In order to obtain an accurate impression of the finish line on a prepared tooth, dentists use various gingival displacement techniques or a combination of techniques. These include mechanical, chemical, electrosurgery and laser. Gingival deflection medicaments, particularly epinephrine, may cause systemic effects in patients. The purpose of this study was to evaluate the current gingival displacement methods and compare the current procedures and medicaments to previously published articles.
Materials and Methods:
A questionnaire was given to dentists who participated in continuing education courses in different states in the US. The questions included initial patient assessment procedures, various gingival displacement methods and the type of retraction cords used currently. Dentists’ knowledge and assessment of systemic manifestations such as increased heart rate and blood pressure, syncope, palpitation and cardiac arrest were also documented. A descriptive statistical analysis was used to assess the percentage of respondents in each category.
Results:
94% of the participants were general practitioners with 24.11 + 12.5 years of experience. 94% of them used gingival retraction cords, while 20% used a soft tissue laser and 31% of them used electro surgery as an adjunct. 57% of the dentists used retraction cords impregnated with a medicament. Out of the pre-impregnated cords, 33% of them were impregnated with epinephrine, 19% and 9.4% were impregnated with Aluminum Chloride and Aluminum potassium sulfate respectively.
Conclusion:
Retraction cords impregnated with epinephrine have a higher potential for systemic effects such as increased heart rate and blood pressure. Surveys conducted in 1977, 1985 and 1999 by three independent groups of researchers showed that epinephrine was used 79%, 55% and 39% respectively. The results from the current study (33%) showed that epinephrine is less frequently by dentists today. These studies show a steady decrease in the use of gingival deflection medicaments.