Product Description
Making a Good Impression
Virtually every dentist will agree that one of the keys to receiving an ideal restoration from a lab is a great impression, and that a significant factor for obtaining a great impression is clear, well-defined marginal detail. Inherent to obtaining the necessary marginal detail in an impression is the management of soft tissue. Sufficient gingival retraction is required to capture subgingival detail as well as the relationship between hard and soft tissue within the final impression.1 A high-quality impression that provides the necessary marginal detail is not only required for good fit, but also for optimal esthetic results.
Gingival retraction was traditionally managed with retraction cord to expose the margins of a preparation; however, there was still the issue of managing a clean, dry field to ensure the best detail in the impression as well as the issue of carefully managing delicate soft tissue. Dentists now have a selection of methods available to provide gingival retraction, including Expasyl, a hemostatic paste with a clay-like consistency that provides the versatility of effective retraction combined with a proven hemostatic agent, aluminum chloride.
Healthy gingival tissue is essential for effective and productive restorative dentistry not only to ensure that esthetics are optimized, but also to ensure adequate control of bleeding and fluids during the impression and cementation phases of the treatment. The restorative process is traumatic to even healthy soft tissue, so it is essential that any periodontal issues a patient may have are effectively managed before restorative treatment begins.3 It is important that gingival tissue is treated gently and with minimal trauma to ensure not only patient comfort, but also quick healing and a great final esthetic result. Expasyl is extruded with a syringe rather than pressed into the sulcus. As a result, it is not only very gentle, but also minimizes the danger of rupturing the epithelial contact.2 The material is left to sit for a few minutes and then is rinsed away with water and the preparation site is dried before the impression is taken.
Expasyl: 7 Years of Success
Launched to the dental market in 2000, Expasyl now has 7 years of successful clinical history with numerous clinical and continuing education articles published on its effective use. This versatile material can be used as a substitute for retraction cord or used in conjunction with retraction cord. When deeper retraction is required, a doublecord technique is typically used; however, the benefits of using Expasyl can still be obtained when it is used to replace the second cord placement.
 The high viscosity of Expasyl combined with the clay-like consistency of the material, displaces gingival tissue through increasing mechanical pressure as it is correctly dispensed directly into the sulcus of the tooth or teeth to be restored.3 Many clinicians prefer to further improve gingival retraction by having patients gently occlude on cotton applicator caps for a few minutes to assist in the physical displacement of the sulcus laterally.1 Patient comfort is of significant concern during the retraction process and Expasyl succeeds with maintaining a level of comfort even when this bite technique is used.
Ideal not only for ensuring a welldefined margin and a clean, dry field for impressions, Expasyl is also highly recommended for quick, easy, and gentle retraction during the placement of a prosthetic. For many dentists, Expasyl has replaced retraction cord altogether because of its ease of use and clinical success.
Hemostatic Effect
When excessive bleeding needs to be controlled, Expasyl can be applied for an initial hemostatic effect and then additional material placed for retraction. In a study using a rabbit calvarium model that was published in the International Journal of Endodontics, it was found that Expasyl alone or in combination with Statis was the most efficient of the tested agents in controlling bleeding in bony defects.
Safe Delivery
The Expasyl Temporary Gingival Retraction System consists of capsules with 1 g of material each, applicator tips, and an applicator gun. The material is dispensed directly into the sulcus, left for 2 minutes, and then rinsed, leaving behind a dry field and retracted gingival tissue. The method of delivery is one of the things that makes Expasyl not only an effective and efficient material to use, it also makes it a safer material for the gentle treatment of thin or delicate gingival tissue as retraction is achieved with minimal pressure applied directly to soft tissue.—Monica Roy-Smith
References
1. Cranham JC. Tips from the lab: predictable impressioning. Dental Equipment and Materials. 2003:46-48.
2. Ho CC. Making great impressions: a fast, safe and simple retraction technique using Expasyl. Australasian Dental Practice. 2007:2-6.
3. Shannon A. Expanded clinical uses of a novel tissue- retraction material. Compend Contin Educ Dent. 2002;23(1 Suppl):3-6.
4. von Arx T, Jensen SS, Hänni S, et al. Haemostatic agents used in periradicular surgery: an experimental study of their efficacy and tissue reactions. Int Endod J. 2006;39:800-808.
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