FLUID CONTROL AND SOFT TISSUE MANAGEMENT

• saliva ejector • svedopter • vacuum tip

3 commonly used vacuum attachments:

High volume vacuum

useful during the preparation phase

High volume vacuum

most effectively utilized with an assistant

High volume vacuum

not practical during the impression or cementation phases

Saliva ejector

Can be utilized effectively in some situations by lone the dentist

Saliva ejector

placed in the corner of the mouth opposite the quadrant being operated, and the patients head is turned toward it

Svedopter

Metal saliva ejector with attached tongue deflector

Svedopter

most effective when used with the patient in a nearly upright position

Rubber Dam

Most effective of all isolation devices utilized in restorative dentistry

Rubber Dam

valuable in the removal of old restorations or excavation of caries when exposure of the pulp is a possibility

Rubber Dam

provides excellent isolation

Antisialogogues

Patients for whom no mechanical device is effective in producing a dry enough field for impression making or cementation

Antisialogogues

for the patients who salivates excessively

Gingival tissue

must be healthy and free from inflammation before cast restoration is begun

preventing recurrent caries and gingival irritation

the marginal fit of a restoration is essential in __

finish line of the tooth

must be reproduced in the impression

some or all of the preparation finish line lies at or apical to the crest of the free gingiva

Obtaining a complete impression is complicated when __

preparation finish line

must be temporarily exposed to insure the reproduction of the entire preparation

Mechanical, Chemicomechanical, Surgical

Three Techniques of Finish Line Exposure

Mechanical

Physically displacing the gingiva

copper band or tube

trimmed to follow the preparation finish line

copper band or tube

displaces the free gingiva

copper band or tube

Can cause incisional injuries of the gingival tissue

copper band or tube

Useful in situations in which several teeth have been prepared

copper band or tube

could negate the necessity of making an entire full arch impression

Chemicomechanical

Combining chemical action with pressure packing to enlarge the gingival sulcus

Chemicomechanical

is used to control fluids seeping from the walls of the gingival sulcus

racemic epinephrine

most popular chemical for gingival retraction

cord impregnated with 8% racemic epinephrine

most commonly used means of producing gingival retraction

2-inch

__ piece retraction cord is cut off

cotton rolls

is used to isolate the quadrant containing the prepared tooth

If a braided or woven cord is used

where twisting is not necessary

thumb and forefinger

is used to form a loop of retraction cord around the tooth

angled slightly

The instrument must be __ the root to facilitate the subgingival placement of the cord

parallel to the long axis of the toot

If the instrument is held __, the retraction cord will be pushed against the wall of the gingival crevice, and it will rebound

Gauze pack

make the patient more comfortable by having something to close on and, at the same time, it will keep the area dry

Inject impression material

to do if the sulcus remains clean and dry

Electrocoagulation and ferric sulfate

effective in stopping persistent bleeding kasi pag may persistent bleeding, abort the impression na

Ferric sulfate solution

applied to the gingiva with the tip of the special syringe

Ferric sulfate solution

Use the fibrous tip to rub or burnish cut sulcular tissue until all bleeding stops

Ferric sulfate solution

is used to wipe off excess coagulum

Rotary Curettage

A “troughing” technique

Rotary Curettage

to produce limited removal of epithelial tissue in the sulcus while a chamfer finish line is being created on tooth structure

gingettage

aka rotary curettage

torpedo-tipped diamond

forms a chamfer finish line and removes the epithelial lining of the sulcus

Electrosurgery

Used in situations in which it may not be feasible or desirable to manage the gingiva with retraction cord alone

Electrosurgery

used to control of hemorrhage to facilitate impression making

Electrosurgery

Commonly used for removal of irritated tissue that has proliferated over preparation finish line

Electrosurgical current

flows from the unit to the active (cutting) electrode (A) to the ground (B), and back to the unit

Electrosurgery Technique

where a small drop of a strongly scented oil is placed on the upper lip to help mask the unpleasant odor

loop electrode

is used in gingivectomy

loop electrode

used to shape the edges of the previous cut to prevent a ledge of gingival tissue adjacent to the tooth