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lect.20

The document discusses gingival retraction techniques used to expose the margin of dental preparations for better impressions, particularly when margins are subgingival. It outlines mechanical, chemomechanical, and surgical methods for retraction, as well as various impression techniques including single stage, two stage, and putty wash techniques. Additionally, it emphasizes the importance of inspecting impressions for continuity, air bubbles, and firm attachment to the tray.

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Mahmoud Ali
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0 views

lect.20

The document discusses gingival retraction techniques used to expose the margin of dental preparations for better impressions, particularly when margins are subgingival. It outlines mechanical, chemomechanical, and surgical methods for retraction, as well as various impression techniques including single stage, two stage, and putty wash techniques. Additionally, it emphasizes the importance of inspecting impressions for continuity, air bubbles, and firm attachment to the tray.

Uploaded by

Mahmoud Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Lect.20 ‫ حيدر حسن‬.

‫د‬

Gingival Retraction

To displace free gingival tissue or to expose the margin of the preparation, so


that better impression could be taken. It is used when the margin is subgingival or
with the level of gingiva.

The objectives of the gingival retraction are :


1. Create access for the impression material to the area of preparation that is
located subgingivally.
2. To provide enough thickness of the impression material at the area of the
finishing line to prevent distortion of the impression.
3. To prevent sulcular hemorrhage and fluid seepage which interrupt the flow
of impression material.

Techniques of gingival retraction could be :

1. Mechanical.
2. Combination of mechanical and chemical (chemomechanical )
3. Surgical technique.

1- Mechanical : We apply pressure on the gingival to open


the gingival sulcus. May be done by :
A- Construction of temporary crown with long margin
and leave it for half hr.
effectiveness is limited because pressure alone often will not
control sulcular hemorrhage.
B- The most common way to do gingival retraction is by
using retraction cord which is special cord made of cotton
comes either with or without medicament
(vasoconstrictor ). The cord that is free from vasoconstrictor is used as mechanical
technique.

1
2- Chemomechanical : The cord contain vasoconstrictor (adrenaline). We use it
as mechanical and chemical retraction.

The Technique of placing the retraction cord:

By packing this cord in gingival sulcus, between the tooth and the free gingival tissue
using plastic instrument ( Ash no .6 or 49 ) so that the cord physically push the
gingival away from the finish line and the combination of the chemical action and
pressure packing help to control seepage of fluid from the wall of the gingival sulcus.
We put the retraction cord inside the gingival sulcus all around the tooth, it is left for
10 minutes. The area during our work should be dry then we remove the cord. The
area will be expanded providing space to inject the impression material around the
tooth at area of finishing line by the impression syringe.

3- Radial or surgical : Means is sometimes done by using electrosurgical unit to


remove gingival tissues from finishing line or sometimes we do gingivectomy in case
of periodontal disease or inflammation.

IMPRESSION TECHNIQUES
1. Single stage technique.
2. Two stage technique.
3. Putty wash technique.
4. Digital Impression technique.

Single Stage Technique :

Most of the time we use this tech . when we have impression material with single
viscosity ( mostly medium viscosity material ), e.g Polyether, after we mix the
impression material part of it is loaded in an impression syringe from the mixing slab,
and we place it on the special try, we inject the material over preparation. And we
start with the most critical parts ( Pin holes , Margins ) then the preparation, and the
remaining part of the dental arch.
After wards, place the special tray over the dental arch, wait for complete set then
remove.

Two Stage Technique :


Used with materials that have two viscosities light and heavy. We mix the heavy
and light body at the same time the heavy body is placed in the special tray, we start
to inject the light body on the dental arch starting with the prepared tooth.

2
After we finish injecting the impression material we place the special tray with
the heavy body in the patient’s mouth.

The pressure exerted by heavy body will create intimate contact between light
body and the prepared tooth and will make direct flow of the light body into the
details of the preparation.

Putty Wash Technique:

This technique use a high viscosity material, we start to take


impression with the heavy body (before or after preparation).
If we make it before preparation:
We leave the impression material until it sets inside the patient mouth, then we
remove it, and do our preparation. After that we start to mix the light body and load it
in the impression syringe and inject it over the preparation and the dental arch then

we reseat the tray inside the patient mouth and wait until setting occurs.
If we make the impression after preparation :
We use it with spacer made of polyethylene materials placed over the heavy body
and inserted in the patient's mouth and wait until setting then remove the
polyethylene (spacer). After that we complete the steps of light body application and
impression taking.
* All techniques can be used in any type of preparation but it depends on the
material.
When we take impression for post crown we need impression
for the root canal space so the impression inserted inside the tiny
canal and even when it fills the canal it might tear off or distorted
during pouring the die materials (stone). So the impression
material need a type of reinforcement either by a plastic post or by
stainless wire placed before setting, the impression will not be torn
or distorted because it is not movable.

3
We shall make the surface of the wire rough by burs in order not be pulled away
from the impression.

After taking the impression we should inspect the impression for the
following points:-
1. Finishing line in the impression must be continuous from
one surface to the other.
2. No air bubbles present on the surface of the impression
especially at the area of Finishing line.
3. The attachment of the impression to the tray must be firm (
major difference among impression materials that every
one has it is own adhesive that used to bind it to the
special tray ).

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