The Impact of Retraction Cords on the Gingival Margin Level.

NCT ID: NCT05949073

Last Updated: 2023-09-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-25

Study Completion Date

2024-05-01

Brief Summary

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The purpose of this study is to examine the relationship between placing specific retraction cord for different periods of time and the post-operative gingival margin level in humans. Determining the amount of immediate reversible and delayed irreversible gingival recession (vertical gingival retraction) that might happen after placing a retraction cord around a natural tooth in healthy humans. It also aims to investigate the impact of mechanical and chemo-mechanical gingival retraction on periodontal health.

Detailed Description

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Dental impression is the communication tool between the dentist and the dental technician during the fabrication of fixed dental prosthesis, capturing a precise impression of the prepared tooth and the finish line is mandatory to ensure the perfect fitting of the final prosthesis.

Atraumatic gingival displacement is performed to provide sufficient both lateral and vertical space between the finish line and the gingival tissue that will allow recording adequate amount of unprepared tooth structure with the least distortion of impression material as well as minimal damage to attachment apparatus of the tooth as maintaining a healthy periodontium is an important factor in the survival of any fixed prosthesis.

The gingival recession that might happen after soft tissue displacement may jeopardize treatment success in esthetic areas of the mouth. Knowledge about the soft tissue reaction to one of the most common gingival displacement methods (retraction cords) is critical yet limited. Also, there is a gap in knowledge about the safety of retraction cords when used for multiple teeth preparations and would then be left in the sulcus for an extended amount of time, as well as the potential harm they can do in terms of persistent gingival recession.

The purpose of this study is to examine the relationship between placing specific retraction cords for different periods of time and the post-operative gingival margin level in humans. Determining the amount of immediate reversible and delayed irreversible gingival recession (vertical gingival retraction) that might happen after placing a retraction cord around a natural tooth in healthy humans. It also aims to investigate the impact of mechanical and chemo-mechanical gingival retraction on periodontal health.

This clinical study is expected to be useful for dental clinicians who use retraction cords during restorative procedures (cervical composite restorations) or for fixed prostheses; awareness about the amount of transient and permanent gingival recession that could occur is important to avoid undesirable effects such as esthetic issues and/or sensitivity.

Conditions

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Gingival Retraction Gingival Recession Periodontal Health

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Non impregnated gingival retraction cord - less than 10 minutes

Non impregnated gingival retraction cord will be placed around the prepared tooth and left for less than 10 minutes.

Group Type ACTIVE_COMPARATOR

Non-impregnated retraction cords/ less than 10 minutes

Intervention Type PROCEDURE

lower first molar will be prepared for full coverage restoration, plain retraction cord will be placed in the sulcus just before impression recording (less than 10 minutes).

Non impregnated gingival retraction cord - more than 10 minutes

Non impregnated gingival retraction cord will be placed around the prepared tooth and left for more than 10 minutes.

Group Type ACTIVE_COMPARATOR

Non-impregnated retraction cords/ more than 10 minutes

Intervention Type PROCEDURE

the preparation of the lower first molar for full coverage restoration will be initiated - occlusal reduction, contact points breaking, and preparation with the roughest bur- then a plain retraction cord will be placed and kept in the sulcus until finishing the preparation and impression recording which will take more than 10 minutes.

impregnated gingival retraction cord - less than 10 minutes

Impregnated gingival retraction cord will be placed around the prepared tooth and left for less than 10 minutes.

Group Type ACTIVE_COMPARATOR

impregnated gingival retraction cord - less than 10 minutes

Intervention Type DRUG

lower first molar will be prepared for full coverage restoration, Aluminum chloride-impregnated retraction cord will be placed in the sulcus just before impression recording (less than 10 minutes).

impregnated gingival retraction cord - more than 10 minutes

Impregnated gingival retraction cord will be placed around the prepared tooth and left for more than 10 minutes.

Group Type ACTIVE_COMPARATOR

impregnated gingival retraction cord - more than 10 minutes

Intervention Type DRUG

the preparation of the lower first molar for full coverage restoration will be initiated - occlusal reduction, contact points breaking, and preparation with the roughest bur- then an Aluminum chloride-impregnated retraction cord will be placed and kept in the sulcus until finishing the preparation and impression recording which will take more than 10 minutes.

Interventions

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Non-impregnated retraction cords/ less than 10 minutes

lower first molar will be prepared for full coverage restoration, plain retraction cord will be placed in the sulcus just before impression recording (less than 10 minutes).

Intervention Type PROCEDURE

Non-impregnated retraction cords/ more than 10 minutes

the preparation of the lower first molar for full coverage restoration will be initiated - occlusal reduction, contact points breaking, and preparation with the roughest bur- then a plain retraction cord will be placed and kept in the sulcus until finishing the preparation and impression recording which will take more than 10 minutes.

Intervention Type PROCEDURE

impregnated gingival retraction cord - less than 10 minutes

lower first molar will be prepared for full coverage restoration, Aluminum chloride-impregnated retraction cord will be placed in the sulcus just before impression recording (less than 10 minutes).

Intervention Type DRUG

impregnated gingival retraction cord - more than 10 minutes

the preparation of the lower first molar for full coverage restoration will be initiated - occlusal reduction, contact points breaking, and preparation with the roughest bur- then an Aluminum chloride-impregnated retraction cord will be placed and kept in the sulcus until finishing the preparation and impression recording which will take more than 10 minutes.

Intervention Type DRUG

Other Intervention Names

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Aluminum chloride-impregnated retraction cords. Aluminum chloride-impregnated retraction cord

Eligibility Criteria

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Inclusion Criteria

1. Age of 18-50 years
2. Systemically healthy no history of medical disease
3. Volunteers should have a lower first molar indicated for full coverage restoration, of healthy periodontium with an antagonist tooth and proximal contacts.
4. Gingival index score 0,1
5. Plaque index score 0,1
6. Probing depth ≤3 mm
7. No bleeding on probing.

Exclusion Criteria

1. Gingival and periodontal disease
2. Pregnancy and lactation
3. History of systemic diseases such as hypertension, diabetes mellitus, HIV, bone metabolic disorders, radiation therapy, and cancer.
4. History of prolonged use of steroids/immunosuppressive agents/aspirin/anticoagulant/other medications.
5. Heavy Smoking.
6. Deleterious habits.
7. Teeth with high scalloped margins, keratinized tissue less than 2 mm, fibrotic gingival tissue, gingival recession, pocket formation deeper than 3mm.
8. Teeth with thick flat gingival phenotype.
9. Teeth with Sub-gingival caries or restoration at the buccal surface.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Jordan

OTHER

Sponsor Role lead

Responsible Party

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Majdoleen Fouad

Postgraduate Student.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmad Mahmoud, Phd

Role: STUDY_DIRECTOR

University of Jordan

Locations

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the University of Jordan

Amman, , Jordan

Site Status RECRUITING

Countries

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Jordan

Central Contacts

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Majdoleen Fouad, Msc

Role: CONTACT

+962799019839

Mohammad Al-Rabab'ah, Phd

Role: CONTACT

+962792131548

Facility Contacts

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Majdoleen Fouad

Role: primary

+962799019839

mohammad al--rabab'ah

Role: backup

+962792131548

References

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Al Hamad KQ, Azar WZ, Alwaeli HA, Said KN. A clinical study on the effects of cordless and conventional retraction techniques on the gingival and periodontal health. J Clin Periodontol. 2008 Dec;35(12):1053-8. doi: 10.1111/j.1600-051X.2008.01335.x.

Reference Type BACKGROUND
PMID: 19040582 (View on PubMed)

Ruel J, Schuessler PJ, Malament K, Mori D. Effect of retraction procedures on the periodontium in humans. J Prosthet Dent. 1980 Nov;44(5):508-15. doi: 10.1016/0022-3913(80)90069-4.

Reference Type BACKGROUND
PMID: 7003108 (View on PubMed)

Sarmento HR, Leite FR, Dantas RV, Ogliari FA, Demarco FF, Faot F. A double-blind randomised clinical trial of two techniques for gingival displacement. J Oral Rehabil. 2014 Apr;41(4):306-13. doi: 10.1111/joor.12142. Epub 2014 Jan 22.

Reference Type BACKGROUND
PMID: 24446590 (View on PubMed)

Feng J, Aboyoussef H, Weiner S, Singh S, Jandinski J. The effect of gingival retraction procedures on periodontal indices and crevicular fluid cytokine levels: a pilot study. J Prosthodont. 2006 Mar-Apr;15(2):108-12. doi: 10.1111/j.1532-849X.2006.00083.x.

Reference Type BACKGROUND
PMID: 16650011 (View on PubMed)

Einarsdottir ER, Lang NP, Aspelund T, Pjetursson BE. A multicenter randomized, controlled clinical trial comparing the use of displacement cords, an aluminum chloride paste, and a combination of paste and cords for tissue displacement. J Prosthet Dent. 2018 Jan;119(1):82-88. doi: 10.1016/j.prosdent.2017.03.010. Epub 2017 May 5.

Reference Type BACKGROUND
PMID: 28478985 (View on PubMed)

Other Identifiers

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Retraction cords

Identifier Type: -

Identifier Source: org_study_id

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