summery about periodental dressing

1. PERIODONTAL DRESSING
Done by:
Ahamed mohammed
Ahmed saad
Baraa hassaoon
Hassan kareem The supervision:
Hassanain abd al-razaq Dr- talib Ali
Hussein asghar
Zahraa mohsen
Zainb haider
Zena menhal
Shahad mohammed

2. PERIODONTAL DRESSING

3. Introduction
The periodontal dressing:
Is a physical barrier that is placed in the
surgical site to protect the healing tissues from
the forces produced during mastication for
comfort and close adaptation.

4. Who?
Dr. AW Wardin 1923

5. Physical Properties of Dressing
• The dressing should be
• soft but have enough plasticity and flexibility to facilitate its
placement in operated area and to allow proper adaptation.
• Set within a reasonable time
• have sufficient rigidity after setting
• have Smooth surface
• have bactericidal property
• not interfere with healing
• have Dimensional stability
• not induce reaction
• have acceptable taste.

6. USES OF PERIODONTAL
DRESSING
1.Provide mechanical protection for the surgical
wound and therefore facilitate healing .
2.Enchancement of patient comfort .
3. Prevents post operative bleeding by
maintaining the initial clot in place.
4. Maintenance of debris free area.

7. 5. Control of bleeding
6. Supports mobile teeth during
healing
7. Helps in shaping or molding the newly formed
tissue
8. Provide patient comfort by isolating area from
external irritations or injuries

8. Classified On The Basis Of
Presence Or Absence Of
Eugenol.
• Zinc oxide Eugenol Dressing (Hard pack)
• Non-Eugenol Dressing (Soft pack)
• Other types are as follows;
1. Collagen materials.
2. Methacrylate gels.
3. Light cure dressing.
4. Cyanoacrylate.
5. Oral adhesive bandage
6. Wax pack.

9. Types of Dressings
•Zinc oxide Eugenol
dressing (hard pack)

10. *_*Popular following gingivectomies Eugenol
has an obtudent effect on exposed dentine and
connective tissue Eugenol has an antiseptic
property which can affect bacterial growth.
• Brand names : wonder-pak , by ward 1923

11. Its provide as ( powder and liquid)
• Powder component :
• ZnO
• Resin - improve setting
• Tannic acid - improve setting
• Cellulose fibers - improve setting
• Zinc acetate –accelerator, better working time .
• Asbestos binder and filler

12. • Liquid :
• Eugenol,
• vegetable oil,added to dissolve Eugenol
• thymol, a weak antiseptic.
• colour additives

13. • Note the setting involves both chemical and
physical properties and is influenced by:
1. moisture
2. proportions of powder and liquid used
3. mixing time
4. temperature
• Note :Eugenol can induce an allergic reaction
that produces reddening of the area and
burning pain in some patients

14. Disadvantages
1. Unpleasantness
2. Spicy taste
3. Burning sensation
4. Lack of smoothness
5. Difficulty with adaptation
6. Frequency of fracture
7. Crazing of acrylic materials

15. Non-eugenol dressings (soft pack)
developed in 1950s
• Coe-Pak
• Coe-Pak Automix
• Peripac
• Perioputty
• Perio care
• Cyanoacrylate
• Light-cure Periodontal Dressings
• Tissue conditioners.

16. • Basic ingredients :
a. base
b. accelerator
• Brand names:
• Coe-Pak Dr Gene Moinar of coe –laboratories

18. • one paste:
• oxides of various metals –zinc oxide
• Oil-plasticity
• Gum –cohesiveness
• Lorothidol-fungicide

19. • Other paste:
• liquid coconut fatty acids
• Resin or rosin
• Chlorothymol-bacteriostatic
**Note : The reaction between a metallic oxide
and fatty acids is the basis of Coe-Pak

20. •Coe-Pak
Automix

21. • Noneugenol Surgical Dressing and Periodontal
Pack
• Comes in Two-Pack: Two Double Barrel
Cartridges

23. • Peripac: *Perioputty
ready mix : *-*Methyl and Propyl
parafens –bactericidal
and fungicidal property
*-*Benzocaine–topical
anesthetic

24. PERIOCARE
• Two paste, highly elastic periodontal dressing
which sets resiliently hard does not chip or fall
apart in the mouth.
• After mixing, PerioCare is ready to be picked up
with wet fingers in about 75-90 seconds.
• It has a 7 minute working time and sets in 15
minutes.
• It is patient pleasing, and has a neutral odor and
taste.
• contains no eugenol or asbestos

26. Cyanoacrylate
• DROPS/ SPRAYS
• SOLIDIFIES IN 5-10 SEC
• ADHESION FOR 2-7 DAYs

27. • DECREASES TIME REQUIRED FOR
SUTURING
• PROVIDES RAPID HAEMOSTASIS DUE
TO POLYMERIZATION IN THE PRESENCE
OF MOISTURE
• ACCERLERATE EARLY PERIODONTAL
HEALING
• AIDS IN PRESICE POSITIONING OF THE
FLAP/ FREE GINGIVAL GRAFT

28. Zinc oxide & glycol alcohol
(Peridres)
• Powder
1. Zinc oxide & rosin
2. tannic acid
3. Kaolin
• Liquid
1. ethelene glycol
2. Butyl alcohol

29. Light-cure Periodontal Dressings
• Brand names : Barricaid
• Characteristics
a. Non brittle & very elastic
b. No mixing
• single-component, light-activated periodontal
dressing eliminates time-consuming mixing of
pastes.

31. Other types areas follows
• METHACRYLIC GELS
• Oral adhesive bandage
• WAX PACK

32. • It is collagen sponge; an example of this
dressing is CollaCote (Helitrex, lac). This
material is Type-1 collagen, which is derived
from bovine Achilles tendon. It is a completely
resorbable dressing that is used to cover and
protect palatal graft sites,

34. METHACRYLIC GELS
• Methacrylic gels were used primarily in
dentistry as tissue conditioners or as denture
liners.

35. Oral adhesive bandage
• It is composed of :
1. polyisobutylene,
2. sodium carboxy methyl cellulose,
3. pectin,
4. gelatin and a polyethylene backing
• is supplied in this form (2x4x0.02) and a thick
form (3x4x0.06).

36. WAX PACK
• Mixture of coca butter and paraffin in equal
amounts, available in thin strips and can be cut
into prescribed sizes and applied after
gingivectomy and other surgical procedures

37. CHLORHEXIDINE AS AN
ADDITIVE TO DRESSING:
• Asboe-Jorgensen et al (1974) found that a
dressing containing chlorhexidine promoted
healing because it decreases the bacterial
colonization of the wound. Following bilateral
flap surgery, one side received a 0.2%
chlorhexidine rinse interdentally, and healing was
examined for up to 36 days post surgically .The
sites treated with chlorhexidine had less gingival
exudate, less bleeding and lower gingival index
scores than the control sites

38. •Application of Hard
and Soft Periodontal
Dressing

39. • A.Hard Pack
1.Mix maximum amount of powder into the
liquid to achieve a putty mix
2. consistency is firm and thick
• B. Soft Pack :
Extrude equal lengths & quickly mix together
with tongue blade until blended

42. • use water on gloves to form pack
• If there are open embrasures with missing
papillae or recession, use small sections of the
dressing to mold into wedge shapes to press
interproximally.

43. • Apply 1 U-Strip starting from distal and placing on the
facial & lingual
• Press interproximally and with a plastic instrument
adapt around the gingival surface and interproximal
areas to gain retention and create festooning
• For protection & promotion of healing, the dressing
should not exceed 1-2 mm beyond the surgical site
• Any edentulous areas can be filled in to make dressing
continuous

44. Notes
• Muscle trim cheeks, lips and tongue to prevent
movement or dislodgement dressing should not
interfere with muscle, cheek and frenum
attachments;overextension causes irritation
• Check occlusion
• 1. dressing should extend only to the height of
contour of the teeth
• 2. it should not be in occlusal contact during
closure

48. Repacking
• After the pack is removed, it is usually not
necessary to repeat it. However in some
condition it is advisable to repack for
additional 1 week. The conditions are:
• i) A low pain threshold value patients who are
particularly uncomfortable when the pack is
removed.
• ii) Unusual extensive periodontal Involvement
• iii) Slow healing.

49. RETENTION OF PACKS
• MECHANICALLY INTERLOCKING in
interdental spaces
• Splints
• Stents
• Placement of dental floss
• Wire ligation

50. Anti bacterial properties of packs
• Bacitracin
• Oxytetracycline
• Neomycin
• Nitrofuranzone

51. Allergy to a periodontal dressing
• Fraleigh–noted allergic reactions due to
Terramycin in a dressing
• Pulsion–reported an anaphylactic reaction after
application of Eugenol containing dressing
• Lysell––reported a case of contact allergy to
rosin, urticaria on the abdomen, swelling on
dorsum of the hand, involvement of
interphalangeal joints

52. REFERENCES
• Gilbert AD, Lloyd Ch, Scrimgeour SN. The
effect of a light-cured periodontal dressing
material on HeLa cells and fibroblasts in vitro.
J Periodontol. 65(4): 324-9 199
• Binnie WH and Forrest JO. A study of tissue
response to cyanoacrylate adhesive in
periodontal surgery. J Perio,45:619,1974
• Glendinning D. A method for retention of
periodontal pack. J Perio,47:236,1976

53. • Haugen E, Gjermo P. Clinical assessment of
periodontal dressings . J Clin Perio.5: 50,1978
• Jorkjend L , Skoglund LA. Effect of non-
eugenol and eugenol containing periodontal
dressings on the incidence and severity of pain
after periodontal soft tissue surgery. J Clin
Perio.17: 341,1990
• O'Neill TCA. Antibacterial properties of
periodontal dressings. J Perio,46:469,1975

54. • Rubinoff CH, Greener EH, Robinson PJ.
Physical properties of periodontal dressing
materials, J Oral Rehab,13: 757.1986