Comparative Evaluation of Clinical Efficacy of Two New Gingival Retraction Systems-An In Vivo Research (original) (raw)
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The Journal of Indian Prosthodontic Society, 2019
The goal of Prosthodontics is to achieve esthetic and functional restoration of what is missing. [1] Fixed prostheses have been the most common treatment modality to replace the missing tooth structure or teeth. Tissue management or gingival displacement, defined as 'the deflection of marginal gingiva away from the tooth' [1] is a crucial step before recording the impressions for optimum reproduction of marginal details in fixed restorations. The optimum gingival displacement has been reported to be approximately 0.2 mm without which impressions have higher incidences Aim: Displacement of gingiva is essential for obtaining accurate impressions for the fabrication of fixed prostheses, particularly when the finish line is at or within the gingival sulcus. Various newer impression materials have been introduced to achieve gingival displacement while recording the impressions. A comparative evaluation of these new gingival displacement materials was deemed necessary for efficacy in tissue management and dimensional accuracy. Materials and Methods: Ten individuals were selected according to the inclusion and exclusion criteria for gingival displacement using retraction cord impregnated with aluminum chloride and two polyvinyl siloxane impression materials (Aquasil and NoCord VPS impression system) according to Latin block design. Intraoral scanner and Vernier caliper were used to study and compare the dimensional accuracy of each die obtained following which the dies were sectioned and evaluated under optical microscope with image analyzer to measure the amount of gingival retraction. Results and Conclusion: Statistical analysis showed that the amount of gingival retraction obtained by using retraction cord impregnated with aluminum chloride as gingival retraction agent was maximum as compared to NoCord followed by Aquasil. All three gingival displacement techniques could produce gingival displacement >0.2 mm which is the optimum amount of retraction required for impression making. All the three materials are found to be dimensionally accurate.
Comparative clinical efficacy evaluation of three gingival displacement systems
Journal of Natural Science, Biology and Medicine, 2015
We compared the clinical efficacy of three gingival displacement systems to accurately record intra-crevicular margins of tooth preparation. One mechanical (magic foam cord) and two chemico-mechanical (expasyl paste and retraction cord impregnated with 15% aluminum chloride) gingival displacement systems were used. This study was conducted on the maxillary central incisors of 20 patients (20-60 years old) requiring full coverage restoration. All the three gingival displacement systems were tested in three sessions at an interval of 14 days in same order. The casts were sectioned and viewed under an optical microscope, followed by quantitative measurements of the width of the pre and postretracted sulci. All the three displacement systems produced highly significant horizontal gingival displacement. Retraction cord soaked in 15% aluminum chloride produced maximum displacement (0.74 mm), followed by expasyl paste (0.48 mm) whereas magic foam cord produced the least displacement (0.41 mm). Gingival displacement shown by each displacement system was found to be more than the accepted value necessary for elastomeric impression accuracy (0.2 mm) to record intra-crevicular margins of tooth preparation.
An in-vivo study to evaluate the clinical efficacy of different gingival retraction systems
International Journal of Advance Research, Ideas and Innovations in Technology, 2019
Background: Meticulous impression of the prepared teeth is of extreme importance for successful fixed prosthetic restorations. Gingival retraction allows access to finish lines and to create space for the impression material to record prepared and unprepared tooth structure. Dentists should carefully consider the various materials and methods of gingival retraction in light of the potential risks involved. Aim: The aim of this study was to assess and compare the amount of displacement in terms of lateral displacement by the Expasyl and Magic FoamCord retraction systems. Materials and methods: Study was conducted on the unprepared right and left maxillary central incisors for 10 subjects. Subjects were selected based on certain selection criteria. The pre-displacement and post-displacement impressions were made in a custom tray with monophase addition silicone material using a single mix-one step impression technique. Final cast of maxillary central incisors was sectioned longitudinally into two equal halves. The sectioned halves were oriented on mounting jig using a spirit level and assessed under a traveling microscope. The measurements were made from the crest of the gingival margin to the mid-buccal surface of the tooth. The amount of gingival displacement in each group was calculated by subtracting the pre-displacement values from post-displacement values. From the observations obtained statistical analysis was performed using paired't' and unpaired't' test. Results: Group I produced more amount of lateral displacement than Group II. However, the amount of gingival displacement between Group I and Group II showed a statistically significant difference. Conclusion: Expasyl pastes retraction system showed more lateral displacement of gingiva compared to Magic Foam Cord system.
Recent advances in gingival retraction -A literature review
Success of fixed prosthesis depends on accuracy of the impression. Marginal integrity plays a key role in prognosis of restoration. For this adequate exposure of the finish line is a must. The goal of gingival retraction is to atraumatically displace gingival tissues to allow access for the impression material to record the finish line and provide sufficient thickness of gingival sulcus so that the impression does not tear off during removal. This article describes some recent advances in the field of gingival retraction.
Asian Journal of Pharmaceutical and Clinical Research, 2018
Objective: The purpose of this in vivo study was to compare and evaluate the clinical efficacy of two gingival retraction systems; Ultrapak and Traxodent, on the basis of the amount of gingival retraction achieved in vertical and horizontal direction and their hemorrhage control. Methods: A total of 60 subjects were selected requiring fixed prosthesis. The two gingival retraction systems were used on the prepared abutments randomly. The vertical gingival retraction was measured before and after retraction using flexible measuring strip with 0.5 mm grading. The horizontal retraction was measured on the casts poured in polysilicone impressions made before the retraction and after retraction. Results: Statistically significant difference (p<0.05) was found between the amount of the retraction (vertical and horizontal) achieved by Ultrapak as compared to Traxodent. However, in achieving hemostasis Traxodent showed better efficiency than Ultrapak (p<0.05). Conclusion: The mean retraction width and depth achieved with retraction cord (Ultrapak) was significantly greater when compared with retraction paste. Although retraction paste (Traxodent) showed bleeding index significantly less when compared to that of retraction cord (Ultrapak).
Zenodo (CERN European Organization for Nuclear Research), 2023
Background : Gingival retraction is crucial for impression making in fixed prosthodontics. This invivo study aimed at comparing the gingival retraction in vertical and lateral axes produced by mechanical and chemical retraction systems through digital impressions using intraoral scanner. Materials and Methods: This in vivo, experimental study included 15 subjects,in which further 3 sample groups were allotted making the sample size 45. The mean vertical and lateral gingival displacement done by mechanical and chemical methods was measured at five points of maxillary anterior teeth after preparation on digital impression files made through direct intraoral scanning. Comparison of the mean values without retraction and with different retraction systems were done. The results were analyzed using the One-Way ANOVA, unpaired/independent t test, The Shapiro-Wilk test and Levene's test. Results : The displacement cord, showed mean vertical displacement to be 0.75 mm and the lateral displacement 1.13 mm. For the retraction paste, the resultant mean vertical displacement was calculated to be 0.68 mm and the lateral displacement 0.67 mm. For vertical displacement, no significant differences were found between the cord and the paste. But statistically significant results were seen for the lateral displacement between the same groups. Conclusion: The cord/mechanical system showed a greater amount of displacement than the cordless/chemical system. Intraoral scanning was found to be an effective means of measuring gingival retraction.
A literature review on techniques of gingival retraction
IP Annals of Prosthodontics and Restorative Dentistry
For the better out come of the fixed dental prosthesis in terms of periodontal health, in terms of aesthetics and longevity of the prosthesis, a good and proper retraction of the gingival tissue is very much required. For the proper placement of the fixed dental prosthesis over the prepared tooth requires close contact with the adjacent tissue i.e. gingiva, so for the proper and placement of the prosthesis in the close proximity requires adequate isolation and retraction of the soft tissue around the prepared tooth. For the procedure of gingival retraction various methods and different materials are available.
Gingival Retraction Techniques for Implants Versus Teeth: Current Status
Journal of the American Dental Association, 2008
The authors reviewed and compared gingival retraction techniques used for implants and teeth. The authors searched the literature using article databases Ovid MEDLINE up to May 2008, PubMED and Google Scholar (advanced search) and the following search terms: gingival retraction, implant abutment, impressions, cement-retained implant restoration, impression coping, peri-implant tissue, emergence profile and tissue conditioning. The authors found insufficient evidence relating to gingival displacement techniques for impression making for implant dentistry. Gingival retraction techniques and materials are designed primarily for peridental applications; the authors considered their relevance to peri-implant applications and determined that further research and new product development are needed. The use of injectable materials that form an expanding matrix to provide gingival retraction offers effective exposure of preparation finish lines and is suitable for conventional impression-making methods or computer-aided design/computer-aided manufacturing digital impressions in many situations. There are, however, limitations with any retraction technique, including injectable matrices, for situations in which clinicians place deep implants.
Innovative Publication, 2016
Aim: The aim of the study was to investigate different gingival retraction methods to check for the most accurate method and their effect on gingival and periodontal health. Material and Method: Sixty patients requiring crown on mandibular first molar were divided into four categories: Group I included retraction with plain cord, Group II included retraction with cord soaked in local anaesthetic solution, Group III used Expasyl for retraction and in Group IV Magic foam cord was used. For marginal fit, marginal discrepancy between the measurement coping and the cast was assessed at 8 reference marks using Digital Vernier calipers. Result: This study showed that all retraction techniques caused an acute injury after 1 day of retraction, which took 1 week to heal in the cord (plain and impregnated) and the Magic Foam groups. The Expasyl group had the highest GI compared with others, and showed slower healing. Its use might cause sensitivity in a small number of cases. The use of cordless techniques did not require haemostatic agent to control bleeding during retraction. All the four techniques showed adequate gingival retraction for the prosthesis. Clinically insignificant differences were seen in the four groups regarding the retraction achieved. Conclusion: Within the limitations of the study, it was concluded that all the four methods were effective for gingival retraction. Judicious clinical judgment & skill of the operator are the deciding factors for the selection of any one of the various methods of soft-tissue management.
Journal of Prosthodontics Dentistry, 2023
The marginal integrity of a restoration depends on the ability of impression material to accurately record the finish lines, which in turn will assure marginal adaptation and restoration aesthetics. To reveal the subgingival finish lines of preparation and to create enough room for the impression material, the gingiva must retracted vertically and horizontally be laterally. The most common and widely used method of gingival retraction uses a cord system for gingival displacement. Due to the technique dependence of gingival displacement with cord, products like expasyl paste and magic foam gel were developed. Thus the primary objective of this study was to determine the amount of gingival retraction achieved in width and depth using impregnated stayput retraction cord compared to magic foam gel and expasyl paste measured in micrometers using stereomicroscope under 10X resolution of the cast obtained before and after retraction which was sliced buccolingually to obtain a three millimetre specimen. Secondary objective was to assess presence or absence of gingival bleeding in the sulcus after retracting all three agents and to determine time taken for placement. Null hypothesis was there is no significant difference in the width and depth of gingival sulcus retracted in fixed prosthodontic treatment using impregnated stay put cord compared to magic foam gel and expasyl paste gingival displacement systems. Results revealed that the null hypothesis was ruled out. Expasyl paste caused the greatest horizontal retraction.The largest vertical retraction was obtained by the impregnated stayput cord. The best hemostatic effect was shown by the magic foam gel retraction system. Applying Expasyl paste to the sulcus required less time.