When obtaining an impression for a crown or bridge procedure, management of soft tissue is absolutely vital. Regardless of whether dental practitioners are recording an impression by conventional or digital means, achieving a high degree of accuracy is reliant on adequate gingival displacement and keeping moisture under control.
To achieve sufficient retraction for impression material and hemostasis, clinicians commonly employ a number of means. In most cases, the means of managing tissue and fluids are either mechanical, chemical or some combination of the two (mechanochemical).
One of the earliest techniques developed for managing gingival tissue was mechanical displacement. This method entails physically moving tissue away from the tooth and margins in order to access the area for preparation, impression-taking or cementation. Gingival retraction cords (used in conjunction with packing instruments) are perhaps the most popular tools for mechanical displacement. These cords are usually made of either cotton, silk or yarn wool and are available in a variety of dimensions and configurations such as knitted, braided and twisted. The type of cord chosen is dependent on the application.
Various astringent and hemostatic chemicals are also used as agents to cause drying of gingival tissues and constrict blood flow. Aluminum chloride, ferric sulfate and epinephrine are among the most widely used chemical agents. Often, these chemicals are paired with retraction cords: practitioners can either apply the chemical to the cord manually or obtain cords with an agent pre-impregnated into the material.
While retraction cords are often effective, they have the potential to create problems such as excessive bleeding, gingival recession, inflammation and post-operative discomfort. To combat these issues, a cordless method of expanding the sulcus was developed. Gingival retraction pastes like Traxodent by Premier Dental are clay-based and contain aluminum chloride making them excellent for absorbing moisture and facilitating hemostasis. When combined with a cotton compression cap to create direct pressure on the area, a clean and dry clinical environment for impressioning is easy to achieve. Likewise, pastes can be used in conjunction with cords as needed.
To learn more and purchase Traxodent and other tissue management products, please visit Premier’s website.