Clinical evaluation of different gingival retraction cords

Objectives: Impression techniques in restorative dentistry require displacement of gingival tissues to expose subgingival finish lines on tooth preparations. Retraction cords are commonly used for this purpose. Some cord systems include various medicaments, which may remain in the sulcus after retraction procedures. The purpose of this study was to determine whether any of the commonly used gingival retraction medicaments could influence the surface characteristics of the impression material and to evaluate the clinical performance of retraction cords. Method and Materials: Sixteen cord systems in various shapes, sizes, and medications were used in this study. The clinical performances of cords were evaluated with a blind experimental study design, according to predetermined criteria. Results were analyzed by using chi-square test and ordinal logistic regression analysis (P .05). Results: Statistically significant differences were found in all criteria among groups (P .05). None of the materials investigated appeared to have any influence on the surface characterization of the polyvinyl siloxane impression material used. Better impression qualities were observed in groups with easy insertion, proper dilatation, less recurrent bleeding, and no remnants or fraying. Logistic regression analysis revealed that both retraction cord medicaments (odds ratio = 0.63, P = .00 .05) and cord thicknesses (odds ratio = 2.09, P = .00 .05) were important risk factors on the gingival margin quality. Conclusions: The applied gingival retraction cord systems had no influence on the surface characterization of the polyvinyl siloxane material tested. Gingival margin quality of the impression and clinical application procedures were affected by the retraction systems. Untreated, medium-braided, and epinephrine-impregnated cord systems were clinically successful. However, the potential systemic effects of epinephrine must be considered. Keywords: medicament, polyvinyl siloxane, retraction cord