Earlier this year in a post on tissue management I mentioned using cord as part of a restorative protocol to protect the gingival tissues. Since then I have gotten multiple questions about “how” I do this and decided I’d answer in a post instead of one by one via e-mail. One of the things I like the least is tissue that is cut or bleeding when I am trying to get an impression. Many years ago I learned a technique that eliminated most of the tissue damage I had been causing during the preparation of the tooth.
The first step is to due the gross reduction of the tooth and leave the margin position of the preparation equigingival, or just supragingival avoiding the tissue. Next place your first cord. I use a size zero, and my preference for cord is one made by Dux Dental called UniBraid. What I like about it, is the rigidity of the cord, so it stays where I place it, and it holds its dimensions and does not stretch. I place the cord around the circumference of the tooth, and cut it so there is no overlap, and no tails are visible.
This first cord acts to retract and move the tissue away from the margin of the preparation. I can now go back and drop my margin without cutting the tissue. I conclude the prep and do all of my polishing and refinement. At this point you can now focus on retraction for impression taking.
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