assessing subgingival clamp in handling and retracting the gingival tissue at the cervical area to see its effect on the gingival health and its technique sensitivity compared to the most commonly used method (retraction cord), as gingival displacement for cervical restorations affects smile and therefore patient satisfaction with the result.
Gingival displacement for restoring cervical lesions using retraction cord or subgingival clamp with their technique sensitivity affects the smile as they may cause gingival bleeding, laceration or recession and therefore affects patient satisfaction. There are several methods to achieve retraction; retraction cord is the most commonly used method. It controls the soft tissue displacement, gingival bleeding and expose the margins which provide good visualization and access. They are effective and safe if the gingiva is healthy, also inexpensive retraction method. However, the use of retraction cord has some disadvantages like: it is time consuming, may cause gingival recession after healing and bleeding after removal, its application needs practice and skill as improper handling of the cord can cause traumatic injuries, gingival recession and marginal exposure of the restoration, it may cause postoperative discomfort and pain for the patient and finally leaving the retraction cord for long time or forgetting to remove it from the sulcus can cause permanent damage to the gingival tissue. Using gingival retracting clamps with rubber dam isolation prevent the gap caused around the teeth due to vertical and horizontal tissue displacement occurred beneath the area of dento-gingival attachment upon the application of the retraction cord. Also, after clamp stabilization in position, it prevents accidental slippage and trauma to surrounding soft tissue during the restorative procedure. They also provide maximum tissue retraction without laceration of gingival tissues. Also, their availability in different sizes and shapes provide a good adaptation to any tooth configuration and any inaccessible area.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
22
retraction cord ( Ultra dent sizes #0, #00, #000 ) is placed in the gingival sulcus using blunt instrument and using cotton roll isolation.
subgingival clamp (KSK clamps W8A, #44, #42, #43) or (Brinker clamps B5, B6) is placed to retract the gingiva with rubber dam isolation
Time of application
Assessed using timer and the measuring unite is seconds
Time frame: Immediately after application
Number of patients need local anesthesia
It will be measured by patient self assessment for the need of local anesthesia through a Yes/No question
Time frame: Immediately after application
Degree of isolation from cervical fluids
Presence of cervical fluids will be assessed visually using magnifying loup with a Yes/No result
Time frame: Immediately after application
Degree of patient satisfaction
Using visual analogue scale (units on scale from 0-10)
Time frame: Immediately after application
Pink esthetics evaluation
Using a pink esthetic score with a grades from 0-2
Time frame: 4 month
Amount of gingival bleeding
Assessed using a score for gingival hemorrhage from 0 -2
Time frame: 4 month
Presence of gingival laceration
Occurence of gingival laceration assessed visually using magnifying loup with a Yes/No result
Time frame: 4 month
Degree of gingival sensitivity
Assessed using visual analogue scale (units on scale from 0-10)
Time frame: 4 month
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.