Literature Review: Gingival Retraction Systems for Indirect Restorations

Authors

Fotima Jaludi, University of the Pacific
Nurain Rehman, University of the Pacific
Priyanka Unnam, University of the Pacific
Jim Milani, University of the Pacific

Lead Author Affiliation

International Dental Studies Program

Lead Author Program & Year

IDS Year 1

Second Author Program & Year

IDS Year 1

Third Author Program & Year

IDS Year 1

Fourth Author Program & Year

Faculty/Staff/Researcher

Presentation Category

Literature Review

Introduction/Context/Diagnosis

Fixed prosthodontics requires accurate impressions to record the finish lines, which is instrumental for the success of a single crown or fixed dental prosthesis. If the finish line is adjacent to or below the gingival margin, an adequate amount of gingival retraction is necessary to capture the impression that will help the lab in delivering a therapeutic, preventive, and esthetically stable restoration. This review discusses the different gingival retractions methods to achieve maximum hemostasis and retraction for successful indirect restorations.

Methods/Treatment Plan

Literature was selected through PubMed, MEDLINE and google scholar databases 2010 onwards using the following keywords for search: gingival retraction, periodontitis , gingivitis, crowns and bridges, indirect restorations, hemostatic agents.

Results/Outcome

Nineteen articles were reviewed. Retraction cords or cords impregnated with astringents are proven to be most effective in providing displacement of healthy gingiva, but retraction pastes are relatively gentle on periodontium. In esthetic areas, gingival recession (<1 mm) is more likely to occur when conventional cords are used during impression making. In subgingival margins, the cord technique resulted in increased displacement compared to the cordless technique and expasyl paste was the most effective cordless material. However, when 1- to 2-mm-deep subgingival preparation finish line is formed the displacement paste and cap application may be the first choice given the benefits of hemostasis, time saving, and ease of application. The cord technique generally loses most of its advantage of better gingival displacement in cases of mild gingivitis, thus the aluminum chloride paste technique can be selected more frequently in mild gingivitis.

Significance/Conclusions

Clinician’s expertise and judgment based on clinical factors and the current evidence is necessary to choose the type of retraction to be used for a particular case. More research is needed in surgical lasers for gingival retraction.

Comments/Acknowledgements

Jim Milani

Format

Event