Retraction Paste Research Articles

Clinical assessment of monolithic zirconia crowns fabricated using an intraoral scanner.

This in vivo study assessed the accuracy of single-tooth monolithic zirconia crowns made using an intraoral scanner (IOS) and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Thirty patients requiring single posterior crowns were selected. The teeth were prepared with a deep chamfer finish line with a 1-mm extension subgingivally and a 1-mm reduction in all surfaces by one prosthodontist. The gingival margins were retracted using a gingival retraction paste before making impressions using a Trios scanner. All the digital impression files were sent to one laboratory using the dental designer software (3Shape, Copenhagen, Denmark). After completing the milling and sintering processes, the crowns were dyed and glazed. After removing the temporary crown, the qualitative assessment of proximal contacts of definitive monolithic zirconia crowns was performed according to the CDA criteria. Data were analyzed with Friedman's two-way analysis and independent t-test at α=0.05. The difference in axial and total gaps between premolar and molar teeth was not significant; however, the mean marginal gap of molars was higher than that of the premolars (P=0.043). Furthermore, the comparison of the axial, total, and marginal gaps between the upper and lower jaws showed no significant difference (P>0.05). The distribution of occlusal and proximal contacts indicated 60% and 66.7% proper contacts and no contacts in 6.7% and 10% of cases, respectively. Using IOSs could result in accurate monolithic zirconia crowns in terms of adaptation. Also, most occlusal and proximal contacts did not need any adjustments.

Evaluation of Lateral and Vertical Gingival Displacement Produced by Three Different Gingival Retraction Systems using Impression Scanning: An in-Vivo Original Study

Isolation of the prepared margin along with control of gingival fluid and haemorrhage is an important factor to register finish lines, which can be achieved by displacing the gingiva away from the abutment which helps in better visualization of the prepared tooth surface. This study utilized digital scanning of rubber based impression material to compare the amount of gingival displacement produced by 3M ESPE capsule, plain retraction cord and impregnated retraction cord.  Aims: The aim of the study was to compare lateral and vertical gingival displacement produced by the three materials  Settings and Design: Case-Control  Methods and Material: Twenty participants requiring a full coverage restoration were selected. Gingiva around each tooth requiring a crown was retracted using the three materials and a rubber based impression was made. The impression was scanned using EXOCAD software to obtain readings for gingival displacement for control group, non- impregnated cord, impregnated cord and retraction paste.  Statistical analysis used: The scores were analysed in SPSS software using one way ANNOVA and post hoc analysis  Results: Significant difference was seen among all trial groups when compared to control. Highest mean vertical displacement was seen in clinical trial II (non- impregnated cord) followed by trial III ( retraction paste).  Conclusions: Impregnated cord and retraction paste both produced adequate retraction for the margings to be registered. Use of paste was less time consuming and less traumatic for the patient and therefore can be substituted for retraction cords.

Clinical and immunological aspects of gingival retraction systems in fixed dental prostheses: A systematic review

Objective To describe the existing knowledge on the efficacy of the different gingival retraction systems (GRSs) in gingival displacement, to know their effects on biological functions of human gingival fibroblasts (HGFs), and on the expression of inflammatory mediators (TNF-α and MCP-1) in gingival crevicular fluid (GCF), and saliva. Methods The protocol used for this systematic review was registered in INPLASY: 202410005. A digital search was performed in the databases PubMed/MEDLINE, Scopus, Science Direct, Web of Science, and Google Scholar of the literature published in the English language in the last 17 years (from December 10th, 2006, to May 15th, 2023), and included retrospective randomized clinical studies, prospective, and in vitro experimental studies. In addition, PRISMA criteria were followed. The methodological validity of the selected articles was assessed using Joanna Briggs Institute (JBI) critical appraisal tool, and the modified Consolidated Standards of Reporting Trials checklist (CONSORT). Results 27 articles published between 2006 and 2023 were evaluated. Six hundred 32 subjects, aged between 18 and 65, participated in the clinical studies. 93.7% of the studies assessed periodontally healthy patients, and only 6.3% evaluated patients with mild gingivitis. Also, 882 teeth were samples, of which the majority were posterior teeth (54%). The most commonly used GRSs was aluminum chloride gingival retraction paste (74%). The GCF samples were taken in 67% of the studies, and ELISA was used in all studies (100%) to determine inflammatory mediators. The most frequently analyzed marker was TNF-α (67%). Conclusion The system Merocel Strips (Mystic, conn, USA) achieved the highest level of gingival displacement (1.66 ± 3.7 mm). In addition, the braided cords produced the lowest TNF-α levels (0.43 ± 0.08pg/mL). Astringent systems such as ferric sulfate had higher toxicity in HGFs.

Dentists’ knowledge and preference regarding gingival displacement methods

IntroductionAn accurate impression is an essential procedure for fabricating indirect fixed restorations. To achieve a precise final impression, the management of gingival tissue is without doubt a crucial.AimTo evaluate the use of different gingival displacement techniques among dental clinicians and to assess their associated knowledge and technique preferences.MethodsA self-designed survey was created electronically and sent to a list of dentists. The survey was composed of multiple sections. Participants who stated that they do not use GD methods were asked to answer the survey questions based on their knowledge. Descriptive statistics were generated, andChi-square test was used to examine the association between the different variables.ResultsA total of 188 dentists participated in this study. The majority 144 (76.6%) use GD in their practice. When asked which technique yields a more accurate impression with lower incidence of repeating the impression, 93 (64.6%) reported retraction cord technique with a hemostatic agent results in a higher impression accuracy, while only 14 (9.7%) declared the retraction paste technique as being more accurate.ConclusionThe cordless GD technique is believed to be easier, faster, and less traumatic to the gingival tissues, nevertheless, the outcome of dental impressions is believed to be more predictable with the use of conventional retraction cords and hemostatic medicaments.

A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing.

The aim of the current article is to analyze and compare post-retraction gingival height changes resulting from six different types of gingival-displacement methods, encompassing both conventional and surgical approaches. The study involved a comparative analysis of 263 teeth (consisting of 128 front teeth, 69 premolars, and 66 molars) from 23 patients. For the investigation, three classic retraction methods were utilized, namely the single-cord technique, retraction paste Expasyl, and retraction paste Astringent. Additionally, three surgical techniques were employed, which included ceramic bur rotary curettage, Er:YAG laser troughing, and diode laser troughing. A randomized split-mouth design was implemented, and a significance level of 0.05 was used for the study. The recovery of the free gingival margin height was assessed on gypsum models that were scanned using an intraoral scanner during the first and second week after the retraction procedure. The results revealed that all retraction methods, except for ceramic bur rotary curettage, led to clinically insignificant levels of gingival recession. The article provides insights into the effectiveness and safety of various gingival-displacement techniques, highlighting that most methods tested in the study resulted in minimal or negligible gingival recession post-retraction.

PERIODONTIUM RESPONSE TO GINGIVAL DISPLACEMENT

Aim. To evaluate the effect on post-operative results of different types of retraction techniques on periodontium. Material and methods. The following electronic databases sources were searched: PubMed, the Cochrane library and Researchgate. The search was carried out according to PRISMA guidelines. Due to lack of appropriate articles earliest period was not restricted, but only in vivo studies were included, articles were collected using keywords: “gingiva”, “displace”, “periodontal health”. Studies that met the inclusion criteria were evaluated using Cochrane risk of bias tool. Only low and moderate risk articles were included into this systematic review. Results. After duplicates removal 55 articles left from which 9 were included into this systematic review. The data from studies were collected and evaluated in a systematic manner. Data tables were created for summarisation. Conclusion. Gingival retraction has negative, but reversible effect on periodontium, which could lead to gingival bleeding, inflammation and even recession. Conventional retraction using retraction cord has more negative effect on periodontium also it is more painful method, than retraction paste.

COMPARITIVE EVALUATION OF HORIZONTAL GINGIVAL DISPLACMENT USING STAY-PUT RETRACTION CORD AND ASTRINGENT RETRACTION PASTE: AN IN VIVO STUDY

Introduction: Gingival retraction cord is the most commonly used gingival displacement material however, it causes discomfort and produces damage to the periodontium. Various new gingival retraction materials have been introduced to overcome these problems. Aim: Thisstudy aims at comparative evaluation of horizontal gingival displacement using Stay-put retraction cord and Astringent retraction paste. Materials and Methods: A total of 40 subjects were selected and 40 samples were made for the study. Samples were divided into two groups,20 subjects in each group) depending on the materials used for gingival displacement.The impressions obtained after placing retraction system were poured in type IV die stone.The amount of gingival displacement was then measured as a distance from the tooth to the crest of the gingiva in a horizontal plane using stereomicroscope &analysed in image analysis software. Results: Among the experimental groups, astringent gingival retraction paste showed the highest value for gingival displacement (0.518mm) and the stay‑put retraction cord (0.435mm ) showed the least value. Conclusion: Within the limitations of this in vivo study, astringent gingival retraction paste showed the highest value for gingival displacement whereas, stay‑put retraction cord showed the least value.

GUM RETRACTION METHODS IN ORTHOPEDIC DENTISTRY: CURRENT STATE OF THE PROBLEM

Gingival retraction is the procedure of bending the gingival margin away from the tooth surface, which provides sufficient horizontal and vertical space between the prepared finish line and the gingiva for the introduction of a sufficient amount of impression material. Several factors influence the success and durability of orthopedic restorations in dentistry. In particular, supragingival margins are necessary to maintain periodontal health, but do not provide optimal aesthetics. The gingival margin should be clean and accessible during impression making, and the gingival groove should be wide enough (from 0.15 to 0.20 mm). Therefore, in orthopedic dentistry, the problem of the optimal gum retraction technique, the influence of the chosen technique on the impression procedure is relevant. Ideally, the gum retraction technique should be simple, fast and inexpensive, should not cause damage to the periodontal tissues. Today, there are various methods of retraction, including retraction cords, rotary curettage, copper tapes, electrosurgical techniques, laser retraction, and the use of some types of polymer and plastic materials. The article provides an overview of the main commonly accepted methods of gum retraction, which can be classified into mechanical, chemical and surgical. Particular attention is paid to such retraction methods as non-medicated cords, medicated cords, wireless methods, astringent hemostatic agents, retraction paste for gums, vasoconstrictors, lasers, rotary curettage, electrosurgery.
 Study substantiation: Despite significant progress of orthopedic dentistry in the last decades, clear criteria for selection of method of retraction are not currently allocated.
 The purpose of the study: to conduct an analysis of modern and available methods of gum retraction in orthopedic dentistry, to highlight the safety and effectiveness criteria of each of the methods, depending on the clinical situation.
 The materials and methods: the available scientific sources of recent years, devoted to the technique of gum retraction in orthopedic dentistry, analyzed by the methods of review, system and content analysis. The search strategy was to manually search the Pub-Med and Google Scholar databases from 1985 to 2022 for articles related to retraction prior to making an impression of a fixed prosthesis. Key words included "impression making" and "gingival retraction".
 The clinical effectiveness of retraction methods is assessed according to the following criteria: A – effectiveness (degree of horizontal and vertical gum recession, possibility of controlling bleeding and outflow of gum fluid). B – degree of retraction (ideally, the agents used should not lead to damage to the epithelial tissue). Otherwise, this damage should be reversible. The maximum apical recession after gingival retraction should not exceed 0.10 mm. C-absorption of retraction agents in tissue should not cause systemic effects.
 The conclusion of the review is a general assessment of the effectiveness of retraction methods according to the following criteria: effectiveness, degree of retraction, absorption of retraction agents. Emphasis is placed on the greatest efficiency of the laser retraction method. The author suggests further research in this direction. Despite the significant progress of orthopedic dentistry in recent decades, additional research should be conducted to develop clear criteria for the effectiveness of gum retraction methods.

Comparative evaluation of gingival displacement produced by three different gingival retraction materials

Aim: To compare and evaluate the gingival displacement produced by three different gingival retraction materials. Materials and Methods: A study was conducted to evaluate the gingival displacement produced by three gingival retraction materials. 12 subjects were selected for the study. T-stat retraction paste system (Nexobio co.Ltd,Korea), 3M ESPE Retraction Paste (3M Deutschland GmbH, Germany), Roeko Stay- put retraction cord (Coltene Whaledent Pvt. Ltd.) were used in the study. Results: Out of the three materials used, lateral displacement was maximum with the Stay-put retraction cord followed by 3M retraction paste and least by T-Stat retraction paste. All the materials produced acceptable amount of vertical gingival retraction. When compared Stay-put retraction cord was found to be most effective among the three materials. On comparison of the cordless retraction materials, it was found that the material which was more viscous in consistency (3M retraction paste) was able to produce more lateral gingival displacement than the material having less viscosity (T-stat retraction paste) even though both the cordless materials provided almost similar amount of vertical gingival displacement. The overall gingival retraction produced by the Stay-put cord was the highest followed by 3M retraction paste and least by the T-stat retraction paste.

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

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.

Comparative Evaluation of the Clinical Efficacy of Four Different Gingival Retraction Systems: An In Vivo Study

Introduction: There are numerous gingival retraction systems available on the market. This study aimed to evaluate the clinical efficacy of four gingival retraction systems, namely, impregnated retraction cord, gingival retraction capsule, retraction paste, and polyvinyl acetate strips.Methods: A total of 20 people were chosen for the study, and 100 specimens were collected. The specimens were classified into five groups based on the materials used for gingival displacement. On the first day, a baseline impression without gingival displacement was made. Afterward, impressions were made with any of the following four gingival retraction systems: impregnated retraction cord (SURE-Cord® Plus; Sure Dent Corporation, Jungwon-gu, South Korea), retraction capsule (3M ESPE astringent retraction paste capsule; 3M Corporation, St. Paul, MN), retraction paste (Traxodent® Hemodent® Paste Retraction System; Premier Dental Co., Plymouth Meeting, PA) and polyvinylacetate strips (Merocel; Merocel Co., Mystic, CT), with a 14-day interval between each system. The amount of gingival displacement was measured using an optical microscope as the distance from the tooth to the gingiva crest in a horizontal plane.Results: All experimental groups had higher gingival displacement than the control group (P < 0.01). Among the experimental groups, polyvinyl acetate strips had the highest gingival displacement value (541.65 μm), followed by impregnated retraction cord (505.37 μm), retraction capsule (333.57 μm), and retraction paste (230.63 μm).Conclusion: Within the limits of this in vivo study, significant differences in horizontal gingival displacement were discovered among the four evaluated systems. The horizontal displacement requirements of 200 μm were exceeded by all four systems. The maximum value for gingival displacement was found in polyvinyl acetate strips (Merocel), followed by impregnated retraction cord (SURE-Cord), and retraction capsule (3M ESPE), and the lowest value was found in retraction paste (Traxodent).

Evaluation of Effectiveness and Adverse Effects of Retraction Cord vs Retraction Paste: A Systematic Review

Evaluation of Effectiveness and Adverse Effects of Retraction Cord vs Retraction Paste: A Systematic Review

Gingival Displacement in the Vertical and Horizontal Dimension under the Condition of Mild Gingivitis-A Randomized Clinical Study.

This randomized clinical study aimed at quantifying the gingival displacement performance in the vertical and horizontal directions of the 3M™ Astringent Retraction Paste (3M Oral Care, Seefeld, Germany) in comparison with the double-cord technique with aluminum chloride as an astringent. Afterward, any soft-tissue changes were assessed for 12 months. After inducing mild gingivitis, 18 probands received the intervention ‘cord’ and 22 probands received the intervention ‘paste’ at the palatal half of upper premolars prior to conventional impression making. The resulting plaster casts were digitized and analyzed for the vertical and horizontal gingival displacement, applying a newly developed computer-assisted methodology. The entire palatal half of the tooth was evaluated instead of only single sites. Under the condition of mild gingivitis, the gingival displacement performance was comparable for both techniques in the horizontal direction (width) and only somewhat better for the cord technique in the vertical direction (depth). The magnitude of displacement was in a similar range in both directions, with somewhat higher values in the vertical direction. The marginal gingiva height changes were of such low extent during the follow-up period of 12 months with only minimally higher values for the paste that they cannot be considered as clinically relevant recessions.

Evaluation of the Cytocompatibility of Novel Gingival Retraction Pastes based on Boswellia papyrifera

Evaluation of the Cytocompatibility of Novel Gingival Retraction Pastes based on Boswellia papyrifera

Comparative Evaluation of the Amount of Gingival Displacement Using Three Recent Gingival Retraction Systems - In vivo Study.

Background:Gingival retraction cord is the most commonly used gingival displacement material; however, it causes discomfort and produces damage to the periodontium. Various new gingival retraction materials have been introduced to overcome these problems. This in vivo study was conducted to compare the efficacy of three recent gingival displacement materials in achieving gingival tissue displacement.Materials and Methods:A total of 10 subjects was selected and 40 samples were made for the study. Samples were divided into four groups depending on the materials used for gingival displacement. The schedule for gingival displacement and impression making followed Latin block design. On day 1, baseline impression was made without gingival displacement. On day 2, day 22, and day 42 impressions were made after gingival displacement on intact maxillary right central incisor with any one of the three agents. The amount of gingival displacement was then measured as a distance from the tooth to the crest of the gingiva in a horizontal plane using stereomicroscope.Results:Statistical analysis was performed using one-way ANOVA test. The amount of gingival displacement obtained by all the experimental groups was more than the control group (P < 0.01). Among the experimental groups, astringent gingival retraction paste showed the highest value for gingival displacement (0.50 mm) followed by the stay-put retraction cord (0.48 mm), whereas expasyl (0.34 mm) showed the least value.Conclusion:Within the limitations of this in vivo study, astringent gingival retraction paste showed the highest value for gingival displacement followed by stay-put retraction cord whereas, expasyl showed the least value.

Comparison of Gingival Retraction Materials Using a New Gingival Sulcus Model.

To investigate the pressure generated by different retraction materials using a novel gingival sulcus model. A gingival sulcus model was made using a polymer frame filled with silicon. A pressure sensor and a sulcus-fluid simulation were embedded into the silicon chamber to evaluate the pressure generated by different retraction materials. Six sizes of Ultrapak retraction cords (Ultradent, sizes #000 - 3), 4 retraction pastes (Expazen, Expasyl, Acteon, Access Edge, Traxodent) and 2 retraction gels (Sulcus Blue, Racegel) were analyzed. The mean and median pressure, interquartile range, and standard deviation (SD) of n = 10 repeated measurements were calculated. Statistical analysis was conducted by Kruskal-Wallis test for differences between the main groups of retraction materials, and Mann-Whitney U-test was performed to analyze differences between the single retraction materials. Pressure (mean ± SD) generated by retraction cords increased with increasing size (48.26 ± 11.29 kPa, size #000 to 149.27 ± 28.75 kPa for #3). There was a significant difference between sizes (p < 0.01), except in #0 versus #1, and #2 versus #3. Retraction pastes generated pressures that ranged from 82.74 ± 29.29 kPa (Traxodent) to 524.35 ± 113.88 kPa (Expasyl). Retraction gels generated pressures from 38.96 ± 14.68 kPa (Racegel) to 95.15 ± 24.18 kPa (Sulcus Blue). Pressure generated by Expasyl was significantly higher than pressure generated by all other tested materials (p < 0.001). Pressure generated by retraction pastes and gels depends on the consistency of the retraction material, while pressure generated by retraction cords increased with increasing size of cords. Expasyl was found to generate the highest pressure compared to all other retraction materials.

The use of retraction paste to simplify impression and cementation of ceramic veneers and crowns: 3-year follow-up report.

Proper gingival displacement is an important prerequisite to obtain good quality impressions. Retraction pastes could eliminate the need for retraction cords, as they have advantages such as comfort reported by patients, faster technique, ease of use, no need for anesthesia, and reduced tissue trauma. The objective of this paper was to present a clinical case of ceramic veneers and crowns in which a retraction paste was used for gingival displacement during both the impression and cementation stages, with 3 years of follow-up. Treatment planning consisted of the replacement of preexisting crowns and ceramic veneers on the anterior teeth. After finishing the preparations, gingival displacement with Astringent Retraction Paste was performed without anesthesia or the use of cords and the impression was taken. Before cementation of the crowns and veneers, the Astringent Retraction Paste was applied. Avoiding the use of cords during cementation prevented trauma. The soft tissue margins remained stable and healthy after a period of 3 years. It can be concluded that retraction pastes could be indicated for displacement of soft tissue when preparation margins are at the gingival level or slightly intrasulcular prior to impressions, restoration cementations, direct restorations, and before relining provisional restorations. Clinical significance: The impression appointment can be traumatic to some patients. The use of cords for gingival displacement usually requires local anesthesia and is time consuming. Retraction astringent pastes instead of cords seems to be a good option for some cases in gingival tissue displacement.

Effect of Gingival Retraction Method to Lateral Gingival Displacement Width

Objective: To analyze the efficacy of retraction cord with a hemostatic agent in comparison with retraction paste on lateral gingival displacement, to achieve the success of fixed dental prostheses (FDP). Material and Methods: Test samples included 32 teeth that required treatment with metal-porcelain FDP at RSKGM FKG Universitas Indonesia. Impressions were taken before the gingival retraction procedure. From the 32 samples, 16 teeth were retracted using a combination of retraction cord and hemostatic agent, whereas the other half were retracted with retraction paste. Impressions were then taken. The sample was made using cutting die. Lateral gingival displacement width was measured on die-cast using an optical microscope. Results: The mean value of group A before gingival retraction was 0.1695 mm, and after gingival retraction was 0.4705 mm. The mean value of group B before gingival retraction was 0.1767 mm, and after gingival retraction was 0.3289 mm. Lateral gingival displacement width between a combination of cord retraction and hemostatic agent group in comparison with the retraction paste group showed a significant difference (p<0.001). The combination of cord retraction and hemostatic agent group showed higher mean value. Conclusion: Gingival displacement width as a result of cord retraction with the hemostatic agent was larger compared to the retraction paste. Even though both of them are still considered to be effective in providing access for impression material.

A comparative evaluation of two contemporary cordless methods of gingival retraction – An In vivo study

Aim: The aim of this study was to compare and evaluate two different cordless methods of gingival retraction. Materials and Methods: For this study, a total of 30 participants aged above 18 years were selected. Out of 30 patients, 15 patients required fixed prosthesis in the anterior arch and 15 patients required fixed prosthesis in the posterior arch with minimum of two abutments surrounded by healthy periodontium, respectively. Same abutments were used for both retraction systems. After tooth preparation, three impressions for each patient were made, one without retraction, second after application of less viscous syringeable retraction paste, and third after 7 days after application of more viscous retraction paste with applicator gun. This was followed by fabrication of definitive Type IV gypsum cast. Undamaged retrieved casts were sawed out, buccolingually with the help of die cutting saw followed by measurement of the width of the retracted gingival sulcus under a stereomicroscope. The width was measured as the distance from the abutment tooth to the crest of the free gingiva. Results: The mean horizontal retraction attained from the control and two gingival retraction systems was compared using one-way ANOVA with the level of significance (P) set at 0.05. Amount of mean horizontal gingival retraction attained by syringeable retraction system was higher than control but statistically not significant in the anterior segment, whereas in the posterior segment, it was statistically significant.

Influence of gingival retraction paste versus cord on periodontal health: a systematic review and meta-analysis.

The effect of gingival retraction paste versus gingival retraction cord on periodontal tissue health is controversial. The aim of the present study was to evaluate the effect of gingival retraction paste versus gingival retraction cord on periodontal health by a systematic review and meta-analysis and to provide scientific guidelines for gingival retraction method selection in clinical work. The databases were systematically queried to collect studies exploring the effect of gingival retraction methods on periodontal tissue health in randomized controlled trials. Literature covering the period of January 1998 to April 2017 was extracted and the quality was assessed, followed by a random-effects meta-analysis with standardized mean differences and 95% confidence intervals. Eight studies met the inclusion criteria. The result of meta-analysis revealed that gingival retraction paste exhibited a less deleterious effect on the periodontal tissue compared with the gingival retraction cord technique measured by probing depth, Gingival Bleeding Index, and bleeding on probing (P < .05). However, no statistically significant differences were found in the measurements of Plaque Index, Gingival Index, and gingival recession between these two methods (P > .05). Gingival retraction paste can work better than the gingival retraction cord method in protecting periodontal tissue health.