Periodontal dressings


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Periodontal dressings

  2. 2. <ul><li>Definition </li></ul><ul><li>Periodontal dressing or periodontal packs is a productive materials applied over the wound created by periodontal surgical procedures </li></ul>
  3. 3. <ul><li>Uses </li></ul><ul><li>To protect the wound postsurgically </li></ul><ul><li>To obtain and maintain a close adaptation of mucosal flaps to underlying bone </li></ul><ul><li>Comfort to the patient </li></ul><ul><li>Prevents post-operative bleeding </li></ul><ul><li>Prevents formation of excessive granulation tissue </li></ul>
  4. 4. Properties <ul><li>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 </li></ul><ul><li>2. Should harden with in a reasonable period of time </li></ul><ul><li>3. After setting the dressing should be sufficiently rigid to prevent fracture and dislocation </li></ul>
  5. 5. <ul><li>4.The dressing should have a smmoth surface after setting to prevent irritation to cheeks and lips </li></ul><ul><li>5.The dressing should preferably have bactericidal properties to prevent excessive plaque formation </li></ul><ul><li>6.Dressing must not detrimentally interfere with the healing </li></ul>
  6. 6. TYPES <ul><li>Zno eugenol packs  packs based on reaction of zno & eugenol include – wondr pak developed by Ward </li></ul><ul><li>The addition of accelerators such as Zinc acetate gives the dressing a better working time </li></ul><ul><li>It is supplied as a liquid and a powder thet are mixed prior to use. </li></ul><ul><li>Eugenol may produce allergic reaction </li></ul><ul><li>(reddening of area and burning pain ) </li></ul>
  7. 7. Non eugenol packs <ul><li>Reaction between metallic oxide and fatty acid is basis for coe-Pak </li></ul><ul><li>Supplied in two tubes </li></ul><ul><li>One tube contains oxides of various metals </li></ul><ul><li>(Mainly zinc oxide) and lorothidol (a fungicide) and second tube contains non ionized carboxylic acids and chlorothymol (bacteriostatic agents) </li></ul><ul><li>Equal parts of both mixed together immediately prior to insertion </li></ul><ul><li>Setting time is prolonged by adding a retarder </li></ul>
  8. 8. <ul><li>Other non eugenol packs </li></ul><ul><li>Light curing dressing e.g </li></ul><ul><li>Barricaid </li></ul><ul><li>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 </li></ul>
  9. 9. <ul><li>Disadvantage </li></ul><ul><li>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 </li></ul>
  10. 10. <ul><li>2. Cyanoacrylates </li></ul><ul><li>It is applied in a liqiud directly on to the wound or spread over the wound </li></ul><ul><li>3.Tissue conditioners ( methacrylate gel) </li></ul>
  11. 11. Retention of packs <ul><li>Periodontal dressing are kept usually in place mechanically by interlocking the interdental spaces </li></ul><ul><li>& </li></ul><ul><li>Joining lingual and facial portions of pack </li></ul><ul><li>In isolated teeth or when several teeth in arch are missing --- retention of pack may be difficult </li></ul><ul><li>So numerous reinforcement and splints and stents placement of dental floss tied loosely around the teeth enhances retention of packs </li></ul>
  12. 12. Application techniques <ul><li>Ensure that the bleeding from operated tissues has ceased before the dressing material is inserted </li></ul><ul><li>Carefully dry teeth and soft tissues before the application for optimal adherence of dressing </li></ul>
  13. 13. <ul><li>Moistened the surgical gloves to avoid the material sticking to finger tips </li></ul><ul><li>Zinc oxide packs are mixed with eugenol or non eugenol liquids o a wax paper pad with a wooden tongue depressor </li></ul><ul><li>The powder is gradually incorporated with the liquid until a thick paste is formed </li></ul>
  14. 14. <ul><li>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 </li></ul><ul><li>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 </li></ul>
  15. 15. <ul><li>The pack is then rolled into two strips and placed on the surgical wound </li></ul><ul><li>the dressing should not be covered more than the apical third of tooth surface </li></ul><ul><li>Excess pack irritates the mucobuccal fold and floor of mouth and interfere with the tongue </li></ul>
  16. 16. <ul><li>Pack that interfere with the occlussion should be trimmed away failure to do this cuases discomfort and jeopardized the retention of pack </li></ul><ul><li>The pack is kept on for one week after surgery </li></ul>
  17. 17. <ul><li>Instructions for the patients after the packs are placed </li></ul><ul><li>1. The pack should remain in place until it is removed in the office at the next appointment </li></ul><ul><li>2. For the first three hours after the operation avoid hot foods to permit the pack to harden </li></ul><ul><li>3. Do not smoke </li></ul><ul><li>4. Do not brush over the pack </li></ul>
  18. 18. <ul><li>References </li></ul><ul><li>Periodontics-medicine surgery and implants by Louis F Rose and Brian L Mealey </li></ul><ul><li>2. clinical Periodontology and implant dentistry by Jan Lindhe </li></ul>