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1.
Medicina (Kaunas) ; 60(8)2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-39202587

RESUMO

Background and Objectives: Gingival retraction is a critical pre-impression procedure in fixed prosthodontics, crucial for exposing tooth margins and ensuring accurate impressions for restorations like crowns and bridges. This study aimed to evaluate the absorptive capacity of different gingival retraction cords. Materials and Methods: Ninety samples each of Ultrapak (Ultradent, South Jordan, UT, USA) #00, braided cord, coreless thread, and monofilament thread (totaling 270 samples) were immersed in 0.9% NaCl, 10% aluminum chloride, and 12.7% ferrous sulfate solutions for 120, 300, and 1200 s. The liquid absorption capacity was measured using a gravimetric method, and the data were analyzed using an F-test, setting the significance threshold at p < 0.05. Results: The results revealed statistically significant differences in absorption, particularly for aluminum chloride and ferric sulfate (p < 0.001). Ultrapak demonstrated the highest absorption, followed by the coreless cotton thread, while the monofilament thread absorbed the least, especially at 1200 s. Conclusions: These findings indicate that Ultrapak's superior absorption could enhance moisture control during procedures, highlighting the importance of selecting an appropriate retraction cord for optimal clinical outcomes. Further research is needed to confirm these findings in a clinical setting.


Assuntos
Cloreto de Alumínio , Técnicas de Retração Gengival , Humanos , Técnicas de Retração Gengival/instrumentação , Técnicas In Vitro , Hemostáticos/farmacologia , Hemostáticos/uso terapêutico , Compostos Ferrosos , Gengiva/efeitos dos fármacos , Compostos Férricos , Cloretos/análise
2.
J Indian Prosthodont Soc ; 24(2): 136-143, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38650338

RESUMO

AIM: To evaluate and compare the effect of impregnated retraction cord vs Laser on gingival attachment level and pain perception following retraction for subgingival margins. SETTINGS AND DESIGN: Many methods for achieving and measuring the amount of gingival retraction in fixed prosthodontic work have been advocated. Though the gingival attachment level is crucial in Periodontology, the literature available regarding the effect of these retraction methods on the same is scarce. Hence, this clinical study was designed to compare the pain perception and amount of gingival recession when impregnated cord and laser were used for retraction. MATERIALS AND METHODS: In 40 subjects (age range of 20 to 40 years) with single missing maxillary incisor, the abutments were prepared with subgingival margins, to receive a full coverage metal-ceramic fixed dental prosthesis. The gingiva was retracted on one of the abutments with impregnated retraction cord and on the other with diode laser. Gingival attachment levels were compared at six sites per abutment using superimposition of digital scans, preoperative and four weeks after cementation of final prosthesis. STATISTICAL ANALYSIS USED: Statistical analysis of the data for gingival recession was done using t-test. Pain perception was analysed with Chi-square test. Pain perception by patients following retraction was compared with VAS scale. RESULTS: The average values of gingival recession on buccal side were 0.61 mm and 0.38 mm and on the palatal side were 0.58 mm and 0.35 mm for impregnated retraction cord and laser respectively. The P values of <0.01 indicated a highly significant difference between the two groups. Intragroup comparison did not show significant differences between various sites. Pain and discomfort produced by cord method was moderate in comparison with mild/no pain with diode laser and the difference was highly significant.Conclusion: Retraction cord produced more gingival recession than the diode laser, which was statistically highly significant on both buccal and palatal aspects of the teeth. Patients experience with diode laser technique was less painful in comparison with retraction cord method.


Assuntos
Retração Gengival , Percepção da Dor , Humanos , Adulto , Estudos Prospectivos , Feminino , Masculino , Percepção da Dor/fisiologia , Adulto Jovem , Técnicas de Retração Gengival/instrumentação , Gengiva , Lasers Semicondutores/uso terapêutico , Medição da Dor/métodos
3.
Eur Rev Med Pharmacol Sci ; 27(17): 8019-8025, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37750631

RESUMO

OBJECTIVE: The study aimed to evaluate and compare gingival retraction in terms of lateral and vertical displacement with a magic foam cord, conventional retraction cord, and laser. PATIENTS AND METHODS: This in-vivo experimental study was performed on 60 patients. Three different gingival retraction systems were used to evaluate the amount of vertical and lateral displacement. The study sample units were divided into three groups of 20 units each. Tooth preparation was done for a metal-ceramic restoration with a subgingival finish line. Gingival displacement was accomplished with a magic foam cord, conventional retraction, and laser. Vertical and Lateral displacement was measured by the distance from the finish line to the free gingival margin in pre and post-displacement casts with the help of a traveling microscope. Stereomicroscopic images of the impression of ×10 resolution were scanned into an image analyzer to measure the lateral displacement. The data analyzed using one-way ANOVA and Bonferroni test were used to determine the significant difference at the p<0.05 level. RESULTS: Independent group analysis comparing the vertical and lateral displacement within each group showed a statistically significant difference (p<0.05) with mean maximum vertical and lateral displacement achieved by lasers (0.73 and 0.61) followed by magic foam (0.37 and 0.21) and least by retraction cord (0.21 and 0.13), respectively. CONCLUSIONS: Laser provided the maximum lateral and vertical displacement of the gingival margins, followed by magic foam cord, and the least with conventional retraction, which was statistically significant.


Assuntos
Técnicas de Retração Gengival , Humanos , Gengiva
4.
Eur Rev Med Pharmacol Sci ; 27(6): 2222-2231, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-37013740

RESUMO

OBJECTIVE: Conventional use of retraction cord in soft tissue management is effective only when the non-resilient nature of material does not jeopardize gingival health. Therefore this study aims to clinically evaluate the gingival displacement, ease of application and bleeding from polytetrafluoroethylene (PTFE) retraction cord. PATIENTS AND METHODS: This study is a single-center, parallel-group, randomized controlled clinical trial (1:1). Sixty patients indicated for full coverage metal-ceramic restoration for first molars were enrolled and randomly allocated to experimental (PTFE Cord) and control (conventional plain retraction cord) groups. After crown preparation and isolation, a pre-displacement impression was made. Assigned gingival displacement material was applied for 5 minutes, followed by post-displacement impression. Casts were prepared and used for assessment of mean horizontal gingival displacement by measuring displacement using a stereomicroscope (20 x). Post-displacement gingival bleeding and ease of application were also assessed clinically. t-test and Chi-square tests were used for statistical assessment of gingival displacement, gingival bleeding and ease of application. RESULTS: Gingival displacement, bleeding and ease of application were similar among study groups (p > 0.05). Mean gingival displacement in the experimental group was 197.1 µm, and 167.7 µm in the control group. Bleeding was observed in 30% and 20% of cases of experimental and control group, respectively. Ease of application was 'difficult' in 53.3% and 43.3% of cases of experimental and control group, respectively. Non-impregnated gingival retraction cord and PTFE cord displayed similar outcomes of gingival displacement, ease of placement and bleeding after cord removal. CONCLUSIONS: Post-displacement bleeding and discomfort for PTFE cord placement suggest that this technique needs improvement. Therefore further studies are warranted to improve and investigate the physical and biological response to PTFE retraction cord.


Assuntos
Gengiva , Técnicas de Retração Gengival , Humanos , Politetrafluoretileno
5.
Am J Orthod Dentofacial Orthop ; 161(6): 838-848, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35219553

RESUMO

INTRODUCTION: This study compared the changes of gingiva and alveolar bone parameters, including cortical and cancellous bones between thick and thin gingival biotypes after en-masse retraction. METHODS: Thirty-two adult subjects (mean age, 20.6 years) with maxillary anterior teeth protrusion and proclination were studied and divided into 2 equal groups: thick gingival biotype (TKB) and thin gingival biotype (TNB). Maxillary anterior teeth were retracted using nickel-titanium coil springs at 150 g of force bilaterally for 4 months. Lateral cephalograms, study models, and cone-beam computed tomography scans were taken before retraction and 3 months after 4 months of retraction. Nonparametric tests compared the changes within the groups at these periods and between the groups. RESULTS: The gingiva gained thickness and length (P <0.01) on the labial and palatal sides. The gingival thickness gained more on the palatal side (P <0.01), whereas the length gained equally in both groups. Labial alveolar bone showed increased thickness and height (P <0.01) as opposed to the palatal alveolar bone that presented with loss of thickness and height (P <0.01). The height loss occurred more in TNB (P <0.01). Labial cortical bone increased in thickness and height (P <0.01), whereas palatal cortical bone thinned (P <0.01) at levels in which no cancellous bone was present at the crestal level for TKB and the crestal and midroot levels for TNB. TKB showed slower incisor movement and less retroclination than the TNB (P <0.01) with minimal incisor extrusion. CONCLUSIONS: Favorable gingiva and labial bone responses after en-masse retraction were found in both gingival biotypes, whereas more palatal alveolar bone height loss was presented in TNB. Cortical bone thickness decreased when cancellous bone was absent.


Assuntos
Gengiva/fisiologia , Maxila , Adulto , Perda do Osso Alveolar/etiologia , Tomografia Computadorizada de Feixe Cônico/métodos , Gengiva/diagnóstico por imagem , Gengiva/patologia , Técnicas de Retração Gengival , Humanos , Incisivo , Palato , Adulto Jovem
7.
Braz. dent. sci ; 25(1): 1-8, 2022. tab, ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1361503

RESUMO

Objective: To compare the effectiveness of local and topical anesthesia during gingival retraction in prepared abutment teeth. Material and Methods: 72 patients desiring full mouth rehabilitation or bilateral fixed partial denture in the same arch were selected based on the inclusion criteria framed and were randomly allocated into Groups A and B of 36 each. Patients in Group A received gingival retraction with topical anesthesia and Group B received gingival retraction with infiltration anesthesia. All the patients were tested for pain, discomfort and bleeding during gingival retraction. Results: There was no significant difference in pain, discomfort and gingival bleeding (P >.05) during gingival retraction using topical and local anesthetic agents. Conclusion: Topical anesthesia was equally effective as infiltration anesthesia in managing the pain, discomfort and bleeding during gingival retraction by cord packing in prepared abutment teeth. (AU)


Objetivo: Comparar a eficácia da anestesia local e tópica durante a retração gengival previa a moldagem em dentes pilares preparados. Material e Métodos: Foram selecionados 72 pacientes indicados para reabilitação bucal total ou prótese parcial fixa bilateral na mesma arcada com base nos critérios de inclusão formulados e alocados aleatoriamente nos Grupos A e B com 36 pacientes cada. Os pacientes do Grupo A receberam retração gengival com anestesia tópica e no Grupo B receberam retração gengival com anestesia infiltrativa. Todos os pacientes foram testados para dor, desconforto e sangramento durante o procedimento. Resultados: Não houve diferença significativa na dor, desconforto e sangramento gengival (P>. 05) durante a retração gengival com anestésicos tópicos e locais. Conclusão: A anestesia tópica foi tão eficaz quanto a anestesia de infiltração no controle da dor, desconforto e sangramento durante a retração gengival com fio retrator gengival em dentes pilares preparados.(AU)


Assuntos
Humanos , Dor , Infiltração Dentária , Técnicas de Retração Gengival , Anestésicos Locais
8.
J Contemp Dent Pract ; 22(8): 922-927, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34753845

RESUMO

AIM: To analyze the clinical effectiveness of three new gingival retraction systems: knitted retraction cord, expanding polyvinyl siloxane, and aluminium chloride containing paste. MATERIALS AND METHODS: Twenty patients were enrolled with age-group of more than 18 years and who required fixed prosthesis with minimum of two abutments. A preliminary impression of the arch was made with a stock metal tray and irreversible hydrocolloid impression material. Group WR-impression without retraction, Group A-impression after retraction with gingival retraction cord, Group B-impression after retraction with expanding polyvinyl siloxane, and Group C-impression after retraction with aluminium chloride containing paste. A total of four impressions were made for each abutment tooth. Each impression was given a label 1WR, 1A, 1B, 1C-20WR, 20A, 20B, 20C: where 1 denoted the sample number. Comparison of the stereomicroscopic images was done using image analysis software. Time required from start of placement of gingival displacement agents till completion was recorded in seconds with the help of a stop clock. RESULTS: The mean gingival retraction was found to be the highest for subjects of Group C followed by Group A, Group B, and Group WR. This difference was found to be statistically significant. Highly significant mean difference in time of placement was observed between Group A and Group B, between Group B and Group C, and between Group C and Group A. CONCLUSION: The aluminium chloride containing paste was found effective in almost all the variables considered. CLINICAL SIGNIFICANCE: The choice of particular gingival retraction system/technique is dependent upon the clinical variables and on operator's preference.


Assuntos
Técnica de Moldagem Odontológica , Técnicas de Retração Gengival , Adolescente , Cloreto de Alumínio , Materiais para Moldagem Odontológica , Gengiva , Humanos
9.
J Contemp Dent Pract ; 22(6): 703-706, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34393130

RESUMO

AIM: The aim of this study was to assess the effectiveness of different gingival displacement materials in the management of the width of the gingival sulcus. MATERIALS AND METHODS: Totally, 60 participants who were aged 18 years and more were chosen for this study. The eligible participants were those who required fixed prosthesis with at least one abutment. A modified sectional tray was used to make impressions with elastomeric materials along with additional polysilicon using the double mix single impression technique. All participants were divided randomly into three experimental groups with each group having 20 participants as follows: group I-Expasyl, group II-Magic Foam Cord, and group III-Traxodent. Soon after retraction, impressions were made and assessed in a comparable manner to pre-retraction impressions. Image analysis software was used to measure the quantity of displacement of the gingiva, marked as the distance from the tooth to the gingival crest in the horizontal level under stereomicroscope. RESULTS: The highest mean sulcular gingival width (0.644 ± 0.22) was found in Traxodent group followed by Expasyl group (0.590 ± 0.11) and Magic Foam Cord group (0.528 ± 0.01). A statistically significant difference (p<0.001) was found between the groups. Intergroup comparisons between the gingival displacement materials showed a statistically significant difference (p<0.05) between group II and group III. CONCLUSION: The present study concluded that all three gingival displacement materials lead to gingival displacement, which is needed for impression making. Slightly more retraction was seen in the Traxodent group when compared to the Expasyl group and Magic Foam Cord group. CLINICAL SIGNIFICANCE: The success of fixed prosthodontic treatment depends upon precision and accuracy in every step involved in the procedure.One of the most vital stepsis making precise impressions in relation to dimensional accuracy, tear strength, etc. It is essential to have an adequate thickness of the impression material along the margins to avoid distortion. This objective can be achieved by acceptable gingival retraction.


Assuntos
Gengiva , Técnicas de Retração Gengival , Adolescente , Adulto , Assistência Odontológica , Materiais para Moldagem Odontológica , Técnica de Moldagem Odontológica , Elasticidade , Humanos
10.
Eur J Prosthodont Restor Dent ; 29(1): 47-53, 2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33026719

RESUMO

The objective of this study was to evaluate the use of naphazoline hydrochloride in comparison with aluminum chloride for vertical gingival displacement. The inclusion criteria were: patients with a good general systemic condition; periodontal health; and thick gingival biotype. Moreover, the exclusion criteria were: smoking individuals; canine teeth or central incisors with carious lesions, abrasion, erosion, prosthetic abutments or unsatisfactory restorations; patients with periodontal disease; and users of continuous medication. 72 teeth were included and the Square Block Design was used to randomize the samples. Three measures were obtained from each tooth, and mean vertical gingival displacement was calculated. A descriptive analysis of the average displacement was performed. The normality test used was the Lilliefors' Test and for comparison between treatments, the Kruskal-Wallis Test was used. The Bartlett's Test for homogeneity of variances was used and a 5% (p ⟨ 0.05) significant level was considered. Thus, the Aluminum Chloride and Naphazoline Hydrochloride showed no statistically amount of gingival retraction than the control group (p = 0.3822). The average of gingival vertical displacement in all groups were less than 0,5 mm. The technique used did not allow any amount of horizontal displacement on obtained models.


Assuntos
Técnicas de Retração Gengival , Nafazolina , Cloreto de Alumínio , Dente Canino , Gengiva , Humanos
11.
J Prosthet Dent ; 125(1): 46-55, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32008797

RESUMO

STATEMENT OF PROBLEM: Unsatisfactory adaptation of restorations with subgingival margins can cause problems such as accumulation of biofilm, secondary caries, and inflammation of the periodontal tissue. Therefore, special attention should be given to gingival displacement and impression procedures to optimize marginal fit. PURPOSE: The purpose of this systematic review and meta-analysis was to compare gingival displacement with conventional cords and cordless techniques and determine the reliability of the measurement methodologies. MATERIAL AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and identified studies through September 2018. The studies were submitted to the Cochrane risk-of-bias assessment. The gingival displacement was evaluated by using the Review Manager Software. RESULTS: Nine studies were selected, and the most common risks of bias were random sequence generation, blinding of outcome assessment, and absence of sample size calculation. Most of the studies reported obtaining a width greater than 0.2 mm. CONCLUSIONS: The cord technique resulted in increased displacement when compared with the cordless technique. The evaluation of sulcular width with digital microscope images obtained from sectioned gypsum casts is an adequate and versatile experimental methodology for measuring displacement.


Assuntos
Gengiva , Técnicas de Retração Gengival , Humanos , Reprodutibilidade dos Testes
12.
J Esthet Restor Dent ; 32(4): 410-415, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32442353

RESUMO

OBJECTIVES: This clinical study measured the change in opening and height of the displaced gingiva using paste and cord retraction materials for definitive impression making of natural teeth and assessed if they were comparable and clinically acceptable. METHODS: Impressions of 4 maxilla premolars from 10 participants were taken using a split-mouth protocol. All participants were free of periodontal disease, had a thick biotype, a minimal of 3 mm height of keratinized gingival tissue and gingival sulci depths of 2 mm. The bleeding index (BI), gingival index (GI) plaque index (PI), sulcular depth, level of attachment and tooth sensitivity were recorded at baseline, just after retraction, at 24 hours and at 2 weeks. Impressions were poured in stone and then after initial analysis were cross-sectioned to allow measurements of the gingival height change and gap size to be recorded. RESULTS: The paste produced a slightly smaller gap compared to the cord (0.041 mm less, P = .014) whilst the mean displacement for the cord was 0.282 mm and paste was 0.241 mm respectively. Gingival height with the paste was 0.047 mm lower than that achieved by the cord (P = .208). CONCLUSIONS: Cord and paste retraction produced comparable clinically acceptable gingival gaps, with the cord producing statistically larger gap size. CLINICAL SIGNIFICANCE: The cord and paste retraction materials produced comparable clinically acceptable gingival retraction.


Assuntos
Cloreto de Alumínio , Técnicas de Retração Gengival , Compostos de Alumínio , Cloretos , Gengiva
13.
Med Princ Pract ; 29(5): 492-498, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32241014

RESUMO

OBJECTIVE: A widely used chemical-mechanical method of gingival retraction can cause gingival tissue damage. The aim of this study was to test the influence of the chemical-mechanical gingival retraction procedures on the gingival bleeding index (GBI) and the salivary concentration of monocyte chemoattractant protein 1 (MCP-1) as an indicator of inflammatory changes in the gingiva. MATERIALS AND METHODS: The effects of 2 different retraction agents (aluminum chloride and ferric sulfate) were compared, particularly their tissue damaging effect during tooth preparation. Therefore, GBI values and the salivary concentration of MCP-1 were assessed during the chemical-mechanical method of gingival retraction in a homogenous group of respondents. The subjects (n = 60) were divided into 2 experimental groups (G1 and G2) regarding the need for tooth preparing and making artificial crowns. Each group was further divided into 2 subgroups (R1 and R2) according to the type of the gingival retraction agent used (aluminum chloride and ferric sulfate). RESULTS: Compared to the values at the study start, a statistically significant increase in GBI and salivary MCP-1 (p < 0.001) 1 day after gingival retraction agent application was observed in both experimental groups. After 72 h, the values were lower than in the second observation period but still statistically significantly higher compared to the study start (p < 0.001), which indicated the reversibility of the tissue changes. CONCLUSION: Higher values of the investigated parameters were observed in the group of subjects with prepared teeth, and clinical changes were more pronounced after the use of ferric sulfate.


Assuntos
Quimiocina CCL2/análise , Técnicas de Retração Gengival/efeitos adversos , Gengivite/induzido quimicamente , Saliva/imunologia , Adulto , Cloreto de Alumínio/efeitos adversos , Feminino , Compostos Férricos/efeitos adversos , Humanos , Inflamação/imunologia , Masculino , Índice Periodontal , Adulto Jovem
14.
Int. j. odontostomatol. (Print) ; 14(1): 136-146, mar. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1056513

RESUMO

RESUMEN: En ortodoncia, las miniplacas se utilizan como dispositivo de anclaje temporal (TAD) para la realización de movimientos dentales que permiten el uso de fuerzas ortopédicas en ellos. En comparación con los mini tornillos, las miniplacas tienen la ventaja de una tasa de falla muy baja, pero la desventaja es que para la extracción se necesita el mismo acto quirúrgico que se realizó para la instalación. El objetivo de este estudio es realizar una revisión bibliográfica de las indicaciones de miniplacas en pacientes con mordidas abiertas, clase II y anomalías de clase III, y buscar cómo las miniplacas han mejorado los tratamientos de ortodoncia. La información principal se reunió buscando en PubMed con las palabras clave enumeradas a continuación. Afirmamos que las miniplacas están indicadas para la retracción en masa de la arcada, donde se observó que la fuerza de 150 g aplicada en los molares superiores es suficiente no solo para empujar los molares hacia atrás en una clase I corregida, sino también para iniciar la retracción de premolares, caninos e incisivos. En pacientes con mordida abierta, las miniplacas se definen como un método seguro, una alternativa rápida y menos costosa a la cirugía ortognática. Y en pacientes de las clases II y III se utilizan sin producir efectos dentoalveolares que sustituyan a los dispositivos extraorales como máscaras, con dispositivos intraorales y elásticos (BAMP).


ABSTRACT: In orthodontics, miniplates are used as a Temporary Anchoring Device (TAD) for the purpose dental movements, allowing the use of orthopedic forces. In comparison with mini-screws, miniplates have the advantage of a very low rate of failure. Nonetheless, their removal requires the same surgical procedure as during installation, which is an obvious disadvantage. The aim of this study is to review the indications of miniplates in patients with open bite, class II and class III anomalies, and review how miniplates improved orthodontics treatments. Information was obtained by a search in PubMed with the keywords listed below. Miniplates are indicated for retraction in mass of the arcade, where it was seen that the force of 150 g applied on maxillary molars, is sufficient not only to push the molars back into a corrected class I, but also to initiate retraction of premolars, canines, and incisors. In open-bite patients, mini plates, are achieved as a safe method, that is quick and a less expensive alternative to orthognathic surgery. Further, in class II and III patients they are used without producing dentoalveolar effects replacing extraoral devices as facemasks, with intraoral devices and elastics. (BAMP).


Assuntos
Humanos , Técnicas de Movimentação Dentária/instrumentação , Parafusos Ósseos/efeitos adversos , Implantes Dentários , Procedimentos de Ancoragem Ortodôntica/instrumentação , Má Oclusão Classe II de Angle/cirurgia , Má Oclusão Classe III de Angle/cirurgia , Placas Ósseas , Cefalometria , Técnicas de Sutura , Âncoras de Sutura , Processo Alveolar/cirurgia , Técnicas de Retração Gengival , Dente Molar
15.
J Prosthodont ; 28(7): 784-789, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31206914

RESUMO

PURPOSE: To investigate the pressure generated by different retraction materials using a novel gingival sulcus model. MATERIALS AND METHODS: A gingival sulcus model was made using a polymer frame filled with silicon. A pressure sensor and a sulcus-fluid simulation were embedded into the silicon chamber to evaluate the pressure generated by different retraction materials. Six sizes of Ultrapak retraction cords (Ultradent, sizes #000 - 3), 4 retraction pastes (Expazen, Expasyl, Acteon, Access Edge, Traxodent) and 2 retraction gels (Sulcus Blue, Racegel) were analyzed. The mean and median pressure, interquartile range, and standard deviation (SD) of n = 10 repeated measurements were calculated. Statistical analysis was conducted by Kruskal-Wallis test for differences between the main groups of retraction materials, and Mann-Whitney U-test was performed to analyze differences between the single retraction materials. RESULTS: Pressure (mean ± SD) generated by retraction cords increased with increasing size (48.26 ± 11.29 kPa, size #000 to 149.27 ± 28.75 kPa for #3). There was a significant difference between sizes (p < 0.01), except in #0 versus #1, and #2 versus #3. Retraction pastes generated pressures that ranged from 82.74 ± 29.29 kPa (Traxodent) to 524.35 ± 113.88 kPa (Expasyl). Retraction gels generated pressures from 38.96 ± 14.68 kPa (Racegel) to 95.15 ± 24.18 kPa (Sulcus Blue). Pressure generated by Expasyl was significantly higher than pressure generated by all other tested materials (p < 0.001). CONCLUSION: Pressure generated by retraction pastes and gels depends on the consistency of the retraction material, while pressure generated by retraction cords increased with increasing size of cords. Expasyl was found to generate the highest pressure compared to all other retraction materials.


Assuntos
Gengiva , Técnicas de Retração Gengival , Assistência Odontológica , Humanos
16.
Quintessence Int ; 50(3): 234-244, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30773575

RESUMO

OBJECTIVES: The effect of gingival retraction paste versus gingival retraction cord on periodontal tissue health is controversial. The aim of the present study was to evaluate the effect of gingival retraction paste versus gingival retraction cord on periodontal health by a systematic review and meta-analysis and to provide scientific guidelines for gingival retraction method selection in clinical work. DATA SOURCES: The databases were systematically queried to collect studies exploring the effect of gingival retraction methods on periodontal tissue health in randomized controlled trials. Literature covering the period of January 1998 to April 2017 was extracted and the quality was assessed, followed by a random-effects meta-analysis with standardized mean differences and 95% confidence intervals. Eight studies met the inclusion criteria. The result of meta-analysis revealed that gingival retraction paste exhibited a less deleterious effect on the periodontal tissue compared with the gingival retraction cord technique measured by probing depth, Gingival Bleeding Index, and bleeding on probing (P < .05). However, no statistically significant differences were found in the measurements of Plaque Index, Gingival Index, and gingival recession between these two methods (P > .05). CONCLUSIONS: Gingival retraction paste can work better than the gingival retraction cord method in protecting periodontal tissue health.


Assuntos
Retração Gengival , Técnicas de Retração Gengival , Índice de Placa Dentária , Gengiva , Humanos , Índice Periodontal
17.
J Prosthet Dent ; 121(2): 265-270, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30722986

RESUMO

STATEMENT OF PROBLEM: Although the conventional chemicomechanical cord technique is widely used, packing the cord into the sulcus may cause pain and bleeding. Cordless displacement techniques have been introduced, but a comparison of these systems is lacking. PURPOSE: The purpose of this clinical study was to evaluate the efficiency and gingival response of 4 cordless gingival displacement systems. MATERIAL AND METHODS: One hundred twenty teeth in 30 participants were allocated to 4 groups according to the material used: Tr (Traxodent; Premier Dental Products Co), Es (Expasyl; Acteon UK), Ez (Expazen; Acteon UK), and Mr (3M Retraction; 3M ESPE). Baseline measurements of periodontal indices and a digital scan were acquired. The cordless displacement pastes were applied according to the manufacturer's instructions. After removal, a second scan was acquired. Participants were recalled on the 2nd and 14th day to measure periodontal indices and for scans. Screenshots were superimposed to measure changes in the gingiva. Statistical differences among the different materials in achieving lingual and buccal vertical gingival displacement were tested using the related-samples Friedman 2-way ANOVA test by ranks at 3 time points such as immediate, at 2 days, and at 14 days (α=.05). RESULTS: Immediate gingival displacement varied with the system used. For horizontal displacement, median values ranged between 150 µm (Tr) and 725 µm (Ez) for buccal displacement and between 93 µm (Tr) and 550 µm (Ez) for lingual displacement. Minimum and maximum displacements also varied and followed a similar trend, with Traxodent providing the lowest displacement. The plaque index and attachment level did not statistically differ before and after the treatment. The periodontal parameters were not statistically significant among the groups at all time intervals, except for the gingival index that increased for all the groups after 2 days. CONCLUSIONS: Significant differences were found among the 4 tested systems in both vertical and horizontal gingival displacement. Expasyl, Expazen, and 3M Retraction exceeded the 200-µm requirements for horizontal displacement. Traxodent provided the least displacement in both vertical and horizontal dimensions.


Assuntos
Gengiva , Técnicas de Retração Gengival , Índice de Placa Dentária , Índice Periodontal
18.
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1056848

RESUMO

Abstract Objective: To analyze the efficacy of retraction cord with a hemostatic agent in comparison with retraction paste on lateral gingival displacement, to achieve the success of fixed dental prostheses (FDP). Material and Methods: Test samples included 32 teeth that required treatment with metal-porcelain FDP at RSKGM FKG Universitas Indonesia. Impressions were taken before the gingival retraction procedure. From the 32 samples, 16 teeth were retracted using a combination of retraction cord and hemostatic agent, whereas the other half were retracted with retraction paste. Impressions were then taken. The sample was made using cutting die. Lateral gingival displacement width was measured on die-cast using an optical microscope Results: The mean value of group A before gingival retraction was 0.1695 mm, and after gingival retraction was 0.4705 mm. The mean value of group B before gingival retraction was 0.1767 mm, and after gingival retraction was 0.3289 mm. Lateral gingival displacement width between a combination of cord retraction and hemostatic agent group in comparison with the retraction paste group showed a significant difference (p<0.001). The combination of cord retraction and hemostatic agent group showed higher mean value Conclusion: Gingival displacement width as a result of cord retraction with the hemostatic agent was larger compared to the retraction paste. Even though both of them are still considered to be effective in providing access for impression material.


Assuntos
Humanos , Hemostáticos , Técnica de Moldagem Odontológica/instrumentação , Prótese Dentária , Técnicas de Retração Gengival/instrumentação , Estatísticas não Paramétricas , Indonésia/epidemiologia
19.
Quintessence Int ; 49(9): 719-732, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30202835

RESUMO

The purpose of this topic review is to give a general overview of gingival retraction agents used during prosthodontic treatment, and the possible difficulties connected to them that may be faced by the dentist. Hemostatic agents are important for successful gingival retraction and in achieving hemostasis. However, these agents may show numerous negative effects on the prosthodontic treatment and oral tissues of which the practicing dentist must be aware, and which will be elucidated in this review. PubMed and Google Scholar databases were searched for publications up to and including 2017. The following key words were used in different combinations: "hemostatic agent," "astringent," "astringency," "epinephrine," "ferric sulfate," "aluminum chloride," "hemorrhage control," "soft tissue," "hard dental tissue," "self-etch adhesive," "total-etch adhesive," "bond strength," "impression," "gypsum," "plaster cast," and "dental cast." In the last three decades the hemostatic agents used by practicing dentists have changed from epinephrine towards astringents, with AlCl3 and Fe2(SO4)3 now the most popular. All of the currently known hemostatic agents cause some local, temporary gingival tissue damage, but only epinephrine is known to elicit negative systemic effects. Studies concerning the influence of hemostatic agents on impression materials show highly contradictory results regarding the possible polymerization-inhibiting properties of hemostatic agents, probably due to the lack of standardization of methodology. Hemostatic agents seem to alter the dentinal surface properties making it more resistant to acid etching. Therefore the relatively low acidity of self-etch adhesives when compared to total-etch systems may not be strong enough to sufficiently etch a more resistant dentinal surface, and consequently may result in lower adhesive bond strengths.


Assuntos
Técnicas de Retração Gengival , Hemostáticos/farmacologia , Prostodontia , Humanos , Propriedades de Superfície
20.
Artigo em Inglês | MEDLINE | ID: mdl-29889917

RESUMO

This study was aimed at comparing the most common two methods for gingival troughing: presaturated cord and lasers (including diode, Nd:YAG, and Er:YAG). A total of 108 anterior teeth (58 maxillary and 50 mandibular) in 50 patients were included in this study. Gingival treatment was carried out in the following four groups: presaturated cord, diode laser, Nd:YAG laser, and Er:YAG laser. The gingival width and gingival recession (GR) were measured at different times (at the time of treatment, after 1 week, and after 4 weeks). The presaturated cord resulted in significantly higher (P < .05) GR than lasers and narrower gingival sulci. Er:YAG laser resulted in the quickest and most uneventful wound healing when compared to diode and Nd:YAG lasers.


Assuntos
Gengiva/cirurgia , Retração Gengival/cirurgia , Retração Gengival/terapia , Gengivectomia/métodos , Terapia a Laser/métodos , Lasers Semicondutores/uso terapêutico , Adolescente , Adulto , China , Desenho Assistido por Computador , Feminino , Retração Gengival/diagnóstico por imagem , Técnicas de Retração Gengival/instrumentação , Gengivectomia/instrumentação , Humanos , Terapia a Laser/instrumentação , Lasers de Estado Sólido/uso terapêutico , Masculino , Resultado do Tratamento , Cicatrização , Adulto Jovem
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