title: Efficiency of Cordless Versus Cord Techniques of Gingival Retraction: A Systematic Review.
abstract: OBJECTIVE
  Primarily to assess the efficacy of cordless versus cord techniques in achieving hemostasis control and gingival displacement and their influence on gingival/periodontal health. In addition, subjective factors reported by the patient (pain, sensitivity, unpleasant taste, discomfort) and operator's experience to both techniques were analyzed.
  
  
  METHODS
  An electronic database search was conducted using five main databases ranging from publication year 1998 to December 2014 to identify any in vivo studies comparing cord and cordless gingival retraction techniques.
  
  
  RESULTS
  Seven potential studies were analyzed. Out of the four articles that reported achievement of hemostasis control, three compared patients treated by an epi-gingival finish line and concluded that paste techniques were more efficient in controlling bleeding. Five studies reported on the amount of sulcus dilatation, with contrasting evidence. Only one study reported an increased gingival displacement when paste systems were used. Two studies did not observe any significant difference, although two showed greater gingival displacement associated with cords, particularly in cases where the finish line was placed at a subgingival level. Of the four studies that assessed the influence of both techniques on the gingival/periodontal health, three noted less traumatic injury to soft tissues when gingival paste was used. A paste system, in general, was documented to be more comfortable to patients and user-friendly to the operator.
  
  
  CONCLUSIONS
  Because of heterogeneity of measurement variables across studies, this study precluded a meta-analytic approach. Although both techniques (cord/cordless) are reliable in achieving gingival retraction, some situations were identified wherein each of the techniques proved to be more efficient.
authors.affiliation: Department of Prosthodontics, Wuhan School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of Prosthodontics, Wuhan School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Mirinal
authors.initials: M
authors.lastname: Somar
authors.affiliation: Department of Prosthodontics, Wuhan School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Kang
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Orthodontics, Wuhan School and Hospital of Stomatology, Wuhan University, Wuhan, China.
authors.forename: Jhassu Varsha Naveena
authors.initials: JVN
authors.lastname: Mohadeb
mesh_terms: D060745:Gingival Retraction Techniques / Q000009:adverse effects / Q000295:instrumentation*; D006487:Hemostasis; D006801:Humans; D016896:Treatment Outcome
keywords: Gingival retraction; cordless; cords; gingival displacement; paste