Efficiency of Cordless Versus Cord Techniques of Gingival Retraction: A Systematic Review.

PURPOSE: 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. MATERIALS AND 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.

The Supine Position Technique Method Is Better Than the Conventional Method for Manual Reduction of Acute Nontraumatic Temporomandibular Joint Dislocation.

OBJECTIVE: To comparatively assess the effectiveness of the supine position technique versus the conventional method, for the manual reduction of acute nontraumatic temporomandibular joint (TMJ) dislocation. METHODS: This randomized single blind trial included a total of 40 patients, aged 18 to 80 years presenting with acute nontraumatic TMJ dislocation. Based on the randomization procedure, patients were treated with either conventional method or the supine position technique method. The visibility of dynamic occlusion during jaw manipulation, operation time, and visual analogue scale scores for pain perception were comparatively studied. RESULTS: All patients with dislocated mandible were successfully managed. Unlike the conventional technique, the ability to monitor the dynamic occlusion during jaw manipulation was possible only in the supine position method group. The operation time (P < 0.05) and visual analogue scale scores for pain perception (P < 0.01) during the treatment were significantly reduced in the supine position technique group. No accidental finger biting was reported in any groups. CONCLUSIONS: Reduced operation time and reduced pain perception indicated that the supine position technique method might be a more viable alternative to the conventional method of reduction of acute nontraumatic TMJ dislocation.

Effectiveness of decoronation technique in the treatment of ankylosis: A systematic review.

BACKGROUND: Dentoalveolar ankylosis in growing patients is complex leading to continuing root replacement resorption, tooth infra-position, or may even affect the development of alveolar ridge and adjacent teeth. While extraction of ankylosed teeth might be associated with bone loss, decoronation of the offending tooth (removal of crown portion and instrumentation of pulp canal to stimulate bleeding) has been suggested as a more conservative approach of bone preservation until definitive implant placement is planned. OBJECTIVE: To primarily assess the efficacy of bone width and height preservation around ankylosed permanent teeth following decoronation. METHODS: Pubmed, Embase, Ovid Medline, Thomson's ISI Web of Science and Cochrane library were searched from the year 1984 up to May 2015. Two authors conducted the data extraction. To eliminate publication bias, Open Grey literature and Pro-quest Dissertation Abstracts and Thesis database was also consulted. RESULTS: Through our strict selection criteria, only 12 articles were considered for eligibility. No randomized controlled trials were identified. Only one retrospective cohort study, four case series and seven case reports, were analyzed. CONCLUSIONS: Following decoronation, preservation of ridge height and ridge width were both noted. To maximize the benefits of decoronation, a timely and wellmonitored intervention is required. Treatment in patients, who have surpassed pubertal growth peaks, may not yield maximum effective treatment outcomes.

Nanoleakage evaluation at adhesive-dentin interfaces by different observation methods.

The purpose of this study was to evaluate the capability and characteristics of different nanoleakage observation methods, including light microscope (LM), field-emission scanning electron microscope (FESEM), transmission electron microscope (TEM), and confocal laser scanning microscope (CLSM). Dentin specimens were bonded with either an etch-and-rinse adhesive (SBMP) or a self-etch adhesive (GB), and prepared for nanoleakge evaluation according to different observation methods. LM, FESEM and CLSM results demonstrated that the SBMP group showed more interfacial nanoleakage than the GB group (p<0.05); by contrast, no significant difference was found in TEM results (p>0.05), however, TEM illustrated concrete nanoleakage forms or patterns. The results suggested that different observation methods might exhibit distinct images and a certain degree of variations in nanoleakage statistical results. Researchers should carefully design and calculate the optimum assembly in combination with qualitative and quantitative approaches to obtain objective and accurate nanoleakage evaluation.