Tissue diplacement /certified fixed orthodontic courses by Indian dental academy

Tissue Displacement
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


Tissue Displacement
• Change in the form or position of tissues as
a result of pressure
• Deflection of marginal gingiva away from a
tooth
• Synonyms
– Gingival retraction
– Gingival displacement

AIMS & OBJECTIVES
• Reflect gingiva and produce enlargement or
dilate gingival sulcus
• To obtain 0.2
- 0.4 mm of horizontal
displacement of marginal gingiva
• To achieve 0.5 mm of vertical exposure of
unprepared portion of tooth

METHODS
Mechanical
Mechanochemical
Surgical

Mechanical Methods
 Rubber dam
 Retraction cords - Plain
 Copper band
 Temporary acrylic resin coping

Rubber Dam


Retraction Cords


• Classification
–
–
–
–

Surface texture
Configuration
Surface finish
Thickness (colour
coded)

-

Wet or Dry
Twisted, knitted or plain
Waxed or unwaxed

-

– Chemical treatment
– Number of strands

-

Black 000 (extra small)
Yellow 00 (small)
Purple 0
Blue 1
Green 2
Red 3 (extra large)
Plain or impregnated
Single or Double string


IDEAL REQUIREMENTS
 Safe locally , and systemically
 Effective for its intended use
 Effects should be spontaneously reversible
 Absorbent
 Provide hemostasis
 No chemical injury to gingival tissues

Advantages
(Plain cord)
 Tissue recovery is excellent
 Provide pressure hemostasis
 Ease of manipulation
 Commonly used

Disadvantages
Poor in its ability to displace gingiva
Trauma and recession from packing
pressure


Copper Band


 Advantages
– To retrieve the localised impression defect in
multiple preparation

Disadvantages
– Incisional injury
– Inaccuracy

Mechanochemical method
• Chemical action + pressure pack- enlargement
of gingival sulcus
• Materials used-retraction cord &
medicaments


• Criteria
– Effectiveness of gingival displacement and
hemostasis
– Absence of irreversible damage to gingiva
– Paucity of untoward systemic effects

Techniques
• Single string technique
• Deknatel technique / double string
technique
• Selective double string

ARMAMENTARIUM


Packing Instruments


DOUBLE CORD TECHNIQUE


Selective Double String
• Indications:
– Spontaneous bleeding of gingival crevice is
present

• Techniques:
– Pre packing of extra thin cord only into the area
of inflamed crevice
– Followed by packing with thin cord which is
removed during impressing making.

Epinephrine 0.1 & 8%
• Recommended time & Mechanism of action
– 5-10 min Pronounced vasoconstriction

 Advantages
– Good displacement & haemostasis

• Tissue Recovery
– Fair

Disadvantages
– Systemic reactions
– Contraindications – Cardiovascular disease,
hyperthroidism, hypersensitivity to epinephrine
– Epinephrine syndrome – Increased heart rate, respiratory
rate and BP.

Alum (100%)Potassium
Aluminium Sulphate
– 10 – 20 min. Precipitation of protein and inhibiting
transcapillary movement of plasma protein

 Advantages
– Minimal tissue loss
– Extended working time

• Tissue Recovery
– Good

Disadvantages
– Less displacement and haemostasis

Aluminium Chloride 5%-25%
Aluminium sulphate 25%
– 10 mins. Weak Vasoconstrictor

 Advantages
– Minimal tissue loss
– Good haemostasis

• Tissue recovery
– Good

Disadvantages
– Local tissue destruction > 10%concentration

Ferric Sulphate 13.3%
– 1 – 3 minutes

 Advantages
– Good tissue response
– Compatible with Aluminium Chloride

• Tissue recovery
– Good

Disadvantages
– Not compatible with epinephrine
– Transient tissue discoloration

Ferric sub Sulphate
(Monsel’s Solution)
 Recommended time & Mechanism of action
3 mins

 Advantages
Good displacement

 Tissue recovery
Good

Disadvantages
Highly acidic and messy to work

Zinc Chloride 8% & 40%
 Advantages
– Good displacement

• Tissue recovery
– 8% - Fair
– 40% - Fair

Disadvantages
– Tissue necrosis and permanent tissue injury

Tissue diplacement /certified fixed orthodontic courses by Indian dental academy

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