05 - Gingival Retraction

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Last updated 11:37 PM on 8/12/26
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4 Terms

1
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purpose of retracting gingiva

capture 3D shape and details of prepared tooth and surrounding structures

  • prepared tooth anatomy → reproduce exact margins, contours, and occlusal surface of tooth preparation

  • soft tissue profile → capture gingival architecture around preparation


2
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gingival retraction cord

small, string-like material that is placed into gingival sulcus around a prepared tooth to expose finishing line, control moisture and bleeding, and improve impression accuracy

  • plain → non-impregnated to use with minimal bleeding

  • impregnated → contains astringents, vasoconstrictors, or hemostatic agents for bleeding control

    • astrigents: aluminum chloride, ferric sulfate, tannic acid

    • hemostatic agent: epinephrine

  • knitted, braided, or twisted → based on clinician preference


3
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two cord tissue management

  • place one cord half the depth of gingival sulcus and push gingival tissues about 1mm apically

    • pack clockwise

    • thin diameter (smallest possible; 00)

  • place second cord to fill remaining half of sulcus

    • pack counterclockwise

    • wider diameter, dependent on gingival biotype (01)

  • impression taken after second cord is removed


4
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gingival biotypes

  • thick-flat → thick, fibrous gingiva with flat gingival margin and wide zone of attached tissue

    • typically accompanied by square-shaped crowns

    • resilient tissue less prone to recession

    • margin placement is more forgiving

  • thin-scalloped → delicate translucent gingiva, high scalloped margins, narrow papillae

    • probe visible through gingiva

    • high risk of recession

    • requires conservative margin placement and gentle handling

    • benefits from soft tissue grafting for better esthetic outcomes

    • may require gentler cord (fine cord or paste)

  • average-scalloped → intermediate thickness with moderate scalloping and papilla height

    • mixed features of thin-scalloped and thick-flat

  • average-flat → moderate to thick gingiva with flatter contour and wider gingival band

    • mixed features of thin-scalloped and thick-flat