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The clinical success and longevity of indirect restorations depend on the careful and accurate completion of several procedures. One of the challenging procedures is management of the gingival tissues and gingival esthetics. The goal for management of gingival tissues and gingival esthetics is to maintain the normal appearance of healthy gingival....
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Context 1
... of the popular hemostatic agents is AC with a concentration ranging from 20% to 25% (Fig. 10). Studies showed that a 5% to 10% AC solution along with a displace- ment cord is safe and effective. 35,58 However, if used with in concentrations higher that 10%, AC can be irritating and may cause damage to the gingival tissue. 72 Buff- ered AC was introduced to prevent irritation of the gingival tissue. Reiman 41 found that AC is ...
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... popular hemostatic agent is FS with a concentration ranging from 12.7% to 20% (Fig. 11). At high concentration FS is highly acidic and an irritant to the gingival tissues. 61,62,66,74 For optimal results, FS can be rubbed into the bleeding area using a soaked cotton pellet or an even better technique is to use a dento-infuser syringe tip to burnish the gingival surface with the FS (Fig. 12). Due to its high iron content, ...
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... displacement materials (CDM) have been recently introduced as an alterna- tive to the liquid hemostatic medicaments. They are available in different forms (paste, foam, or gel) and meant to be injected or packed into the sulcus (Fig. 13). 31,32,43,47,84,85 CDM in the form of pastes are thick, firm, and viscous and contain 15% AC along with 85% fillers (mostly a Kaolin matrix) in addition to water and some modifiers. 86 Bennani and colleagues 31 showed that their viscosity decreased with increasing shear stress demonstrating a typical pseudoplastic behavior. This high ...
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... ES, also referred to as tissue dilation or troughing, has been used alone or as an adjunct to mechanochemical tissue displacement. 91,92,94,95 ES is mostly used to reduce hyper- plastic tissues, expose the gingival margins, and prevent bleeding (Fig. 14). 91,94,96 It is also used to widen the gingival sulcus without reducing the height of the gingival margin so the impression material gains access to the prepared finish line and records some tooth structure apical to the finish line. It also facilitates removal of the impression after polymerization without tearing of the marginal ...
Context 5
... tissue sculpting for tissue displacement has offered the practitioner an alternative surgical technique for tissue displacement (see Fig. 13). Laser is an acronym from Light amplification by stimulated emission of radiation. It is a device that generates an intense (high energy) beam of coherent monochromatic light converted into thermal energy (heat) when it enters the soft tissue. The result is the vaporization or ablation of the tar- geted tissue, hence a controlled ...
Citations
... Merocel strips are synthetic strips made of polymer hydroxylate polyvinyl acetate inserted in the gingival sulcus to create a space allowing the impression material to record the details of the prepared tooth [12]. The strips showed promising results without any damage to the gingival tissues in addition to having the ability to absorb oral fluids making the area clean [11] [13] [14]. ...
... To our knowledge, this is the first documented case report to describe using flowable composite as a gingival retraction method. The most significant factor is to provide appropriate access for the impression material and digital scanning to record the tooth and soft tissue details without gingival damage[12] [18]. However, gingival retraction cords still the standard technique for gingival retraction in taking final impressions. ...
... Impressions taken without gingival displacement, results in higher chances of voids, tearing of impression materials, and less marginal accuracy. 23,24 Astringents are the substances used for management of bleeding during gingival retraction. They also help in enhancing the gingival resistance against infections. ...
A drug is defined as a chemical substance which alters functions of living organisms. These are used as a medication for the diagnosis, prevention, control or for treatment of a disease. Drugs effects depend on various factors such as body size, general health of individual, amount and strength of medication and whether one drug is taken or two are taken at same time. Dentists also use certain medications for management of some health conditions which affect oral cavity. Medications used in dentistry may be used for management of pain, prevention of diseases or fight against infections. These can also be used before or after any dental procedure to reduce pain or discomfort and also to prevent complications associated with dental procedure. These drugs may also develop variable adverse effects such as headache, skin rashes, nausea, sweating, lack of appetite etc depending on type, and dose of drug taken. Medications used in dentistry include anaesthetics, pain killers, antibiotics, antiviral drugs and antifungal etc. This paper provides an insight to the various medications, their role in dentistry & how they can help a dentist.
... Ideally, the small cord should stay in the sulcus after the impression has been removed rather than getting incorporated into the impression [34]. If not, the impression material may tear when the impression is removed. ...
... Cutting the small cord so that both ends perfectly meet in the sulcus is one method to prevent the cord from being removed with the impression, as cords that are too short or too long will be incorporated into the impression. Another method is to prevent the cords and sulcus from drying out [28,34]. ...
Addition silicones have revolutionized the field of fixed prosthodontics because of their dimensional stability, sufficient tear strength and excellent detail reproduction. This review study aims to provide a detailed description of the essential variables to be taken into account during the process of making addition silicone impressions in fixed prosthodontics. These variables include the selection of appropriate tray type, size, and fabrication; the use of tray adhesive; gingival displacement techniques; manipulation of the impression material; the choice of the impression material's viscosity; impression techniques; and the proper insertion, removal, disinfection, and pouring of the cast. Additionally, this review aims to help doctors produce high quality impressions by empowering them to critically assess the impressions to spot mistakes and motivating them to redo impressions that have serious problems before submitting them to the laboratory.
... Traxodent Hemodent Paste (Premier Dental Company, Plymouth Meeting, PA) is also comprised of 15% aluminum chloride topical paste along with cotton caps [15]. In summary, cordless techniques, while causing less discomfort to the patient, are considered less invasive and less time-consuming when compared to conventional retraction cords [4,12,18]. From another view since retraction paste systems depend on their expansion property upon contact with crevicular fluids, they might not provide enough displacement especially in cases of deep sulcus depth [4,12,19]. A randomized clinical trial investigated the GD using three different paste systems and reported a mean sulcular gingival width of (0.644 ± 0.22) in the Traxodent group, followed by the Expasyl group (0.590 ± 0.11), and the Magic Foam Cord group (0.528 ± 0.01) [20]. ...
... Surprisingly, only half of the participants reported using GD with both conventional and digital impressions. Nonetheless, it is well known that the GD is an essential step for both impression techniques [18].Almost twothird of participants reported using retraction cords for GD, while specialists and experienced dentists reported the use of both retraction cords and pastes in their practices. This could be attributed to the fact that specialists have a higher flow of advanced cases in which they might need both techniques to get enough GD and control bleeding. ...
Introduction
An accurate impression is an essential procedure for fabricating indirect fixed restorations. To achieve a precise final impression, the management of gingival tissue is without doubt a crucial.
Aim
To evaluate the use of different gingival displacement techniques among dental clinicians and to assess their associated knowledge and technique preferences.
Methods
A self-designed survey was created electronically and sent to a list of dentists. The survey was composed of multiple sections. Participants who stated that they do not use GD methods were asked to answer the survey questions based on their knowledge. Descriptive statistics were generated, andChi-square test was used to examine the association between the different variables.
Results
A total of 188 dentists participated in this study. The majority 144 (76.6%) use GD in their practice. When asked which technique yields a more accurate impression with lower incidence of repeating the impression, 93 (64.6%) reported retraction cord technique with a hemostatic agent results in a higher impression accuracy, while only 14 (9.7%) declared the retraction paste technique as being more accurate.
Conclusion
The cordless GD technique is believed to be easier, faster, and less traumatic to the gingival tissues, nevertheless, the outcome of dental impressions is believed to be more predictable with the use of conventional retraction cords and hemostatic medicaments.
... Numerous authors have focused on various retraction techniques employed in dentistry and the subsequent extent of undesirable gingival recession, as documented in references [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. ...
The aim of the current article is to analyze and compare post-retraction gingival height changes resulting from six different types of gingival-displacement methods, encompassing both conventional and surgical approaches. The study involved a comparative analysis of 263 teeth (consisting of 128 front teeth, 69 premolars, and 66 molars) from 23 patients. For the investigation, three classic retraction methods were utilized, namely the single-cord technique, retraction paste Expasyl, and retraction paste Astringent. Additionally, three surgical techniques were employed, which included ceramic bur rotary curettage, Er:YAG laser troughing, and diode laser troughing. A randomized split-mouth design was implemented, and a significance level of 0.05 was used for the study. The recovery of the free gingival margin height was assessed on gypsum models that were scanned using an intraoral scanner during the first and second week after the retraction procedure. The results revealed that all retraction methods, except for ceramic bur rotary curettage, led to clinically insignificant levels of gingival recession. The article provides insights into the effectiveness and safety of various gingival-displacement techniques, highlighting that most methods tested in the study resulted in minimal or negligible gingival recession post-retraction.
... [1][2][3] The first step, retraction or displacement of the gums, often uses a mechanical element placed in the gingival sulcus, such as a cord or paste. [4][5][6] The aim is to create a gap in the sulcus of about 0.2 mm. [7,8] Studies show that the retraction cord is the retraction device that den-tists use the most. ...
Introduction : Gingival retraction is the withdrawal of the marginal gingiva away from the tooth. This procedure creates a space between the prepared tooth and the gingival tissues to catch more fine details of the impression material. The most common retraction device used in clinical practice is the retraction cord.
Aim : The study aims to evaluate the tensile strength of retraction cords designed with different braiding technology.
Materials and methods : A total of 150 experimental units were studied. They were divided into 3 groups of 50 each according to the type of retraction cord (Ultrapak #00, braided cord without core, and braided cord with monofilament core). We tested the tensile strength in the LMT 100 micro-tensile apparatus. The data were analyzed using SPSS v. 21. A critical significance level of p <0.05 is used.
Results : The comparative analysis of the tensile strength of the retraction cords shows a statistically significant difference between the braided and the knitted threads (Ultrapak #00) ( p <0.001). The results indicated the highest tensile strength of the cord with monofilament 41.95 N/mm ² , followed closely by the cord with the same cotton braid without monofilament with average strength of 39.80 N/mm ² , and last came the Ultrapak cord 22.11 N/mm ² .
Conclusions : The braided retraction cords show higher tensile strength compared to the Ultrapak #00 cord, which is made using knitting technology.
... The contact of surrounding soft tissue should be avoided by restorative materials, but at times such contact is necessary (subgingival margins). Even if these margins are chosen, careful clinical execution allows periodontal health to be maintained in such situations [5]. Depending on the clinical situation and the patient's periodontal status, 3 primary techniques (mechanical, chemical with mechanical, and surgical) accomplish this objective [6]. ...
Background: The present study aimed to compare the clinical performance and gingival sulcus width changes in partially
edentulous patients using cotton and polymer gingival retraction cords.
Material/Methods: Fifty partially edentulous patients were divided into 2 groups (Gp C and Gp P) and were subjected to single
crown/fixed partial denture treatment. Clinical parameters, including plaque index scores, placement time, and
hemorrhage control scores, were assessed. Gingival sulcus width changes before and after retraction were evaluated
using individual type 4 dental stone dies observed under an optical microscope. Statistical analysis was
performed using dependent/independent t tests.
Results: The mean placement time, hemorrhage control time, and hemorrhagic scores were lower in Gp P than in Gp
C, indicating better clinical performance of polymer-based retraction cord. Both groups showed an increase in
sulcus width after retraction, but Gp P had a significantly higher sulcus width (690.03±45.37) compared to Gp
C (471.38±28.13). The mean difference in sulcus width between baseline and after retraction was also significantly
higher in Gp P (525.84 micrometers) than in Gp C (309.11 micrometers).
Conclusions: The present study shows that polymer-based cords produce more sulcus width and have better clinical performance
compared to cotton-based gingival retraction cords. These results suggest that the use of polymerbased
retraction cords can improve the quality of dental impressions in partially edentulous patients.
... The Traxodent system consists of an aluminum chloride topical paste and cotton caps used to efficiently compress the paste material for retraction of the gingival sulcus. Traxodent paste is a clay-based paste that contains 15% aluminum chloride with 85% fillers in addition to water and various modifiers [12]. The fillers are composed of montmorillonite and fumed silica. ...
Objectives:
This study investigated the effect of an aluminum chloride hemostatic agent on the shear bond strength (SBS) of a universal adhesive to dentin.
Materials and methods:
Eighty extracted human molars were trimmed at the occlusal dentin surfaces and divided mesiodistally. According to hemostatic agent application, specimens were randomly allocated into control (C) and hemostatic agent (Traxodent; H) groups. Each group was divided into 4 subgroups according to the adhesive system (n = 20): Scotchbond Multi-Purpose (SBER), Clearfil SE Bond (CLSE), All-Bond Universal etch-and-rinse mode (ALER), and All-Bond Universal self-etch mode (ALSE). SBS was measured for half of the specimens at 24 hours, and the other half were thermocycled in water baths (group T). Fracture surfaces were examined to determine the failure mode. The SBS was measured, and data were analyzed using 1-way analysis of variance, the Student's t-test, and the Tukey honestly significant difference test (p = 0.05).
Results:
No significant differences in SBS were found between groups C and H for any adhesive system at 24 hours. After thermocycling, a statistically significant difference was observed between CT+ALSE and HT+ALSE (p < 0.05). When All-Bond Universal was applied to hemostatic agent-contaminated dentin, the SBS of H+ALSE was significantly lower than that of H+ALER (p < 0.05). The SBER subgroups showed no significant differences in SBS regardless of treatment and thermocycling.
Conclusions:
When exposed dentin was contaminated by an aluminum chloride hemostatic agent before dentin adhesive treatment, application of All-Bond Universal in etch-and-rinse mode was superior to self-etch mode.
... if the finish line is subgingival, as the margin of the restoration must be kept 2 mm away from the crest of the underlying alveolar bone [11]. The relation between the supra crestal fiber attachment, the margin location and the location of the base of the sulcus is a critical factor to avoid encroachment of the biological width [12]. ...
Objective: to assess the amount of vertical and lateral gingival tissue displacement and recovery obtained by aretraction cord and Magic Foam® paste. Material and Methods: twenty- two participants, requiring full coverageprosthesis in the anterior area, were prepared using a deep subgingival chamfer finish line, then randomly allocatedto the retraction cord group (Group RC, n = 11 teeth) or the Magic Foam® Paste group (Group FP, n = 11 teeth).The amount of lateral and vertical tissue displacement was measured by comparing the pre- and post- displacementcasts at three fixed points (midbuccal, mesial and distal) using a stereomicroscope. After two weeks, tissue recoverywas assessed by taking an impression using a double mix. The amount of tissue recovery was measured verticallyfrom the gingival margin to the bottom of the sulcus and by comparing the results to the pre-displacement records.Results: there was no significant difference in the vertical gingival displacement (P > 0.05). However, there wassignificantly less lateral gingival displacement of the Magic Foam® Paste in the mesial and mid-buccal surfaces only(P < 0.05). The Magic Foam® Paste showed significantly more tissue recovery than the retraction cord (P< 0.05).Conclusion: both the retraction cord and the Magic Foam® Paste are considered effective means of retraction asthey give the least amount of retraction needed both laterally and vertically. KEYWORDSGingival retraction techniques; Gingiva; Retraction cord; Tissue recovery; Stereomicroscope.
... Designing a proper temporary restoration is a powerfulblueprint for future restoration in terms of esthetics, function, and biology. At the same time, the shape is responsible for remodeling the soft tissue around the tooth or implants preventing infl ammation and contributing to bleeding control and marginal clearance[9,[12][13][14] (Figure 4).3. When the dentist controls and respect the relationship between the emergence profi le and the new restoration using a correct soft tissue management protocol, the specifi c gingival biotype presents a favorable response by perfectly adapting to the material without any infl ammation or invasion of biological width[10,[15][16][17] (Figure 5). ...
Nowadays, the process of transferring intra-oral information from the dental office to dental laboratories has been a current reality in dentistry. The number of advantages presented in this process include work accuracy, patient acceptance, a transfer, and storage information facility, three-dimensional visualization, and an increase in time efficiency [1].
