Soft Tissue Management_Retraction Flashcards
What haeomstatic solutions are available/
- Hemodent: Aluminium chloride (21%), pH 1.2
- Astringident Brown: Ferric sulphate (25%), pH 0.7-1.2
- Astringident Clear: Aluminium chloride
- Viscostat : 20% Ferric sulphate Gel
- Gingibraid (cord): Potassium aluminium sulphate
- Gingipak: Adrenaline
What materials can retraction cords be made of?
Cotton or polyester
Can be twisted, braided, knitted
What are the desirable properties of retraction cords?
- Efficacy for gingival displacement
- No damage to gingiva
- No systemic effects
What sizes of Gingibraide cords are available? What are they made of? Are they impregnated with any haemostatic agents?
- 00, 0, 1, 2, 3
- Braided cotton
- Impregnated with aluminium potassium sulphate
What sizes of ultrapak are available? Are they impregnated with any haemostatic agents?
- Knitted poly cotton
- 000, 00, 0, 1, 2, 3
- No haemostatic agent
What is Trichloroacetic acid? What is it used for?
- Escharotic agent (causes corrosion or falling away of skin) by denaturing and precipitating proteins
- Protein peels away after a few days, with full tissue recovery
- Self limiting when applied to tissue surface
- Fine film applied via tip of metal instrument
What are the functions of retraction cords (general)?
- Allow visual and physical access to prep margins
- Protect epithelial attachment and sulcus from bur trauma
- Moisture control from blood and gingival fluids
Which retraction cord should be damped with haemostatic solution?
-The primary cord ONLY
How is the two cord technique used? What are the specific functions of primary and secondary cord?
- Place primary cord
- vertical retraction,
- vision + bur access + allows subgingival margin placement
- protects epithelial attachment
- control of bleeding)
Place secondary cord
- vertical and lateral displacement of gingiva
- moisture control
- lateral widening of sulcus
When should a one cord technique be used and when should a 2 cord technique be used?
One cord: sulcus 2mm deep or less (0 or 00)
Two cord: sulcus depth greater than 2mm (primary size 1, secondary same or one size larger than primary)
How long should the cord be?
3cm for anteriors, 4 cm for posteriors
What else should be ordered along with the retraction cord?
-Scissors
-Plastic
Hemodent or astringident
-Moisture control (cotton rolls, dry guard shields, gauze.
What factors shoudl be considered when placing the cord?
Primary
- Moisten with haemostatic agent
- Start mid labially
- Cut so two ends touch without overlapping
- Should not be visible within sulcus
- Not removed until just before temp crown cementation
What factors should be considered when placing secondary cord?
- Start mid-labially
- Should be visible
- Leave for 5 minutes whilst setting up for taking impression
- Remove immediately before syringing light body
