Clinical


Fig 4 Continued »


tively high cost, lack of tactile feedback during operation, further training requirements and the risk of eye injuries have been cited as barriers to the widespread use of lasers in general practice.


Chemico-mechanical This technique has been described as the most commonly used form of soft tissue management and typically combines the


Fig 5


use of a compound which induces haemostasis and temporary shrinkage of the tissues together with a retrac- tion cord which physically displaces the tissues. Several chemicals have


been described for use with retraction cord: • epinephrine (adrenaline) • aluminium chloride • aluminium sulphate • ferric sulphate. Although adrenaline has


been used in conjunction with retraction cord for many


Fig 6


Fig 7


years, concerns have been raised regarding the possible negative cardiovascular effects produced by adrena- line impregnated cords. For this reason, and the fact that adequate retraction can be achieved using alternative compounds, the use of adren- aline impregnated cords is no longer recommended. Aluminium chloride


(Alustat, QED) has been described as an extremely effective compound for retracting soft tissues and


for controlling haemorrhage without the production of systemic side effects. An injectable paste form of aluminium chloride in a kaolin matrix (Expasyl, Kerr) has been marketed as an alter- native to retraction cord and chemical retraction materials. The advantages of this tech-


nique are as follows: • painless control of soft tissues • does not damage the healthy periodontium • green coloured paste is


54 Scottish Dental magazine


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