Establishing a Protocol for Gingival Retraction- A Review
Main Article Content
Keywords
Impression making, gingival retraction, cordless retraction, and implant
Abstract
To ensure the success of fixed dental prostheses, it is critical to obtain accurate impressions of the prepared finish line, whether it is a tooth-supported or implant-supported prosthesis. Gingival retraction techniques can be used to reduce any discrepancy between the restoration and the abutment if the prepared finish line is near the gingival sulcus. Accurate marginal positioning is crucial for optimal therapeutic, preventive, and aesthetic outcomes. Gingival retraction techniques can be classified into mechanical, chemical, or surgical methods. This article provides an overview of various conventional and modern methods of gingival retraction used in impression making of tooth-supported and implant-supported prostheses, and summarizes the conclusions extracted from studies on gingival tissue management.
References
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3. Rajambigai MA, Raja SR, Soundar SIJ, Kandasamy M. Quick, painless, and atraumatic gingival retraction: An overview of advanced materials. J Pharm Bioallied Sci. 2016 Oct;8(Suppl 1):S5–7. 4. Merchant A, Ganapathy DM, Maiti S. Effectiveness of local and topical anesthesia during gingival retraction. Braz dent sci. 2022;1–8.
5. Murugan T, Inbasekaran D, Murthykumar K. Enhanced Gingival Recession Coverage by Er,Cr:YSGG Laser Root Biomodification. Contemp Clin Dent. 2021 Sep 21;12(3):328–31.
6. Rajasekar A. Comparative Evaluation Of Different Concentrations Of Povidone Iodine As Subgingival Irrigant In The Management Of Chronic Periodontitis. 2021 Sep 23 [cited 2023 May 5]; Available from: https://zenodo.org/record/5702381
7. Al Hamad KQ, Azar WZ, Alwaeli HA, Said KN. A clinical study on the effects of cordless and conventional retraction techniques on the gingival and periodontal health. J Clin Periodontol. 2008 Dec;35(12):1053–8.
8. Kannan A, Venugopalan S. A systematic review on the effect of use of impregnated retraction cords on gingiva. Research Journal of Pharmacy and Technology. 2018;11(5):2121–6.
9. International Journal of Dentistry, Oral Science (IJDOS). Prevalence And Distribution Of Drug-Induced Gingival Enlargement In Urban Population -A Retrospective Cohort Study Research Article. SciDoc Publishers [Internet]. 2021 Jan 1 [cited 2023 May 5]; Available from: https://www.academia.edu/57505301/Prevalence_And_Distribution_Of_Drug_Induced_Gingival_Enlargement_In_Urban_Population_A_Retrospective_Cohort_Study_Research_Article
10. Maischberger C, Stawarczyk B, von Hajmasy A, Liebermann A. Hemostatic gingival retraction agents and their impact on prosthodontic treatment steps: A narrative review. Quintessence Int. 2018;49(9):719–32.
11. Kavita K, Sinha RI, Singh R, Singh R, Reddy KRP, Kulkarni G. Assessment of Aluminum Chloride Retraction Cords, Expasyl, and Tetrahydrozoline-Soaked Retraction Systems in Gingival Retraction. J Pharm Bioallied Sci. 2020 Aug;12(Suppl 1):S440–3.
12. Singh A, Rao B, Gujjari A. Evaluation of gingival displacement using foam cord and retraction cord: An in vivo study. J Int Oral Health. 2019;11(1):8.
13. Shillingburg HT, Hobo S. Fundamentals of Fixed Prosthodontics. 1981. 454 p.
14. Anand PS, Bansal A, Shenoi BR, Kamath KP, Kamath NP, Anil S. Width and thickness of the gingiva in periodontally healthy individuals in a central Indian population: a cross-sectional study. Clin Oral Investig. 2021 Nov 16;26(1):751–9.
15. Hong LG, Guo LP, Xue LL. [Gingival retraction paste versus gingival retraction cord for fixed prosthodontics: a systematic review]. Shanghai Kou Qiang Yi Xue. 2013 Aug;22(4):456–61.
16. Nallaswamy D. Textbook of Prosthodontics. JP Medical Ltd; 2017. 1417 p.
17. Ponnanna AA, Maiti S, Rai N, Jessy P. Three-dimensional-Printed Malo Bridge: Digital Fixed Prosthesis for the Partially Edentulous Maxilla. Contemp Clin Dent. 2021 Dec 21;12(4):451–3.
18. Merchant A, Ganapathy DM, Maiti S. Effectiveness of local and topical anesthesia during gingival retraction [Internet]. Vol. 25, Brazilian Dental Science. 2022. p. e2591. Available from: http://dx.doi.org/10.4322/bds.2022.e2591
19. Aparna J, Maiti S, Jessy P. Polyether ether ketone - As an alternative biomaterial for Metal Richmond crown-3-dimensional finite element analysis. J Conserv Dent. 2021 Nov-Dec;24(6):553–7.
20. Agarwal S, Ashok V, Maiti S. Open- or Closed-Tray Impression Technique in Implant Prosthesis: A Dentist’s Perspective. J Long Term Eff Med Implants. 2020;30(3):193–8.
21. Maiti S, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai, Nadu T, India. Correlation of soft tissue biotype with pink aesthetic score in single full veneer crown [Internet]. Vol. 16, Bioinformation. 2020. p. 1139–44. Available from: http://dx.doi.org/10.6026/973206300161139
22. Maiti S, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai, Nadu T, India. Data on dental bite materials with stability and displacement under load [Internet]. Vol. 16, Bioinformation. 2020. p. 1145–51. Available from: http://dx.doi.org/10.6026/973206300161145
23. Subhashree R. Gingival Retraction Methods Used In Different Gingival Biotypes As Classified By Anon Ross And Seibert And Lindhe Classification. 2020 Dec 18 [cited 2023 May 5]; Available from: https://zenodo.org/record/5652341
24. Jokstad A. Clinical trial of gingival retraction cords. J Prosthet Dent. 1999 Mar;81(3):258–61.
25. Raja Z, Nair C. A clinical study on gingival retraction. J Indian Prosthodont Soc [Internet]. 2003; Available from: https://www.researchgate.net/profile/Chandrasekharan-Nair-3/publication/343769765_A_Clinical_Study_on_Gingival_Retraction/links/5f3e8fe1a6fdcccc 43d8ee99/A-Clinical-Study-on-Gingival-Retraction.pdf
26. Wang Y, Fan F, Li X, Zhou Q, He B, Huang X, et al. Influence of gingival retraction paste versus cord on periodontal health: a systematic review and meta-analysis. Quintessence Int. 2019;50(3):234–44.
27. Donovan TE, Chee WWL. Current concepts in gingival displacement. Dent Clin North Am. 2004 Apr;48(2):vi, 433–44.
28. Cloyd S, Puri S. Using the double-cord packing technique of tissue retraction for making crown impressions. Dent Today. 1999 Jan;18(1):54–9.
29. Abadzhiev M. Comparative research of the subgingival impression quality by fixed prosthesis using one and double cord retraction technique. J IMAB - Annu Proceeding (Sci Pap). 2010 Mar 26;15, book 2(2009):52–4.
30. Kumbuloglu O, User A, Toksavul S, Boyacioglu H. Clinical evaluation of different gingival retraction cords. Quintessence Int. 2007 Feb;38(2):e92–8.
31. Thimmappa M, Bhatia M, Somani P, Kumar DRV. Comparative evaluation of three noninvasive gingival displacement systems: An in vivo study. J Indian Prosthodont Soc. 2018 Apr-Jun;18(2):122–30.
32. Hansen PA, Tira DE, Barlow J. Current methods of finish-line exposure by practicing prosthodontists. J Prosthodont. 1999 Sep;8(3):163–70.
33. Mohan M. Pharmacological agents in dentistry: A review. J Pharm Health Serv Res. 2011 Jan 10;1(3):66–87.
34. Tarighi P, Khoroushi M. A review on common chemical hemostatic agents in restorative dentistry. Dent Res J . 2014 Jul;11(4):423–8.
35. Polat NT, Ozdemir AK, Turgut M. Effects of gingival retraction materials on gingival blood flow. Int J Prosthodont. 2007 Jan-Feb;20(1):57–62.
36. Liu J, Zhang XM, Hao PJ, Hui M, Yu HY. [Comparison of cytotoxicity between chemical retraction agents on human gingival fibroblasts in vitro]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2009 Apr;27(2):202–5.
37. Weir DJ, Williams BH. Clinical effectiveness of mechanical-chemical tissue displacement methods. J Prosthet Dent. 1984 Mar;51(3):326–9.
38. Nowakowska D, Saczko J, Kulbacka J, Wicckiewicz W. Chemical Retraction Agents - in vivo and in vitro Studies into their Physico-Chemical Properties, Biocompatibility with Gingival Margin Tissues and Compatibility with Elastomer Impression Materials. Mini Rev Med Chem. 2017;17(5):435–44.
39. Bader JD, Bonito AJ, Shugars DA. A systematic review of cardiovascular effects of epinephrine on hypertensive dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Jun;93(6):647–53.
40. Kellam SA, Smith JR, Scheffel SJ. Epinephrine absorption from commercial gingival retraction cords in clinical patients. J Prosthet Dent. 1992 Nov;68(5):761–5.
41. Website [Internet]. Available from: https://www.societechirorale.com/documents/Recommandations/recommandations_vasoconstricteurs_gb.pdf
42. Csillag M, Nyiri G, Vag J, Fazekas A. Dose-related effects of epinephrine on human gingival blood flow and crevicular fluid production used as a soaking solution for chemo-mechanical tissue retraction. J Prosthet Dent. 2007 Jan;97(1):6–11.
43. Bowles WH, Tardy SJ, Vahadi A. Evaluation of new gingival retraction agents. J Dent Res. 1991 Nov;70(11):1447–9.
44. Feng J, Aboyoussef H, Weiner S, Singh S, Jandinski J. The effect of gingival retraction procedures on periodontal indices and crevicular fluid cytokine levels: a pilot study. J Prosthodont. 2006 Mar-Apr;15(2):108–12.
45. Laufer BZ, Baharav H, Langer Y, Cardash HS. The closure of the gingival crevice following gingival retraction for impression making. J Oral Rehabil. 1997 Sep;24(9):629–35.
46. Gupta G, Mv SK, Rao H, Garg P, Kumar R, Sharma A, et al. Astringents in Dentistry: A Review. Asian Journal of Pharmaceutical and Health Sciences [Internet]. 2012 [cited 2023 May 3];2(3). Available from: https://ajphs.com/article/2012/2/3/428-432
47. Guntupalli Y, Ganesh SB, Jayalakshmi S. Effect of disinfectants on the tear strength of addition silicone impression material - An study. J Adv Pharm Technol Res. 2022 Dec;13(Suppl 2):S458–61.
48. Sarmento HR, Leite FRM, Dantas RVF, Ogliari FA, Demarco FF, Faot F. A double-blind randomised clinical trial of two techniques for gingival displacement. J Oral Rehabil. 2014 Apr;41(4):306–13.
49. Conrad HJ, Holtan JR. Internalized discoloration of dentin under porcelain crowns: a clinical report. J Prosthet Dent. 2009 Mar;101(3):153–7.
50. Thomas MS, Joseph RM, Parolia A. Nonsurgical gingival displacement in restorative dentistry. Compend Contin Educ Dent. 2011 Jun;32(5):26–34; quiz 36, 38.
51. Schuessler PJ, Ruel JA. The Effect of Various Retraction Procedures in Humans Upon the Periodontium: a Correlation of Clinical and Histologic Observations. 1976. 121 p.
52. Prasad KD, Hegde C, Agrawal G, Shetty M. Gingival displacement in prosthodontics: A critical review of existing methods. Journal of Interdisciplinary Dentistry. 2011 Jul 1;1(2):80.
53. Madaan R, Paliwal J, Sharma V, Meena KK, Dadarwal A, Kumar R. Comparative Evaluation of the Clinical Efficacy of Four Different Gingival Retraction Systems: An In Vivo Study. Cureus [Internet]. 2022 Apr 7 [cited 2023 May 3];14(4). Available from: https://www.cureus.com/articles/91447-comparative-evaluation-of-the-clinical-efficacy-of-four-different-gingival-retraction-systems-an-in-vivo-study
54. S S, Ma VS, Mi VS, F HG, M H. Gingival Retraction Methods for Fabrication of Fixed Partial Denture: Literature Review. J Dent Biomater. 2016 Jun;3(2):205–13.
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Published
May 13, 2023
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Varun Wadhwani, Vinay Sivaswamy, Vaishnavi Rajaraman, & Khushali K. Shah. (2023). Establishing a Protocol for Gingival Retraction- A Review. Journal of Population Therapeutics and Clinical Pharmacology, 30(10), 309–319. https://doi.org/10.47750/jptcp.2023.30.10.035
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