Comparative evaluation of gingival displacement and inflammatory response using different retraction techniques - A randomized controlled trial

不同牙龈退缩技术对牙龈移位和炎症反应的比较评价——一项随机对照试验

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Abstract

BACKGROUND: Precise gingival retraction is critical for accurate impressions in restorative dentistry. Minimizing tissue trauma while achieving adequate displacement remains a key clinical challenge. AIM: To evaluate and compare gingival displacement using four techniques - retraction cord, retraction paste, retraction gel, and diode laser - via intraoral scanning, and assess associated gingival inflammation by measuring interleukin-1β (IL-1β) levels. MATERIALS AND METHODS: Eighty participants requiring maxillary anterior full-coverage restorations were randomly divided into four groups (n = 20): Group 1-retraction cord, Group 2-retraction paste, Group 3-hemostatic gel, and Group 4-laser. Horizontal and vertical gingival displacement was measured pre- and post-retraction using Computer-aided design (CAD) and computer-aided manufacturing (CAM) software. Gingival crevicular fluid was collected at baseline, day 1, and day 7 for IL-1β analysis through the enzyme-linked immunosorbent assay. Data were analyzed using the one-way ANOVA and paired t-tests (P < 0.05). RESULTS: All methods achieved >0.22 mm displacement. Laser retraction showed the greatest displacement, followed by cord, paste, and gel. IL-1β levels increased postretraction, with cord showing the highest inflammatory response. No significant IL-1β differences were found among paste, gel, and laser groups at day 1. CONCLUSIONS: Laser and cord techniques provided superior gingival displacement. However, laser and other cordless methods induced less inflammation, making them preferable for atraumatic gingival management.

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