Post on 03-Jun-2018
transcript
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Indications Subgingival extensions of margins
Control of gingival hemorrhage or fluid f low
Increase length of clinical crowns
Enhancing restoration
Recording preparation margins during impressions
Removal of gingival overgrowth
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Methods for gingival retraction Mechanical
ChemicoMechanical
Rotary curettage
Electrosurgery
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Mechanical method
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Mechanical method
Mechanically displace gingival tissue outwards andapically away from the tooth surface.
Indicated in cases where gingiva is normal & healthywith adequate attached gingiva.
Provides minimal gingival retraction
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Copper band Is use as a means of carrying impression material
Mechanism for displacing the gingiva
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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
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Indication
- Situations in which several teeth have been
prepared
Advantages
-Minimal recession
Disadvantages
-Incisional injuries
Excessive pressure on the tissue
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Retraction cord Pressure packing into the gingival sulcus provide
sufficient gingival retraction
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ChemicoMechanical
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It is a method of combining a chemical with pressurepacking
It enlarge the gingival sulcus as well as controllingfluids seeping from the sulcus
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Types of retraction cord
Cotton Synthetic
Braided Twisted
Woven/ knitted
Coarse
Fine
Impregnated
Non-impregnated
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Knitted cord sizes
#000
#00#0
#1
#2
Braided cord
#7=#00
#8=#0#9=#1
#10=#2
Twisted#7= #00
#8= #0#9= #1#10= #2
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Factors to consider Dark color to maximize contrast with tissues, tooth &
cord
Absorbent to allow uptake of wet medicamentAvailable in different diameters to accommodate
varying morphologies of gingival sulcus
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Commonly used chemicalsAluminum chloride
Aluminum potassium sulphate
Ferric sulfate 8% racemic epinephrine
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CRITERIA FOR GINGIVAL
RETRACTION MATERIAL
Effectiveness in gingival displacement
& hemostasis. Absence of irreversible tissue damage.
Should not produce harmful systemic effects.
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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
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Looped around thetooth and packed intothe gingival sulcusstarting from the mesialsurface and establishnear the distal end
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Packing material
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Instrument should beangled slightly towardsthe root to facilitatesubgingival placement ofthe cord
After 10 minutes the cordshould be removed slowly
to avoid bleeding
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Rotary curretage
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It is a troughing technique, wherein a portion of theepithelium within the sulcus is removed to expose thefinish line
Should be done only on healthy gingiva
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IndicationsAbsence of bleeding upon probing
Depth of the sulcus is
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Hand piece should be run at slow speed
Abundant water supply should be sprayed duringprocedure
Retraction cord is impregnated to control bleeding
Cord is removed after 4-8 mins and sulcus thoroughlyirrigated with water
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Electrosurgery
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Also known as Surgical Diathermy
Produces controlled tissue destruction to achieve asurgical result
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IndicationAreas of inflammation in gingival tissue where the
retraction cord cannot be used
Gingival proliferation around the prepared finish line
Enlargement of gingival sulcus& control ofhemorrhage to facilitate impression making
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Contraindication Patients with cardiac pacemakers
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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
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Ensures smooth passage of electrode without draggingor charring of tissue
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THANK YOU!