Background: An accurate impression is obtained for the fabrication of fixed restorations only when the gingival tissue is managed properly. And this is especially true when the location of the finish line is at, or within, the gingival sulcus. Gingival retraction is an important aspect of currant impression techniques in fixed prosthetic procedures. Effective gingival retraction prior to taking an impression without damaging periodontal tissues is very important in long-term success of cast restorations.
Purpose: To collect and evaluate, in a systematic manner, data available on the post-operative effect of retraction cords on gingival tissue in patients with healthy gingiva compared to cordless techniques in respect to effect on gingival recession, parameters of gingival inflammation and patient comfort.
Methods: PubMed/Medline, Science Direct, ISI Web of Science, the Cochrane library, EMBASE, and Google Scholar databases were searched. The studies were chosen according to the inclusion criteria followed by data extraction, and quality check.
Results: 85 potentially eligible articles were identified, of which only 5 fulfilled the objective of the study and were included. Five studies reported that the gingival retraction techniques affected the gingival health with a variable degree level and this effect was temporary in nature taking in consideration the health of the gingival tissues. One study compared three different techniques of retraction materials and reported that temporary gingival inflammation was observed with all techniques and Expasyl had the greatest effect with slower recovery. Bleeding was induced by the cordless techniques neither during nor after retraction. One study investigated non-aluminum chloride-containing injection-type retraction material (Korlex-GR) compare it with 2 other commercial retraction materials (Ultrapak 1, a medicated retraction cord, and Expasyl), there results indicated that the non-aluminum chloride-containing injection-type retraction material is as effective as the other 2 materials for gingival retraction but produces less pain and limits injury to the gingival tissue during the procedure.
Conclusions: It may be suggested that all tested gingival retraction technique will affect the gingiva negatively temporarily, however, well-fitted fixed dental prosthesis and its procedures performed to periodontaly healthy subjects will have a reversible effect on the periodontal tissue health.
Nahid Y Ashri, Mohammed Q AlRifaiy and Ashraf El-Metwally
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