Effects of pre-soaked retraction cords on the microcirculation of the human gingival margin.
In the direct treatment of cervical lesions and to improve the impression-making procedure prior to fabricating indirect restorations, exposure of the gingival sulcus and control of hemorrhage or gingival fluid seepage are a prerequisite. For gingival displacement, cords impregnated with medicaments are widely used. In this investigation, the authors first studied in vitro the time course of fluid absorption by retraction cords immersed in test solutions. Thereafter, in a clinical trial, they examined the microcirculatory responses of the gingival margin after subgingival insertion and removal of retraction cords pre-soaked in solutions containing saline, AlCl3, Fe2(SO4)3 or epinephrine. Blood flow was recorded using laser Doppler technique. Blood perfusion fell markedly upon inserting the retraction cord, and this response was invariably present with all the compounds tested. After five-minutes, the decrease became less apparent with cords that were impregnated with physiological saline, AlCl3 or Fe2(SO4)3. Removing the cord elicited a prompt, marked and sustained increase in gingival microcirculation. However, removal of the cord impregnated with 0.1% epinephrine failed to reverse the decreased perfusion, and blood flow to the gingival margin remained low over an additional 20-minute observation. The results of this study indicate that with the exception of epinephrine, all retraction substances tested produced gingival hyperemia for operative procedures. Only epinephrine exhibited sustained vasoconstrictor response. It is anticipated that using laser Doppler flowmetry may be a suitable technique to evaluate the appropriate concentration of epinephrine that would elicit topical vasoconstriction.
Semmelweis University Budapest, Department of Conservative Dentistry. fazekas@konfog.sote.hu
Arpád
A
Fazekas
F
F
Csempesz
Zs
Z
Csabai
J
J
Vág
D000042:Absorption; D000293:Adolescent; D000328:Adult; D000077410:Aluminum Chloride; D017607:Aluminum Compounds / Q000627:therapeutic use; D000704:Analysis of Variance; D001252:Astringents / Q000627:therapeutic use*; D002712:Chlorides / Q000627:therapeutic use; D003761:Dental Impression Technique / Q000295:instrumentation*; D003793:Dental Restoration, Permanent / Q000295:instrumentation*; D004837:Epinephrine / Q000627:therapeutic use; D004867:Equipment Design; D005260:Female; D005290:Ferric Compounds / Q000627:therapeutic use; D005881:Gingiva / Q000098:blood supply / Q000187:drug effects*; D005883:Gingival Crevicular Fluid / Q000187:drug effects; D005884:Gingival Hemorrhage / Q000517:prevention & control; D006801:Humans; D006940:Hyperemia / Q000139:chemically induced; D017078:Laser-Doppler Flowmetry; D016014:Linear Models; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D012039:Regional Blood Flow / Q000187:drug effects; D012965:Sodium Chloride; D013223:Statistics as Topic; D013499:Surface Properties; D013997:Time Factors; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D017607:Aluminum Compounds; D001252:Astringents; D002712:Chlorides; D005290:Ferric Compounds; D014662:Vasoconstrictor Agents; D000077410:Aluminum Chloride; C024823:ferric sulfate; D012965:Sodium Chloride; D004837:Epinephrine