Dentists during dental treatment, for one reason or another, are often forced to injure the gums and the teeth surrounding them in order to perform their manipulations with high quality. These injuries include gum retraction.
What is retraction?
Retraction is translated literally as "pulling", and this word reflects the essence of the procedure. Gingival retraction is the expansion of the gingival sulcus, which exposes the tooth root and lowers the level of the gum.
This technique is carried out thanks to the use of special retraction threads, which are a finished product that has the form of a twisted fiber of various sizes and lengths, subjected to special processing. The selection of the thread is done individually, which depends on the size of the gingival sulcus, that is, its depth and width.
Select thread
Only an experienced specialist can pick up a thread, since its size must exactly match the specific properties of a particular section of the patient's oral cavity. Only under these conditions will the correct movement of tissues be guaranteed.
In dentistrythe retraction cord is used to carry out a procedure that precedes a dental restoration - before taking an impression.
When is it necessary?
Gingival retraction needed:
- if it is necessary to protect the gums from injuries and gum fluid during treatment;
- bleeding during other dental procedures;
- if it is necessary to carry out manipulations on the area of the tooth, which is located under the gum;
- teeth whitening;
- making crowns, dentures or veneers and installing them.
Characteristics and composition
Twisted retraction cords are made from 100% cotton. This material has an absorbent effect. Unimpregnated cords can also be used for gingival retraction, but factory-impregnated fibers are the most common in practice, because they do not require time and are more economical.
The liquid has a universal composition that allows the specialist to produce optimal contraction of muscle tissue and constriction of blood vessels during bleeding. Thanks to the retraction thread, Gingi Pak, for example, you can install the necessary device between the teeth without bleeding or other unpleasant phenomena.
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There are three types of threads:
- Cotton, made from fibers. They are very soft and have excellent absorbency.properties.
- Tubes made of cloth. In terms of their absorbent qualities, they are similar to cotton, however, due to the peculiarities of weaving, these threads are better located in the gingival sulcus. They are best for retraction.
- Threads that are not impregnated with a chemical composition. Used for mechanical type retraction, if the patient cannot undergo combined retraction for one reason or another.
Currently, there are new retraction techniques that are based on the use of diode lasers, which are completely painless and safe. The difficulty is that the equipment needed for such a retraction is very expensive.
Basic gingival retraction techniques
There are three main ways of gum retraction.
1) Mechanical method.
Gingival mechanical retraction involves the use of caps, rings and threads. These items are introduced by the doctor under the gum, due to which it, in fact, moves away. The main property of the mechanical method is painlessness, due to which it is mainly carried out under local anesthesia. In addition, mechanical retraction requires quite a lot of time, since the specialist must constantly control the depth of the retraction, all manipulations must be carried out carefully and slowly, with the measurement of the level of the gingival sulcus. The presence of such difficulties has led to the fact that now almost no mechanical retraction is performed, especiallythis applies to cases where the gum needs to be pushed back on several teeth at once. In addition to complexity, mechanical retraction has another disadvantage. Since the gum tissue is highly sensitive, even the slightest mechanical impact can cause serious bleeding or damage the attachment of the tooth to the jawbone.
2) Surgical method. This method is the complete elimination of part of the gum tissue using surgical electrical appliances or an ordinary scalpel. This method is very radical, so it is used only in the following cases:
- if necessary, gum correction;
- when other methods cannot be used for various reasons.
3) Chemical method. Its essence lies in the use of special pastes, solutions or gels that contribute to the reduction of gum tissue, due to which the edge of the gum is pulled back for a while. It should be noted right away that the chemical method is not suitable for all patients, since adrenaline is present in most drugs. This substance, even in small quantities, increases blood pressure and increases heart rate, and this is contraindicated in people with heart rhythm disturbances, ischemia and hypertension. In addition, gum tissue can simply reject chemicals, and in this case, chemical retraction is impossible.
The most gentle for gingival retraction are the meanscontaining aluminum oxide and kaolin. They are produced in the form of a gel or paste and are placed in special cartridges that allow you to accurately control their application to the gum. With the chemical method, it is especially important to observe the duration of exposure in order to avoid chemical burns.
Combined gingival retraction technique
In modern dentistry, the three main techniques are rarely used separately. Specialists prefer to combine these methods. The mechanical-chemical method has gained the greatest popularity. For retraction of this type, retraction threads are most often used in dentistry. For a successful procedure, the specialist must accurately determine the depth and width of the gum groove, and then select the threads of a certain thickness and size. As in the chemical method, the dentist must ask the patient if he suffers from heart disease, if he has intolerance or allergy to certain chemicals. No more than four threads are allowed at a time to avoid chemical burns.
To install the retraction thread, a special tool of a certain size is used (most often the device has rounded edges and a thin blade). When performing the procedure, the dentist must show maximum attention and skill in order to avoid injury when placing the thread. Before inserting the impression material, the thread must be removed from the groove. In some cases, after removing the thread, the specialist prefersRinse the surface as it is recommended to keep it as dry as possible.
Gingi Pack retraction thread
Consists of 100% cotton, impregnated with aluminum sulfate.
Properties and benefits of the epinephrine retraction suture:
- Has a unique texture that makes it easy to hold.
- Due to the impregnation method, a uniform distribution of the solution along the entire length is guaranteed.
- Features unique packaging, cut with sharpened cap without scissors.
- The thread is sterile.
- Fibers do not crumble.
- Possibility of additional impregnation.
Sure Cord retraction thread
Also made from 100% cotton, consists of many small, interconnected loops. This allows you to firmly fix it in the intergingival sulcus. There are several sizes available, the thickness of the threads will be different. Dentists use these threads when working with veneers.
