Scientific Online Resource System

Scripta Scientifica Medicinae Dentalis

Adequate gingival retraction as prerequisite for fabrication of precise fixed partial dentures - algorithm for clinical implementation

Iveta Katreva, Maya Doychinova


Aim: The aim of the paper is to introduce an algorithm for chemo-mechanical retraction with α-adrenomimetic decongestants as impregnating agents for adequate and safe gingival retraction - a prerequisite for production of precise fixed partial dentures (FPD).

Materials and Methods:  The clinical algorithm is based upon the results obtained from our previous researches and data gathered from the literature sources for effectiveness of α-adrenergic sympathicomimetic decongestants - 0.05% xylometazoline HCl, 0.05% tetrahydrozoline HCl and 10% phenylephrine HCl, as alternative retraction agents.

Results:  It is established that following the sequence of the suggested algorithm for the clinical use of α -adrenomimetic decongestants provides sufficient degree of reversible horizontal and vertical gingival retraction without causing harmful effects to the periodontal tissue complex. The effect of conventional and alternative impregnating agents is compared, and the latter exhibits significantly better results both in penetration of the impression material and in terms of bio-tolerance towards the oral tissues. The working algorithm is presented with 0.05% xylometazoline HCl, but it is universal for the whole chemical group of the researched compounds.  It can be introduced in the routine dental practice with any α-adrenomimetic decongestant with no risk of adverse effects or mistakes.

Conclusion: The systematic algorithm favors the implementation of α-adrenomimetic retraction agents in the clinical practice and helps to make the methodology popular among dental specialists.The application of α-adrenomimetic decongestants is systemized within seven easy to follow procedures in order to obtain adequate gingival retraction - a mandatory condition in the fabrication of FPD.


materials; biomaterials; gingival retraction; retraction agents; treatment protocol; fixed partial dentures

Full Text


Abdulaziz M. Gingival Retraction- Techniques and Materials: A Review. Pak Oral Dental J. 2010;30(2):3-14.

Gupta A, Prithviraj DR, Gupta D, Shruti P. Clinical Evaluation of Three New Gingival Retraction Systems:A Research Report. J Indian Prosthodont Soc. 2013;13(1):36-42. doi: 10.1007/s13191-012-0140-y.

Al-Ani A, Bennani V, Chandler NP, Lyons KM, Tomson WM. New Zealand dentists use of gingival retraction techniques for fixed prosthodontics and implants. NZ Dent J. 2010;106:92-6.

Martignoni M, Schönenberger A. Precision fixed prosthodontics: clinical and laboratory aspects. Chicago: Quintessence; 1990. p.580.

Laufer BZ, Baharav H, Cardash HS. The linear accuracy of impressions and stone dies as affected by the thickness of the impression margin. Int J Prosthodont. 1994;73:247-52.

Shilingburg H, Hobo S, Whitsett L, Jacobi R, Bracket S. Fundamentals of Fixed Prosthodontics. Sofia: Quintessence Publishing Co, Inc; 2001. p. 260-77.

Donovan TE, Chee WW. Current concepts in gingival displacement. Dent Clin North Am. 2004;48(2):433-44. doi: 10.1016/j.cden.2003.12.012

Shaw DH, Krejci RF. Gingival retraction preference of dentists in general practice. Quintessence Int. 1986;17:277-80.

Blanchard JP. Nouvelle technique d'ouventure sulculaire pour l'empreinte en prothese fixee. Cah prothese. 2000;109:7-13.

Hansen PA, Tira DA, Barlow J. Current methods of finish-line exposure by practicing prosthodontists. J Prosthodont. 1999;8(3):163-70.

Bowles WH, Tardy ST, Vahadi A. Evaluation of new gingival retraction agents. J Dent Res. 1991;70(11):1447-9. doi: 10.1177/00220345910700111101.

Katreva I, Abadjiev M, Simeonov S, Tivchev O, Doychinova M, Tonchev TS. Application of α-adrenomimetic decongestants as chemical agents for gingival retraction. Scr Sci Med Dent. 2015;2(1):17-23.

Katreva I, Georgieva K, Simeonov S, Doychinova M, Tonchev TS. Application of Xylometazoline for chemo-mechanical retraction of the free gingiva. J IMAB. 2015;21(3):849-52.

Katreva I, Abadzhiev M, Simeonov S, Tivchev O, Doychinova M, Bozukov HR, et al. Research of the attitude towards the application of alternative chemical agents for gingival retraction among the dentists. Varna Medical Forum. 2015;2(4):107-11.

Katreva I. Advantages of α-adrenomimetic decongestants over conventional chemical agents for gingival retraction in order to avoid adverse systemic side effects - PhD thesis. Varna. 2015:145 (in Bulgarian).

Nowakowska D. The impact of retraction astringents on gingival margin tissues from literature review of in vivo studies. Protet. Stomatol. 2009;59(2):128-33.

Nowakowska D, Saczko J, Kulbacka J, Choromanska A, Raszewski Z. Cytotoxic potential of vasoconstrictor experimental gingival retraction agents -in vitro study on primary human gingival fibroblasts. Folia Biol (Praha). 2012;58(1):37-43.

Csempesz F, Vag J, Fazekas A. In vitro kinetic study of absorbency of retraction cords. J Prosthet Dent. 2003;89(1):45-9. doi: 10.1067/mpr.2003.61.

Rosenstiel SF, Land MF, Fujimoto J. Contemporary Fixed Prosthodontics. 4th ed. Mosby; 2006. p. 434-40.

Cloyd S, Puri S. Using the double-cord packing technique of tissue retraction for making crown impressions. Dent Today. 1999;18(1):54-9.



About The Authors

Iveta Katreva
Medical University of Varna, Faculty of Dental Medicine, Department of Prosthetic Dentistry

Maya Doychinova
Medical University of Varna, Faculty of Dental Medicine, Department of Conservative Dentistry and Oral Pathology

Font Size