Comparative Evaluation of Gingival Displacement by Using Retraction Paste and Retraction Cord- In-Vivo Pilot Study

Abstract

Marginal integrity is one of the important principles of Tooth preparation. To achieve this, a satisfactory gingival displacement procedure is necessary. Aim of this study was to determine an appropriate gingival displacement and to access the gingival displacement on an unprepared tooth using retraction paste and impregnated retraction cord.  Fourteen patients were chosen for this in vivo study. Oral prophylaxis was completed 15 days prior to the retraction procedure. Mandibular preliminary impressions were made using rubber base impression material. Gingival retraction procedure was carried out on the right and left  1st   mandibular  molars  alternatively  using  retraction  paste  and  retraction  cord  after  2  days  of  preliminary  impression. Retraction paste was placed directly over the sulcus as per manufacturer’s instructions and kept for 2-3 minutes and rinsed and the required  length of retraction  cord was dispensed  and placed  into the gingival  sulcus using a cord packer  and cord was removed after 5 minutes. Post retraction measurements completed    made an impression with rubber base impression material by using sectional tray alternatively. Statistical analysis was performed with ANOVA test, paired student t test with SPSS version 21. Patients were  more  comfortable  with  retraction  paste  as against  gingival  retraction  cord  with  significance  observed  by observers 1, 3  and 4. (P<0.05). Retraction  paste  had significantly better  retraction  ability  compared to  retraction  cord as observed by observer 1, 3 and 4 (p<0.05) whereas no significant difference was observed by observer 2(p>0.05).  Retraction paste was significantly  less time consuming  compared  to retraction  cord as reported  by observer  1 and 4 (P<0.05)  and no significant differences between the two systems was reported by observer 3and 4(P>0.05.Within  the limitations of the study, both retraction techniques  showed adequate  gingival retraction  for the prosthesis  and clinically insignificant  differences  were seen in both gingival retraction system regarding the retraction achieve. Retraction paste found to be easy for the control of hemorrhage and easy for placement and recommended to use where there is uncontrolled bleeding and sub-gingival finish lines of the tooth preparation However, the amount of vertical gingival retraction observed with the paste retraction system was significantly less than the medicated retraction cord.