Indications

Subgingival extensions of margins

Control of gingival hemorrhage or fluid flow Increase length of clinical crowns

Enhancing restoration
Recording preparation margins during impressions Removal of gingival overgrowth

Methods for gingival retraction

Mechanical
ChemicoMechanical Rotary curettage Electrosurgery

Mechanical method

Mechanical method
Mechanically displace gingival tissue outwards and

apically away from the tooth surface. Indicated in cases where gingiva is normal & healthy with adequate attached gingiva. Provides minimal gingival retraction

Commonly used material

Copper band
retraction cord rubber dam

Wooden wedge

Copper band
Is use as a means of carrying impression material
Mechanism for displacing the gingiva

Technique
Copper Band is welded to form a tube corresponding

to the size of the tooth On end is trimmed, to follow gingival finish line Tube is filled with modeling compound & seated along path of insertion

 Indication

- Situations in which several teeth have been prepared

Advantages

-Minimal recession
Disadvantages

-Incisional injuries Excessive pressure on the tissue

Retraction cord
Pressure packing into the gingival sulcus provide

sufficient gingival retraction

ChemicoMechanical

 It is a method of combining a chemical with pressure

packing It enlarge the gingival sulcus as well as controlling fluids seeping from the sulcus

Types of retraction cord

Cotton Synthetic Braided Twisted Woven/ knitted Coarse Fine Impregnated Non-impregnated

 Knitted cord sizes

#000 #00 #0 #1 #2
Braided cord

Twisted #7= #00 #8= #0 #9= #1 #10= #2

#7=#00 #8=#0 #9=#1 #10=#2

Factors to consider
Dark color to maximize contrast with tissues, tooth &

cord Absorbent to allow uptake of wet medicament Available in different diameters to accommodate varying morphologies of gingival sulcus

Commonly used chemicals

Aluminum chloride
Aluminum potassium sulphate Ferric sulfate

8% racemic epinephrine

CRITERIA FOR GINGIVAL RETRACTION MATERIAL

Effectiveness in gingival displacement

& hemostasis. Absence of irreversible tissue damage. Should not produce harmful systemic effects.

Technique
Operating area should be dry and the quadrant of the

prepared tooth should be isolated The cord is twisted to make it tight and small Cord should be dipped in the solution on a dapen dish

 Looped around the

tooth and packed into the gingival sulcus starting from the mesial surface and establish near the distal end

Packing material

 Instrument should be

angled slightly towards the root to facilitate subgingival placement of the cord After 10 minutes the cord should be removed slowly to avoid bleeding

Rotary curretage

 It is a troughing technique, wherein a portion of the

epithelium within the sulcus is removed to expose the finish line Should be done only on healthy gingiva

Indications
Absence of bleeding upon probing
Depth of the sulcus is <3Mm Presence of adequate keratinized gingiva

Technique Prior to rotary curettage, a

shoulder finish line is formed at the level of the gingival crest using flatend tapered diamond

 Hand piece should be run at slow speed

Abundant water supply should be sprayed during

procedure Retraction cord is impregnated to control bleeding Cord is removed after 4-8 mins and sulcus thoroughly irrigated with water

Electrosurgery

 Also known as Surgical Diathermy

Produces controlled tissue destruction to achieve a

surgical result

Indication
Areas of inflammation in gingival tissue where the

retraction cord cannot be used Gingival proliferation around the prepared finish line Enlargement of gingival sulcus& control of hemorrhage to facilitate impression making

Contraindication
Patients with cardiac pacemakers

Technique
Profound anesthesia
Place a drop of aromatic oil on upper lip Check the equipment for all connections

Use a very light pressure and quick deft strokes

Do not push electrodes through the tissue

 Ensures smooth passage of electrode without dragging

or charring of tissue

THANK YOU!