In dental school, I was taught to manage tissue for crown preparations with the two-cord technique. I used a smaller cord (size 0 or 00) to push the tissue apically before refining my margins. Then I placed a larger cord (size 1 or 2) to push the sulcus laterally in order to record the margins accurately with impression material or my intraoral scanner.
The problem I would frequently run into with this technique was having to pull the second cord right before taking the impression or doing the scan. Often, this would trigger a little bleeding that I would have to deal with at the most inopportune time…right before the scan! Hemostatic retraction paste has helped me change that entire process.
Instead of the second cord and the pulling and the dealing with that possible outpouring of heme, I just use the retraction paste. The paste expands while it’s in the mouth, providing that lateral retraction. It is also hemostatic and can almost stop the sulcus from bleeding. I still rely on my first, smaller cord for lateral retraction, but that doesn’t get pulled until after the provisional is in place. For me, retraction paste has eliminated the second cord and it gives me equal lateral tissue displacement and better hemostasis.
Voco Retraction Paste comes in a unit-dose compule, just like composite, which helps with infection control. The Voco Retraction Paste compule has a thin, flexible cannula tip, which makes for easy, accurate placement right into the sulcus. Accurate placement is vital for retraction pastes because it can only work to expand the sulcus and provide hemostasis if it's actually in the sulcus. The thin, flexible tip here really comes in clutch for that.
Using Voco Retraction Paste couldn’t be easier. After your preparation is completed, rinse and dry the tooth. After expressing a tiny amount of paste to open and clear the tip, simply express it around the finish line of the preparation until the entire finish line is covered. Voco Retraction Paste is blue, so it’s easy to see. I like to use a compression cap on top of the paste to make sure it stays put. I put the cap in place and have the patient bite down on it; that stays in place for two minutes. After the two minutes are up, I remove the compression cap and rinse well. Make sure you rinse all of the paste away to get a good, accurate scan or impression. It’s that easy! The only real precaution you should take is not to use it on open flaps or exposed bone.
Voco Retraction Paste saves me time and frustration and is also one of the more economical hemostatic retraction pastes. Running under $4 per application, it’s less expensive than many of the other options on the market. Voco Retraction Paste also cuts a step out of my crown-prep procedure. It is simple and easy to use and helps me get great scans.
Editor's note: This article appeared in the May 2022 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.