (23.53%)
- Crown cementation (17.65%)
- In-office whitening (29.49%)
- Sealants (11.76%)
- Crown preparation (29.49%)
- Orthodontic bracket bonding (17.65%)
- Crown cementation (17.65%)
This was accomplished by the high level of retraction, but also because the tongue retraction element gave us the ability to let saliva “pool” in the vestibule, away from the teeth. All clinicians reported that limitations arose the farther back in the mouth the procedure was.
In contrast to other retraction devices, the Umbrella is inexpensive and disposable, eliminating issues regarding infection control and blood/airborne pathogens.
Finally, our clinicians were particularly pleased with the Umbrella’s ability to allow occlusion to be checked even with the device fully in place. This has been a limitation for most of our retraction alternatives in the past, requiring us to remove the device, check occlusion, and then reapply. The design of the Umbrella to allow for full occlusal intercuspation while in place was tremendously convenient. This, along with ease of use, is the most valuable and unique characteristic of the Umbrella.
It has only been 3 months since we were introduced to the Ultradent Umbrella, and it has already become indispensable for our hygiene team and our dentists. Although we still find applications for alternative retraction mechanisms, this device is used most often for everyday procedures.
Every Catapult product review clinician was asked whether they would recommend the Ultradent Umbrella to a friend or colleague, and 100% said yes. Nearly 9 in 10 indicated they will continue to use this product in their office.
Catapult Education is happy to award Ultradent’s Umbrella the Catapult Vote of Confidence™.
