Rationale. Dental Dam is the safest and most efficient isolation technique in endodontics and restorative dentistry, but it also used in esthetics, orthodontics, prosthetics, pedodontics and periodontology (for teeth immobilization).

While in most cases the standard clamps are efficient, in some clinical situations clamp adaptation is mandatory in order to assure a tight contact on the tooth.

Objective. The purpose of this study is to list the elements of the clamp, which should be modified in order to assure a secure constriction of the clamp on the anchor tooth, by using the carved gypsum cast method.

Methods and Results. 100 patients were examined, diagnosed and treated for various diagnoses like simple decay, gangrene, chronic apical periodontitis, and endodontic retreatments. The clamps used in this study were produced by Hu-Friedy, Hygenic, KKD, SDI, Hager & Werken.

In 10 cases, the anchor tooth did not provide enough stability to the standard clamp – as provided by the producer. Therefore, we have done some adjustments to some of the elements of the clamp: the arch, the wings, the plateau, the active area, and the contact points. In 6 cases, major clamp adaptations on carved gypsum cast were imperative.

Discussion. The classic clamps cannot provide a grip to be enough in all the clinical cases due to the huge variety and position and implantation of the anchor teeth. Therefore, in such situations, the clamps should be adapted in order to provide stability and assure the safe isolation during the treatment.

The modified clamps will be useful in similar cases, so they must be kept.