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2. Tissue DisplacementTissue Displacement
• Change in the form or position of tissues as
a result of pressure
• Deflection of marginal gingiva away from a
tooth
• Synonyms
– Gingival retraction
– Gingival displacement
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3. AIMS & OBJECTIVESAIMS & OBJECTIVES
• Reflect gingiva and produce enlargement or
dilate gingival sulcus
• To obtain 0.2 - 0.4 mm of horizontal
displacement of marginal gingiva
• To achieve 0.5 mm of vertical exposure of
unprepared portion of tooth
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9. • ClassificationClassification
– Surface texture - Wet or Dry
– Configuration - Twisted, knitted or plain
– Surface finish - Waxed or unwaxed
– Thickness (colour
coded) - Black 000 (extra small)
Yellow 00 (small)
Purple 0
Blue 1
Green 2
Red 3 (extra large)
– Chemical treatment - Plain or impregnated
– Number of strands - Single or Double string
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10. IDEAL REQUIREMENTSIDEAL REQUIREMENTS
Safe locally , and systemically
Effective for its intended use
Effects should be spontaneously reversible
Absorbent
Provide hemostasis
No chemical injury to gingival tissues
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11. AdvantagesAdvantages
(Plain cord)(Plain cord)
Tissue recovery is excellentTissue recovery is excellent
Provide pressure hemostasisProvide pressure hemostasis
Ease of manipulationEase of manipulation
Commonly usedCommonly used
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20. • CriteriaCriteria
– Effectiveness of gingival displacement andEffectiveness of gingival displacement and
hemostasishemostasis
– Absence of irreversible damage to gingivaAbsence of irreversible damage to gingiva
– Paucity of untoward systemic effectsPaucity of untoward systemic effects
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29. Selective Double StringSelective Double String
• Indications:Indications:
– Spontaneous bleeding of gingival crevice isSpontaneous bleeding of gingival crevice is
presentpresent
• Techniques:Techniques:
– Pre packing of extra thin cord only into the areaPre packing of extra thin cord only into the area
of inflamed creviceof inflamed crevice
– Followed by packing with thin cord which isFollowed by packing with thin cord which is
removed during impressing making.removed during impressing making.
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30. Epinephrine 0.1 & 8%Epinephrine 0.1 & 8%
• Recommended time & Mechanism of action
– 5-10 min Pronounced vasoconstriction
Advantages
– Good displacement & haemostasis
• Tissue Recovery
– Fair
Disadvantages
– Systemic reactions
– Contraindications – Cardiovascular disease,
hyperthroidism, hypersensitivity to epinephrine
– Epinephrine syndrome – Increased heart rate, respiratory
rate and BP.
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31. Alum (100%)PotassiumAlum (100%)Potassium
Aluminium SulphateAluminium Sulphate
• Recommended time & Mechanism of action
– 10 – 20 min. Precipitation of protein and inhibiting
transcapillary movement of plasma protein
Advantages
– Minimal tissue loss
– Extended working time
• Tissue Recovery
– Good
Disadvantages
– Less displacement and haemostasiswww.indiandentalacademy.com
32. Aluminium Chloride 5%-25%Aluminium Chloride 5%-25%
Aluminium sulphate 25%Aluminium sulphate 25%
• Recommended time & Mechanism of action
– 10 mins. Weak Vasoconstrictor
Advantages
– Minimal tissue loss
– Good haemostasis
• Tissue recovery
– Good
Disadvantages
– Local tissue destruction > 10%concentration
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33. Ferric Sulphate 13.3%Ferric Sulphate 13.3%
• Recommended time & Mechanism of action
– 1 – 3 minutes
Advantages
– Good tissue response
– Compatible with Aluminium Chloride
• Tissue recovery
– Good
Disadvantages
– Not compatible with epinephrine
– Transient tissue discolorationwww.indiandentalacademy.com
34. Ferric sub SulphateFerric sub Sulphate
(Monsel’s Solution)(Monsel’s Solution)
Recommended time & Mechanism of action
3 mins
Advantages
Good displacement
Tissue recovery
Good
Disadvantages
Highly acidic and messy to work
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