One of the most challenging factors affecting impression quality and good marginal fit is the gingival retraction method, which aims to separate the gingiva from the tooth to expose the finishing line of the prepared tooth. Bleeding and contamination from the crevicular fluid may compete for space with the impression material within the sulcus, leading to indistinct preparations and a lack of detail at the margin. In addition, such procedures might damage the PDL and cause permanent recession. Flowable composite cable, as opposed to traditional retraction cords, offers the proper marginal seal and visibility during the impression record because of its lower viscosity, improved adaptability, and elastic properties. The aim of this report is to present a brand-new, innovative method for controlling gingival hemorrhage in addition to the gingival retraction in restorative and prosthodontic treatment by utilizing a flowable composite during the final impression record procedure. In these case reports, the flowable composite cord technique is used instead of traditional gingival cords to modify and refine the gingival tissue before taking the traditional final impression or digital scan. Two cases were done for patients undergoing fixed prosthodontics and veneer treatment within a 2-year follow-up period. In addition, the flowable composite cord was used as temporary restoration before the final prosthetic cementation or under the provisional crowns. As a result, clean and healthy gingival tissues render cementation of the final prosthesis quicker and easier to perform. The patients in both cases claimed that their prosthodontic treatments, which involved the application of a flowable composite cord to temporarily retraction the gingiva, had produced good outcomes at the yearlong follow-up. In conclusion, the flowable composite cord technique is found to be a useful tool to improve the quality of impressions in fixed prosthodontics by providing excellent access for impression material to record fine details of the finish line of the prepared tooth structure, and to alter the inflamed tissue into a healthy tissue.
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Vaishnav, K., Rana, D., Joshi, R., Agnihotri, R., Shah, D. and Patel, R. (2022) A Study on Clinical Comparison between Expasyl Retraction System and Medicated Retraction Cord on Gingival Retraction. Journal of Coastal Life Medicine, 10, 263-273.
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Hirata, R. (2019) The Use of Retraction Paste to Simplify Impression and Cementation of Ceramic Veneers and Crowns: 3-Year Follow-Up Report. Quintessence International, 50, 604-610.
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Raigrodski, A.J. (2015) Soft Tissue Management: The Restorative Perspective: Putting Concepts into Practice. Quintessence Publishing, Tokyo.
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Poss, S. (2002) An Innovative Tissue-Retraction Material. Compendium of Continuing Education in Dentistry, 23, 13-17.
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Safari, S., Vossoghi Sheshkalani, M., Vossoghi Sheshkalani, M., Hoseini Ghavam, F. and Hamedi, M. (2016) Gingival Retraction Methods for Fabrication of Fixed Partial Denture: Literature Review. Journal of Dental Biomaterials, 3, 205-213. https://pubmed.ncbi.nlm.nih.gov/28959744/
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Lotfi, N., Esmaeili, B., Ahmadizenouz, G., Bijani, A. and Khadem, H. (2015) Gingival Microleakage in Class II Composite Restorations Using Different Flowable Composites as Liner: An in Vitro Evaluation. Caspian Journal of Dental Research, 4, 10-16.
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Wostmann, B., Rehmann, P., Trost, D. and Balkenhol, M. (2008) Effect of Different Retraction and Impression Techniques on the Marginal Fit of Crowns. Journal of Dentistry, 36, 508-512. https://doi.org/10.1016/j.jdent.2008.03.013
[33]
Naveen, Y.G. and Patil, R. (2013) Effect of the Impression Margin Thickness on the Linear Accuracy of Impression and Stone Dies: An in Vitro Study. The Journal of Indian Prosthodontic Society, 13, 13-18. https://doi.org/10.1007/s13191-012-0160-7
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Baharav, H., Kupershmidt, I., Laufer, B.Z. and Cardash, H.S. (2004) The Effect of Sulcular Width on the Linear Accuracy of Impression Materials in the Presence of an Undercut. The International Journal of Prosthodontics, 17, 585-589.
[35]
Tabassum, S., Adnan, S. and Khan, F.R. (2017) Gingival Retraction Methods: A Systematic Review. Journal of Prosthodontics, 26, 637-643. https://doi.org/10.1111/jopr.12522
[36]
Anupam, P., Namratha, N., Vibha, S., Anandakrishna, G.N., Shally, K. and Singh, A. (2013) Efficacy of Two Gingival Retraction Systems on Lateral Gingival Displacement: A Prospective Clinical Study. Journal of Oral Biology and Craniofacial Research, 3, 68-72. https://doi.org/10.1016/j.jobcr.2013.05.006
[37]
Vaishnav, K., Rana, D., Joshi, R., Agnihotri, R., Shah, D. and Patel, R. (2022) A Study on Clinical Comparison between Expasyl Retraction System and Medicated Retraction Cord on Gingival Retraction. Journal of Coastal Life Medicine, 10, 263-273.
[38]
Masek, R. (2005) Margin Isolation for Optical Impressions and Adhesion. International Journal of Computerized Dentistry, 8, 69-76.
[39]
Yang, J.C., Tsai, C.M., Chen, M.S., Wei, J.Y., Lee, S.Y. and Lin, C.T. (2005) Clinical Study of a Newly Developed Injection-Type Gingival Retraction Material. Journal of Dental Sciences, 24, 147-151.
[40]
Khajuria, R.R., Sharma, V., Vadavadgi, S. and Singh, R. (2014) Advancements in Tissue Displace-ment—A Review. Annals of Dental Specialty, 2, 100-103.
[41]
Rajambigai, M.A., Raja, S.R., Soundar, S.I.J. and Kandasamy, M. (2016) Quick, Painless, and Atraumatic Gingival Retraction: An Overview of Advanced Materials. Journal of Pharmacy and Bioallied Sciences, 8, S5-S7. https://doi.org/10.4103/0975-7406.191968
[42]
Baba, N.Z., Goodacre, C.J., Jekki, R. and Won, J. (2014) Gingival Displacement for Impression Making in Fixed Prosthodontics: Contemporary Principles, Materials, and Techniques. Dental Clinics of North America, 58, 45-68. https://doi.org/10.1016/j.cden.2013.09.002
[43]
Shivasakthy, M. and Ali, S.A. (2013) Comparative Study on the Efficacy of Gingival Retraction Using Polyvinyl Acetate Strips and Conventional Retraction Cord—An in Vivo Study. Journal of Clinical and Diagnostic Research, 7, 2368-2371. https://doi.org/10.7860/JCDR/2013/6980.3526
[44]
Donovan, T.E. and Chee, W.W.L. (2004) Current Concepts in Gingival Displacement. Dental Clinics of North America, 48, 433-444. https://doi.org/10.1016/j.cden.2003.12.012
[45]
Tuloglu, N., Tunc, E.S., Ozer, S. and Bayrak, S. (2014) Shear Bond Strength of Self-Adhering Flowable Composite on Dentin with and without Application of an Adhesive System. Journal of Applied Biomaterials & Functional Materials, 12, 97-101. https://doi.org/10.5301/jabfm.5000166
[46]
Lokhande, N.A., Padmai, A.S., Rathore, V.P.S., Shingane, S., Jayashankar, D.N. and Sharma, U. (2014) Effectiveness of Flowable Resin Composite in Reducing Microleakage—An in Vitro Study. Journal of International Oral Health, 6, 111-114. https://pubmed.ncbi.nlm.nih.gov/25083045/
[47]
Sooraparaju, S.G., Kanumuru, P.K., Nujella, S.K., Konda, K.R., Reddy, K.B.K. and Penigalapati, S. (2014) A Comparative Evaluation of Microleakage in Class V Composite Restorations. International Journal of Dentistry, 2014, Article ID: 685643. https://doi.org/10.1155/2014/685643
[48]
Sarmento, H.R., Leite, F.R.M., Dantas, R.V.F., Ogliari, F.A., Demarco, F.F. and Faot, F. (2014) A Double-Blind Randomised Clinical Trial of Two Techniques for Gingival Displacement. Journal of Oral Rehabilitation, 41, 306-313. https://doi.org/10.1111/joor.12142
[49]
Huang, C., Somar, M., Li, K. and Mohadeb, J.V.N. (2017) Efficiency of Cordless versus Cord Techniques of Gingival Retraction: A Systematic Review. Journal of Prosthodontics, 26, 177-185. https://doi.org/10.1111/jopr.12352
[50]
Laufer, B.Z., Baharav, H. and Cardash, H.S. (1994) The Linear Accuracy of Impressions and Stone Dies as Affected by the Thickness of the Impression Margin. The International Journal of Prosthodontics, 7, 247-252.
[51]
Hirata, R. (2019) The Use of Retraction Paste to Simplify Impression and Cementation of Ceramic Veneers and Crowns: 3-Year Follow-Up Report. Quintessence International, 50, 604-610.
[52]
Raigrodski, A.J. (2015) Soft Tissue Management: The Restorative Perspective: Putting Concepts into Practice. Quintessence Publishing, Tokyo.
[53]
Poss, S. (2002) An Innovative Tissue-Retraction Material. Compendium of Continuing Education in Dentistry, 23, 13-17.
[54]
Shannon, A. (2002) Expanded Clinical Uses of a Novel Tissue-Retraction Material. Compendium of Continuing Education in Dentistry, 23, 3-6.
[55]
Safari, S., Vossoghi Sheshkalani, M., Vossoghi Sheshkalani, M., Hoseini Ghavam, F. and Hamedi, M. (2016) Gingival Retraction Methods for Fabrication of Fixed Partial Denture: Literature Review. Journal of Dental Biomaterials, 3, 205-213. https://pubmed.ncbi.nlm.nih.gov/28959744/
[56]
Peskersoy, C., Oguzhan, A. and Gurlek, O. (2022) The Effect of Flowable Composite Resins on Periodontal Health, Cytokine Levels, and Immunoglobulins. BioMed Research International, 2022, Article ID: 6476597. https://doi.org/10.1155/2022/6476597
[57]
Boruziniat, A., Gharaee, S., Sarraf Shirazi, A., Majidinia, S. and Vatanpour, M. (2016) Evaluation of the Efficacy of Flowable Composite as Lining Material on Microleakage of Composite Resin Restorations: A Systematic Review and Meta-Analysis. Quintessence International, 47, 93-101.
[58]
Scotti, N., Comba, A., Gambino, A., Paolino, D.S., Alovisi, M., Pasqualini, D., et al. (2014) Microleakage at Enamel and Dentin Margins with a Bulk Fills Flowable Resin. European Journal of Dentistry, 8, 1-8.
[59]
Hala, A.N., Etman, W.M. and Geniad, T.M. (2023) Internal and Marginal Adaptation of Self-Adhesive and Flowable Composite Resins. Tanta Dental Journal, 20, 299-306. https://doi.org/10.4103/tdj.tdj_47_23
[60]
Lotfi, N., Esmaeili, B., Ahmadizenouz, G., Bijani, A. and Khadem, H. (2015) Gingival Microleakage in Class II Composite Restorations Using Different Flowable Composites as Liner: An in Vitro Evaluation. Caspian Journal of Dental Research, 4, 10-16.
