In some occasions the tooth may be so badly damaged or anatomically difficult that the placement of the rubber-dam can not be properly done (see also preparative procedures). If the tooth/root nevertheless is considered worth a saving effort, other measures must be taken to maintain asepsis during treatment. Sometimes the dam can be set to place to two neighbouring teeth with one bigger continuous hole or own hole to each tooth (picture in main window above).
Other possibilities to improve asepsis in special problems include orthodontic transfer of the root and surgical procedures such as gingivectomy, bone plastia, partial extrusion of the root and extraction followed by root canal treatment in hand and intentional replantation.