Assessment of Technique Sensitivity and Gingival Health in Management of Cervical Lesions Performed Using Subgingival Clamp Versus Retraction Cord: A Randomized Controlled Clinical Trial

Abstract

Aim: the current study was conducted to compare technique sensitivity and gingival health of carious and non-carious cervical lesions performed using subgingival clamps and retraction cords.Methodology: 24 teeth with carious or non-carious cervical lesions were divided randomly into 2 groups receiving one of the two gingival retraction techniques, either subgingival clamp (KSK clamp #44) or retraction cord (Ultrapak E), technique sensitivity was evaluated at baseline (before application) and immediately after application while gingival health was evaluated before and immediately after application, 2 weeks, 1 and 4 months. Statistical analysis was done using t-test, Chi-square test, Kruskal-Wallis test and Mann-Whitney test where significance level was set at P ≤ 0.05.Results: There was a statistical significant difference between retraction cord and subgingival clamp regarding time of application and gingival laceration, where retraction cord took longer application time (p=0.01) and subgingival clamp showed higher laceration frequency (P=0.033). Regarding patient satisfaction, isolation from crevicular fluids, need for local anesthesia, pink esthetic score, gingival bleeding and sensitivity, there was no statistical significant difference between both groups. Conclusion:Technique sensitivity and long term gingival health were the same for both groups except that subgingival clamp provided minimal chairside time and care should be taken upon clamp application to avoid gingival laceration.

Evaluation of Different Intraoperative Patient Preference Factors on Sub-Gingival Clamps Versus Retraction Cord Placement in Non-Carious Cervical Lesions

“…The time required for retraction cord placement was statistically significant compared to the rubber dam application. The results of my study were incomparable with other studies (Loguercio et al, 2015;Shehab Eldin et al, 2021) in which the time difference was insignificant. However, It is commonly seen that rubber dam is considered time-consuming, challenging to use, and cumbersome to apply (Joshi et al, 2023;Jurado et al, 2021).…”

“…These findings align with my study, in which more patients asked for anesthesia while a retraction cord was placed. My study's results contradicted those found in studies (Loguercio et al, 2015;Shehab Eldin et al, 2021), where an almost equal number of participants from both groups asked for anesthesia. This study concluded that gingival bleeding was observed immediately after the procedure in both groups, but the difference was insignificant.…”

“…This study concluded that gingival bleeding was observed immediately after the procedure in both groups, but the difference was insignificant. These findings agree with other studies (Daudt et al, 2013;Loguercio et al, 2015;Shehab Eldin et al, 2021) in which it was deduced that gingival bleeding observed in both groups was the same. However, gingival laceration in patients with retraction cord was observed more compared to the RD group, which is in contrast to the previous studies where it was observed that gingival laceration was significantly more due to gingival clamps19 and no significant difference was observed in both groups (Loguercio et al, 2015).…”

“…However, gingival laceration in patients with retraction cord was observed more compared to the RD group, which is in contrast to the previous studies where it was observed that gingival laceration was significantly more due to gingival clamps19 and no significant difference was observed in both groups (Loguercio et al, 2015). The results of this study are comparable to other studies where no gingival laceration was seen two weeks after the procedure (Shehab Eldin et al, 2021). Another study reported that bleeding with a retraction cord was significant, but using astringentcontrolled bleeding was substantial (Sarmento et al, 2014).…”