78 Questions
What is Magic Foam Cord made of?
Polydimethylsiloxane with a tin catalyst
What caused the fourfold volumetric expansion of Magic Foam Cord?
Release of gas from the reaction
What is used to apply pressure to the expanding foam?
Hollow cotton roll
Which material provides excellent hemostasis and some gingival retraction according to the text?
Racegel
How long should the material be left inside the gingival sulcus during cordless retraction?
5-10 minutes
What is the advantage of cordless retraction technique according to the text?
'Non-traumatic, non-invasive tissue management and excellent hemostasis'
'Surgical techniques' are considered what according to the text?
'True retraction techniques'
'Cordless retraction technique' is mainly used for what kind of dental procedure?
'Fixed prosthodontic impressions'
What is the primary purpose of using a retraction cord?
To physically push the gingiva away from the finishing line
What is the purpose of rotary gingival curettage (gingettage)?
To expose the finish line of the preparation
Which of the following is NOT a common hemostatic solution used to impregnate retraction cords?
Zinc oxide
When is rotary gingival curettage advised to be used?
Only when there is adequate attached gingiva
What is the recommended duration for leaving the retraction cord in place?
10 minutes
What is a disadvantage of the gingettage technique?
It has poor tactile sense
How deep should the sulcus be for gingettage to be performed?
3 mm
Which instrument is typically used to pack the retraction cord into the gingival sulcus?
Fischer packing instrument or Ash no.6
What does gingettage involve?
Removing a portion of the sulcular epithelium to expose the finish line
What is the purpose of drying the field with air before placing the retraction cord?
To prevent saliva contamination during the procedure
Why should rotary gingival curettage be done only on healthy gingival tissue?
To prevent damage to the periodontium
What is the recommended action if the tooth is excessively desiccated during the retraction procedure?
No specific action is mentioned in the text
What is the purpose of squeezing out the excess astringent solution from the cord before placement?
To prevent excessive tissue shrinkage
After removing the retraction cord, what is the expected state of the gingival tissue?
Expanded and flexible
What is the purpose of using a knitted retraction cord?
All of the above
Which color-coded retraction cord is recommended for anterior teeth with minimal crevicular space?
Black and Yellow
What is the primary advantage of knitted cords over braided cords?
Knitted cords afford greater inter-thread space
Which size of retraction cord is recommended for bicuspids?
Purple (0) and Blue (1)
What is the purpose of using a double cord technique?
To achieve better retraction in areas with greater tissue bulk
Which size of retraction cord is classified as 'SMALL'?
000 and 00
Which of the following statements about retraction cords is true?
Knitted cords form an interlocking chain of tiny loops, making them easier to pack and displace tissue
Which type of retraction cord is recommended for use in areas with greater tissue bulk?
Knitted cords
Why should the operative site be isolated during dental procedures?
To obtain a dry clean operating field
What is a common source of fluid in the oral cavity during dental procedures?
Saliva
Why is moisture control important during dental procedures?
To protect from swallowing foreign bodies
What is the average flow rate of saliva while chewing different foods?
3.6 +/- 0.8 ml/min
Which fluid source contributes to gingival crevicular fluid in the oral cavity?
Gingival tissues inflammation
What does isolating the operative site help in preventing?
Contamination
How does moisture control impact adhesion of dental materials?
It improves adhesion effectiveness
What is a function of gingival crevicular fluid in the oral cavity?
Moisture control during procedures
Saliva flow rate is 3.6 mL per minute while chewing different foods.
True
A high speed rotary cutting instrument consumes 50 mL per minute.
False
Gingival crevicular fluid flow rate is 0.25 µL per minute.
False
Moisture control in dental procedures does not impact adhesion of dental materials.
False
Isolating the operative site is only done for patient comfort.
False
Saliva flow rate during chewing foods is always constant for all individuals.
False
Preventing contamination is not a reason for isolating the operative site during dental procedures.
False
Gingival bleeding during tooth preparation is not a potential source of fluid in the oral cavity during dental procedures.
False
It is recommended to moisten the impregnated cord before placing it in the sulcus.
True
Twisting non-braided cords tightly makes them harder to place.
False
The instrument should be angled away from the tooth during cord placement to avoid displacement.
False
Over-packing and repeated use of displacement cord should be avoided during cord placement.
True
It is easier to start cord placement inter-proximally because it offers more sulcular depth than facial or lingual areas.
True
Moisture control is not important in dental procedures involving retraction cord placement.
False
A second instrument holding the cord does not aid in subsequent placement during the cord placement procedure.
False
Gentle and firm pressure should be applied to the cord during placement apical to the margins of preparation.
True
Rubber dam is the most effective method for moisture control when all margins are supra-gingival.
True
Cotton rolls are only placed in the sublingual area for moisture control.
False
Cotton roll holders are used to enhance visibility during dental procedures.
True
Absorbing cards are made of foam material for controlling saliva flow.
False
Multiple Isolation Techniques are performed when a rubber dam cannot be used for optimal saliva control.
True
Cotton rolls are only used in the maxillary arch for moisture control.
False
Rubber dam eliminates the need for any other moisture control methods during dental procedures.
False
Absorbing cards are more effective than cotton rolls in controlling saliva flow in dental procedures.
False
Biologic width acts as a barrier against microorganisms to protect the periodontium.
True
A minimum of 2mm space between the restoration margin and the alveolar bone is required for proper healing.
False
The 3mm space needed for biologic width consists of 2mm of junctional epithelium.
False
The location, fit, and finish of restorative margins do not impact periodontal health.
False
Gingival retraction aids in providing enough thickness of the impression material at the area of the finishing line.
True
Digital impression techniques eliminate the need for careful isolation and retraction.
False
Using a double cord technique is recommended for preserving biologic width.
False
Preserving biologic width does not play a role in maintaining normal values of the periodontium.
False
In a double cord technique, the first cord is thick.
False
The second cord is removed immediately before impression making in a double cord technique.
True
The double cord technique is indicated when there is minimal to no gingival fluid exudates present.
False
One of the advantages of the double cord technique is to control gingival hemorrhage.
True
In the double cord technique, the initial cord is removed immediately before impression making.
False
Using two cords in the double cord technique requires that there should be around 2mm of intact tooth structure remaining between them.
False
The primary purpose of a thick second cord in the double cord technique is to achieve vertical tissue displacement.
False
A key advantage of the double cord technique is to reduce the tendency of the gingival cuff to recoil.
True
Study Notes
Gingival Retraction and Fluid Control in Dentistry
Magic Foam Cord (Coltène/Whaledent)
- A polydimethylsiloxane with a tin catalyst
- Fourfold (x4) volumetric expansion when used in the sulcus
- Expanding foam allows for apically directed flow and enlargement of the gingival sulcus, making it suitable for impression making
Cordless Retraction Materials
- Examples: Racegel (Septodont), Traxodent (Premier), GingiTrac (Centrix)
- Provide excellent hemostasis and gingival retraction
- Used for fixed prosthodontic impressions
Surgical Technique (Radical or Surgical Means)
- Involves removing part or all of the overlying gingival tissue to expose the finish line of the tooth
- More invasive and should only be used in cases with adequate attached gingiva
- Examples:
- Rotary Gingival Curettage (Gingetage): a toughing technique involving simultaneous curettage of the inner lining of the gingival sulcus and preparation of the tooth sub-gingivally
- Criteria to fulfill for Gingetage: no bleeding on probing, sulcus depth of at least 3 mm
- Disadvantages of Gingetage: poor tactile sense, potential damage to periodontium
Retraction Cords
- Classification:
- According to chemical treatment: plain cord, impregnated cord
- According to configuration: twisted, knitted, braided
- According to thickness (diameter): different colors indicate different sizes (e.g., black - 000, yellow - 00, purple - 0, blue - 1, green - 2, red - 3)
- Advantages of knitted cord:
- Affords greater inter-thread space than braided cord
- Forms an interlocking chain of tiny loops, making it easy to pack and stays in place
- Compresses upon packing, then expands for tissue displacement
Isolation and Fluid Control
- Importance of isolation: dry, clean operating field, easy access and visibility, improved properties of dental materials, patient and operator protection, improved operating efficiency
- Fluid sources in the oral cavity:
- Saliva (parotid and submandibular and sublingual glands)
- Inflamed gingival tissues/iatrogenic soft tissue damage
- Water/dental materials (rotary instruments, triplex syringe, etchants, irrigant solutions)
- Gingival crevicular fluid (sulcular fluid)
- Techniques for fluid control and isolation:
- Rubber dam
- Cotton rolls
- Cotton roll holder
- Absorbing cards
Biologic Width
- A minimum of 3 mm space is required between the restoration margin and the alveolar bone to permit adequate healing and maintain a healthy periodontium
- Consists of 1 mm of supraalveolar connective tissue, 1 mm of junctional epithelium, and 1 mm of sulcular depth
- Importance of preserving biologic width in restorative dentistry: prevents penetration of microorganisms into the periodontium, maintains periodontal health
Test your knowledge on moisture control, fluid sources of the oral cavity, and soft tissue management in dentistry. Topics include saliva flow rates, causes of gingival bleeding, and fluid sources during dental procedures.
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