GINGIVAL RETRACTION

[drsushant]

 Tissue Management

Gingival retraction cords are used by most dentists, and are claimed by many dental laboratory technicians to be the most adequate of tissue management techniques (as observed in impressions from their dentists). The double-cord technique is the most reliable cord technique, since usually it reduces bleeding significantly more when compared to the previously taught one-cord procedure. Two popular and effective cord examples are Ultrapak (Ultradent Products) and Stay-Put (Roeko). The Stay-Put cord contains a small copper wire for stability, and it does stay in place most of the time. Both options are cost-effective and provide excellent choices for quick and easy tissue management.

Some dentists strongly prefer to avoid cords. Diode lasers have become increasingly popular in the past few years, primarily due to their decrease in cost. When used properly, they provide excellent hemostasis and can assist in tissue management for difficult situations. One of the most popular diode lasers has been the Odyssey Navigator (Ivoclar Vivadent). However, with the introduction of newer lasers at more affordable costs, other brands are becoming more popular. These include the cordless NV Microlaser (Discus Dental), the ezlase 940 (BIOLASE Technology), and the low-cost Picasso (AMD LASERS). A low-cost alternative to a diode laser technology is electrosurgery. One of the most popular electrosurgery units is the Sensimatic 700SE Electrosurg (Parkell).

Styptic-containing clay products have gained popularity and can provide great retraction, but at a higher cost per crown. Expasyl (Kerr) and Traxodent (Premier Dental Products) are very viable alternatives.

It is important to note that at this time, excellent tissue management is necessary for taking either conventional impressions or digital impressions. For some intraoral imaging systems, tissue management is even more essential, due to the longer amount of time required for scanning when compared to injecting conventional impression material. There are possibilities in the developmental stages that may change the concept in the near future, and tissue management may not be as important as it is currently.