Gingival Retraction
by Mahmoud H. Al-Johani
1. Criteria of Medicaments
1.1. The medicament must be effective
1.2. It should not cause significant and irreversible tissue damage
1.3. It should not produce potentially harmful systemic effects
1.4. It should result in sufficient gingival displacement
1.5. It should result in sufficient control of bleeding
1.6. It should result in sufficient control of fluid seepage
2. Commonly used medicamanets
2.1. 8% Racemic epinephrine
2.2. Aluminum chloride
2.3. Alum (aluminum potassium sulfate)
2.4. Aluminum sulfate
2.5. Ferric Ferric sulfate
3. Hints
3.1. Tissue damage should be reversible and heal (clinically & hitologically) completely within 2 weeks
3.2. There is no consensus in the literature regarding criteria for evaluation the clinical performance of retraction cords
3.3. Knitted and Braided Cord are preferred by some authors
3.4. The largest cord that can be atraumati- cally placed in the sulcus should be used
3.5. The primary error made by inexperienced dentists is to use a cord that is too small in diameter
3.6. No clinical study has demonstrated the superiority of one technique over another
3.7. Before removing the cord, the cord should be soaked in water to allow it to be easily removed from the sulcus
4. It might be difficult because:
4.1. Attempt to make impression when the tissues are clinically inflamed
4.2. When clinically there is inadequate attached gingiva
4.3. When prepared margins are placed too deep in the sulcus
5. Techniques Classifications
5.1. Mechanical
5.2. Chemical
5.3. Surgical
5.3.1. Rotary curettage
5.3.2. Electrosurgical method
5.3.3. LASER
5.4. Combinations
5.4.1. Mechanical-Chemical is the popular technique (Cord + Hemostatic Solution)
5.4.1.1. Single Cord Technique
5.4.1.2. Double Cord Technique
5.4.1.3. Infusion Method
5.4.1.4. The “Every Other Tooth” technique