Tissue Dilation in Dentistry

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Questions and Answers

What is the primary purpose of using a zinc oxide and eugenol pack?

To create a temporary crown for multiple surfaces

To treat gingival hypertrophy in the interproximal space (correct)

To achieve a clean dry field for tooth preparation

To reduce the temperature in the periodontal area

What should be avoided when trimming the margins of a temporary crown?

Use of non-sterile instruments

Excessive length of the crown

Blanching of the gingival tissue (correct)

Mismatch with permanent crown size

What is the correct duration for a rubber dam to be left in place during a procedure?

12 hours

24 hours (correct)

5-10 minutes

1 hour

Which chemical is contraindicated for cardiac patients due to potential side effects?

Epinephrine 1/1000 Signup and view all the answers

What is the role of the chemically impregnated cord in the mechanical chemical method?

Stop hemorrhage and bleeding of the gingival tissue Signup and view all the answers

What action should be taken to prevent tearing of the sulcular epithelium when using an impregnated cord?

Moisten the cord before placement Signup and view all the answers

Which symptom is associated with epinephrine syndrome?

Increased blood pressure Signup and view all the answers

What is a potential consequence of using an orthodontic rubber band incorrectly?

Causing trauma to the gingival tissue Signup and view all the answers

Where is it preferable to start placing the retraction cord?

Interproximal area Signup and view all the answers

What is the main purpose of angling the instrument towards the tooth when placing the cord?

To avoid displacing previously packed cord Signup and view all the answers

What technique is indicated for treating generalized gingival hypertrophy?

Surgical method Signup and view all the answers

What is a disadvantage of the electro-surgery technique?

Need for experienced hands Signup and view all the answers

What should be done to the force of the instrument when placing the distal end of the cord?

Direct it toward the previously packed cord Signup and view all the answers

Which of the following is NOT a contraindication for electro-surgery?

Healthy gingival tissue Signup and view all the answers

What is the purpose of rotary curettage (gingivettage)?

Limited removal of inner epithelial tissues Signup and view all the answers

What is an essential step when cutting excess cord in the mesial interproximal area?

Ensure the cord is tightly packed before cutting Signup and view all the answers

What is the primary purpose of tissue dilatation?

To temporarily push the gingival tissue away for better examination Signup and view all the answers

Which of the following is NOT an indication for gingival tissue dilation?

During routine cleaning of the gums Signup and view all the answers

What is a requirement of tissue dilatation related to the impression material?

It should allow recording of tooth structure beyond the margins Signup and view all the answers

Which method of tissue dilatation is the first developed?

Mechanical methods Signup and view all the answers

What happens if mechanical tissue dilation is left in place for longer than 24 hours?

It may lead to permanent gum recession Signup and view all the answers

Which of the following does NOT describe a requirement for tissue dilatation?

It is used to harvest tissue for grafting Signup and view all the answers

What is a key characteristic of mechanical methods of tissue dilation?

They last for 24 hours before risking gum recession Signup and view all the answers

Which method does NOT involve the use of mechanical displacement for tissue dilation?

Cordless technique Signup and view all the answers

Study Notes

Tissue Dilation

Process of temporarily pushing gingival tissue away from the tooth surface for better examination and accurate impression taking.

Indications for Gingival Tissue Dilation

During Examination: Allows for better visualization of cervical area covered by free gingiva.
During Preparation: Enables accurate preparation and positioning of finishing line, preventing soft tissue injury and bleeding.
During Impression Taking: Displaces gingival tissue, exposing preparation margins and finishing line for accurate elastic impression.
During Finishing and Cementation: Ensures no overhanging or open margins for optimal marginal fitness.

Requirements of Tissue Dilation

Horizontal Space Creation:
- Facilitates recording of tooth structure beyond margins during impression taking.
- Provides sufficient strength for impression material, preventing distortion or tearing during removal or pouring.
Clean and Dry Field: Prevents serum seepage or blood interference.
Periodontal Tissue Health Preservation: Protects and maintains the health of supporting structures.

Methods of Tissue Dilation

Mechanical Methods:
- Copper Band: A festooned tube packed with modeling compound, seated for 24 hours.
- Zinc Oxide or Gutta-Percha Pack: Used for interproximal gingival hypertrophy.
- Temporary Crown: For gingival hypertrophy involving multiple surfaces. Margins should be trimmed for proper displacement.
- Rubber Dam: With a hole punched for access, provides a clean and dry field.
- Orthodontic Rubber Band: Pushed onto free gingiva with a blunt instrument, left for 24 hours.
Mechanical Chemical Method:
- Most common technique, lasting 5-10 minutes.
- Employs chemically impregnated cord, displacing gingiva mechanically while chemicals control bleeding.
- Cord can be treated with:
  - Epinephrine 1/1000 or 8% (contraindicated in cardiac patients due to potential for epinephrine syndrome).
  - Aluminum chloride 5%-25%
  - Alum solution 100%
  - Ferric sulphate 13.3%
  - Tanic acid solution 20-100%
  - Negatol solution 45%
Cordless Technique: Not further described in the text.
Surgical Method:
- Employed for generalized gingival hypertrophy, bleeding, or to increase clinical crown length.
- Gingivectomy: Surgical removal of gingiva to the level of epithelial attachment, tissue regenerates to original height using a scalpel.
- Electro-surgery: Controlled tissue destruction with high-frequency current, requiring experienced operators to avoid harming periodontium.
- Contraindications: Patients with pacemakers, delayed healing (e.g. under radiation therapy), thin attached gingiva (e.g., upper canine).
Rotary Curettage (Gingivette "Troughing"):
- Limited removal of inner epithelial tissues in the sulcus, creating a chamfer finish line with a torpedo-nosed diamond.

Step-by-Step Procedure for Mechanical Chemical Method

Isolate prepared tooth with cotton rolls, use saliva evacuators, and dry the field with air.
Cut a length of cord sufficient to encircle the tooth, avoiding excessive drying which can cause sensitivity.
Dip cord in astringent solution, squeezing out excess with gauze.
Twist non-braided cord tightly for easy placement.
Loop cord around tooth, gently pushing it into the sulcus with a suitable instrument.
- Start in the interproximal area for easier placement.
- Angle the instrument towards the tooth to push the cord directly into the area.
- Angle instrument slightly toward previously packed cord to avoid displacement.
- Use a second instrument to aid placement.
Cut a 2" piece of retraction cord, twist tightly.
Form a loop around the tooth, holding taut with thumb and forefinger.
Begin placement by pushing the cord into the sulcus on the mesial surface.
Tack the cord tightly into the distal crevice.
Angle the instrument toward the tooth for direct placement. Cut excess cord in mesial interproximal area.
Continue placement of the distal end, overlapping the mesial. Direct force towards previously packed cord.

Double Cord Technique

Not further described in the text.

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Description

Explore the importance of tissue dilation in dental procedures. This quiz covers the indications, requirements, and processes involved in effectively pushing gingival tissue away for examinations, preparations, and accurate impressions. Test your knowledge and understanding of gingival tissue management in clinical practice.