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Periodontal dressings
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Periodontal dressings

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  • 1. PERIODONTAL DRESSINGS
  • 2.
    • Definition
    • Periodontal dressing or periodontal packs is a productive materials applied over the wound created by periodontal surgical procedures
  • 3.
    • Uses
    • To protect the wound postsurgically
    • To obtain and maintain a close adaptation of mucosal flaps to underlying bone
    • Comfort to the patient
    • Prevents post-operative bleeding
    • Prevents formation of excessive granulation tissue
  • 4. Properties
    • 1. The dressing should be soft, but still have enough plasticity and flexibility to facilitate its placement in operated area and to allow proper adaptation
    • 2. Should harden with in a reasonable period of time
    • 3. After setting the dressing should be sufficiently rigid to prevent fracture and dislocation
  • 5.
    • 4.The dressing should have a smmoth surface after setting to prevent irritation to cheeks and lips
    • 5.The dressing should preferably have bactericidal properties to prevent excessive plaque formation
    • 6.Dressing must not detrimentally interfere with the healing
  • 6. TYPES
    • Zno eugenol packs  packs based on reaction of zno & eugenol include – wondr pak developed by Ward
    • The addition of accelerators such as Zinc acetate gives the dressing a better working time
    • It is supplied as a liquid and a powder thet are mixed prior to use.
    • Eugenol may produce allergic reaction
    • (reddening of area and burning pain )
  • 7. Non eugenol packs
    • Reaction between metallic oxide and fatty acid is basis for coe-Pak
    • Supplied in two tubes
    • One tube contains oxides of various metals
    • (Mainly zinc oxide) and lorothidol (a fungicide) and second tube contains non ionized carboxylic acids and chlorothymol (bacteriostatic agents)
    • Equal parts of both mixed together immediately prior to insertion
    • Setting time is prolonged by adding a retarder
  • 8.
    • Other non eugenol packs
    • Light curing dressing e.g
    • Barricaid
    • Useful in anterior tooth region and particularly following mucogingival surgery because it has favorable appearance and it can be applied without dislocating soft tissues age
  • 9.
    • Disadvantage
    • It is not the choice of dressing to be used in situations where flap has to be apically retained due to its soft state before curing
  • 10.
    • 2. Cyanoacrylates
    • It is applied in a liqiud directly on to the wound or spread over the wound
    • 3.Tissue conditioners ( methacrylate gel)
  • 11. Retention of packs
    • Periodontal dressing are kept usually in place mechanically by interlocking the interdental spaces
    • &
    • Joining lingual and facial portions of pack
    • In isolated teeth or when several teeth in arch are missing --- retention of pack may be difficult
    • So numerous reinforcement and splints and stents placement of dental floss tied loosely around the teeth enhances retention of packs
  • 12. Application techniques
    • Ensure that the bleeding from operated tissues has ceased before the dressing material is inserted
    • Carefully dry teeth and soft tissues before the application for optimal adherence of dressing
  • 13.
    • Moistened the surgical gloves to avoid the material sticking to finger tips
    • Zinc oxide packs are mixed with eugenol or non eugenol liquids o a wax paper pad with a wooden tongue depressor
    • The powder is gradually incorporated with the liquid until a thick paste is formed
  • 14.
    • Coe-pack is prepared by mixing equal length of paste from tubes containing the accelerator and the base until the resulting paste is a uniform colour
    • The pack is then placed in a cup of water at room temperature in 2-3 minutes the paste loses its tackiness and can be handled and molded
  • 15.
    • The pack is then rolled into two strips and placed on the surgical wound
    • the dressing should not be covered more than the apical third of tooth surface
    • Excess pack irritates the mucobuccal fold and floor of mouth and interfere with the tongue
  • 16.
    • Pack that interfere with the occlussion should be trimmed away failure to do this cuases discomfort and jeopardized the retention of pack
    • The pack is kept on for one week after surgery
  • 17.
    • Instructions for the patients after the packs are placed
    • 1. The pack should remain in place until it is removed in the office at the next appointment
    • 2. For the first three hours after the operation avoid hot foods to permit the pack to harden
    • 3. Do not smoke
    • 4. Do not brush over the pack
  • 18.
    • References
    • Periodontics-medicine surgery and implants by Louis F Rose and Brian L Mealey
    • 2. clinical Periodontology and implant dentistry by Jan Lindhe
  • 19.  
  • 20.