Dişeti Oluğu Genişletilmesinde Kullanılan Farklı Uygulamaların Klinik Etkinliğinin Karşılaştırılması

Abstract

For a successful fixed prosthetic restoration, finish line of preparation must be followed in detail on the impression and model. Different gingival displacement (gingival retraction) methods are used to detect of preparation finish line and displacement of soft tissues. The purpose of this in vivo study was to determine the quantity of gingival displacement by using different mechanical and chemico-mechanical retraction methods, to evaluate clinical effects and efficacy of gingival displacement applications as well as integrity of finish line on impression. For this purpose, following the approval of Hacettepe University Clinical Studies Ethics Committee, teeth number of 12, 13, 11, 21, 23 in the upper jaw anterior region were prepared in 12 individuals with healthy gingiva. Epigingival finish line was applied on prepared teeth. Four gingival displacement methods were performed for each tooth by using double cord technique. These methods are non-impregnated (plain) retraction cord, 15% AlCl3 impregnated retraction cord, 15% AlCl3 impregnated fine copper wire retraction cord (Stay-put), 15% AlCl3 retraction paste. During application, pain grade, ease of application, bleeding and remnants (debris) besides that after application, integrity of finish line on impression was clinically assessed. Three dimensional digital models of impressions which were taken before and after retraction were examined in a three dimensional imaging and analysis programme and horizontal, vertical and total displacement were measured. Kruskal Wallis, Mann Whitney U and Multidimensional Regression Analysis were used for statistical analyzes. There was no statistically significant difference between the methods in terms of pain grade (p> 0.05). There was a statistically significant difference between the methods in all other parameters (p <0.05). Retraction paste was found to be easier to apply than the other materials even though it had the highest debris presence ratio. Non-impregnated cord showed the highest bleeding rate after application. The best material for achieving integrity of finish line on impression was found as been 15% AlCl3 impregnated retraction cord. The amount of gingival displacement in all of the retraction material formed a sufficient sulcus width for impression. Stay-put and retraction paste methods showed statistically significant higher amount of horizontal and total displacement than other materials. The amount of vertical displacement of Stay-Put was found to be statistically significant higher than other materials.