1. FLUID
CONTROL &
SOFT TISSUE
MANAGEMENT IN
FPD
BY
VESTA ENID LYDIA.R
III BDS
CSICDSR
MADURAI

2. FIXED PARTIAL DENTURE
 A partial denture that
is luted or otherwise
securely retained to
natural teeth ,tooth
roots ,and / or dental
implant abutments
that furnish primary
support for
abutments.


3. TOOTH PREPARATION
DE VANS PRINCIPLE
 The perpetual preservation of what
remains is most important than the
meticulous replacement of what is
lost.
 Care should be taken to prevent
excessive tooth preparation
 There should be minimal possible
reduction done to obtain required
characteristics

4. REQUIRED CHARACTERS OF
PREPARED TOOTH
FINISH
LINE

5. FLUIDS OF ORAL CAVITY
 Saliva
 Gingival bleeding during tooth preparation
 Sulcular fluid
 Water from hand piece

6. OBJECTIVES OF FLUID
CONTROL & TISSUE
MANAGEMENT
 ISOLATION
 RETRACTION
 ACCESSIBILITY

8. HOW CAN V ACHIEVE
ISOLATION TO CONTROL
FLUIDS?
MECHANICAL METHODS
CHEMICAL METHODS

9. a.Rubber dam
b.Suction devices
High volume vaccum
Saliva ejector
Svedopter

10. Y SHOULD V ISOLATE THE
OPERATIVE SITE?
To obtain a dry clean operating field
For easy access and visibility
To improve the properties of dental
materials
To protect the patient and the operator
To improve the operating efficiency

12. USES OF RUBBER DAM
Isolation of 1 or more
teeth
Eliminates saliva
from operating field
Retracts soft tissues

13. DISADVANTAGE OF RUBBER
DAM
Difficult to
use while
preparing tooth
for fixed
partial denture

14. HIGH VOLUME VACCUM
SALIVA EJECTOR
SVEDOPTER

16. HIGH VOLUME VACUM
Helps in removing small debris during
crown preparaton
Good lip retractor

18. SALIVA EJECTOR
It is placed at the
corner of the mouth
opposite to the
quadrent to be
operated

20. SVEDOPTER
It is used teeth for
isolating
mandibular teeth
It is a metal saliva
ejector attached
with a tongue
deflector

21. DISADVANTAGES OF
SVEDOPTER
Access to the lingual surface of mandibular
teeth is limited
Cant be used when mandibular tori
precludes its use
It may injure the soft tissues

22. ANTI-SIALOGOUGES
LOCAL ANASTHETICS

23. CONTROLS SALIVARY FLOW
THEY ARE GIT ANTI-CHOLINERGICS THAT
INHIBIT THE ACTION OF MYOEPITHELIAL
CELLS IN SALIVARY GLANDS,PRODUCING
DRY MOUTH

24. COMMONLY USED ANTI-
SIALOGOGUES
 Methantheline bromide (banthine) :50 mg 1 hour before procedure
 Propantheline bromide (pro-banthine) : 15 mg 1 hour before
procedure
 Clonidine hydrochloride (antihypertensive) : 0.2 mg 1 hour befor
procedure

26. Y DO VHAVE TO RETRACT
THE GIGIVAL TISSUES?
 It is retracted to obtain maximum exposure of finish
line
 Gingival retraction permits completetion of the
preparation and cementation of the restoration and
helps the operator to make a complete impression of
the preparation.

27. FINISH LINE EXPOSURE?
 It is a line of demarcation / or
 The peripheral extension of a
tooth preparation / or
 The planned junction of two
materials / or
 The terminal portion of
prepared tooth

28. IMPORTANCE OF FINISH LINE
EXPOSURE
 The gingival tissue must be healthy & free of inflammation before
cast restorations are fabricated
 The finish line must be reproduced in the impression .the marginal
fit is very important in preventing recurrent caries and gingival
inflammation (marginal intergrity)
 Hence the finish line should be temporarily exposed to reproduce
entire preparation

29. TECHNIQUES OF GINGIVAL
RETRACTION?
THEY ARE CLASSIFIED AS
Mechanical methods
Chemico mechanical methods
surgical

30. Copper band
Retraction cord
Rubber dam

32. COPPER BAND
 It is used to carry the impression as well as to displace the gingiva
to expose the finish line.

33. TECHNIQUE OF COPPER
BAND
 Copper band is a welded tube corresponding to the size of the
prepared tooth.
 One end if the tube is trim to follow the outline of the gingival
finish line.
 After poistioning and contouring the prepared tooth it is filled
with modelling compound and the impression is made.
DISADVANTAGE OF COPPER BAND
Causes injury to the gingival tissues

35. RETRACTION CORD
 Pressure packing the
retraction cord into the
gingival sulcus provides
gingival sulcus.
 Can be made with
absorbent material like
cotton

37. CHEMICO-MECHANICAL
METHODS OF GINGIVAL
RETRACTION
 A chemical with pressure packing in an retraction cord
 enlargement of gingival sulcus as well as control of fluids seeping
from gingival sulcus

38. CHEMICALS USED FOR
GINGIVAL RERACTION
 They are generally local vasoconstrictors which produce gingival
shrinkage.
8 % racemic epinephrine
Aluminium chloride
Alum(aluminium potassium sulphate)
Alumminium sulphate
Ferric sulphate

39. IDEAL REQUIREMENTS OF
CHEMICALS USED FOR
GINGIVAL RETRACTION
CORDS
 Should produce effective gingival displacement and
haemostasis
 It should not produce any irreversible damage to
gingival
 It should not have any systemic side effects

40. CONTRAINDICATIONS OF
EPINEPHRINE

41. TECHNIQUE OF USING
RETRACTION CORD
The cord can be
packed with a special
instrument like fischer
packing instrument or
a DE plastic
instrument IPPA

43. SURGICAL METHODS OF
GINGIVAL RETRACTION
Surgical method are
GINGETTAGE
ELECTROSURGERY

44. (GINGETTAGE)

45. ROTARY CURETTAGE
(GINGETTAGE)
It is a troughing technique , wherein a portion
of the epithelium within the sulcus is removed
to expose the finish line.
It should bedone only on the healthy gingival
tissue

46. FULLFILLED FOR
GINGETTAGE
There should be no bleeding on probing
The depth of the sulcus should be
minimum of 3 mm

47. TECHNIQUE OF GINGETTAGE
 It is usually done simultaneously along with finish line
preparation
 Portion of sulcular epithelium is removed using a torpedo diamond
bur.
 To improve tactile sense handpiece is run very slowly
 Abundant water should be sprayed during the procedure
 A retraction cord is impregnated with AlCl 3 can be used to
control bleeding

48. DISADVANTAGES OF
GINGETTAGE
Instrument has poor tactile sense so this
technique is very sensitive
It can potentially damage the periodontium

50. ELECTROSURGICAL
RETRACTION
It is the surgical
retraction of the sulcular
epithelium using an
electrode to produce
gingival retraction
The procedure is called
surgical diathermy.

51. INDICATIONS OF
ELECTOSURGICAL
RETRACTION
Areas of inflammation in gingival tissue
where the retraction cord cannot be used
Gingival proliferation around the prepared
finish line

52. CONTRAINDICATIONS OF
ELECTOSURGICAL
RETRACTION
Patients with cardiac pacemakers
Use of topical anesthesia such as
ethylchloride and other inflammable
aerosols should be avoided when
electrosurgery is to be used.

53. SURGICAL ELECTRODE or
THE CUTTING ELECTRODE
 It is like a probe and produces intense heat during surgical
procedures
 Numerous cutting edge designs are available some of them are
 Coagulation loop
 Diamond loop
 Round loop
 Small loop

54. USES OF
ELECTROSURGICAL UNIT
Gingival sulcus enlargement
Crown lengthening
Removal of edentulous cuff

55. TECHNIQUE FOR GINGIVAL
SULCUS ENLARGEMENT
USING AN
ELECTROSURGICAL PROBE
 Electode is positioned positioned parallel to the long axis of the
tooth
 A small J shaped bur is used for the procedure
 A whole of the tooth can be covered in 4 separate motions namely
facial,mesial,lingual and distal
 Debris in the sulcus should be removed using cotton pellets dipped
in hydrogen peroxide

56. TECHNIQUE FOR SURGICAL
CROWN LENGTHENING
 It is done when the clinical
crown is shorter than the
anatomic crown
 It is the removal of
hyperplastic gingival in order
to expose the clinical crown
 It is done using diamond
electrode
 When there is excess wound
periodontal dressing is done.

57. TECHNIQUES OF REMOVAL
OF EDENTULOUS CUFF
Edentulous cuff is an remnant of inter
dental papilla
Which is seen in the proximal sides of the
edentulous space
It is removed by using an electrosurgical
unit

58. FINAL IMPRESSION

59. BITE REGISTRATION
 The dentist may determine that an accurate bite
registration is necessary to establish the proper
occlusal relationship during mounting.
 A bite registration can be made in many ways. Some
of the common methods use reinforced bite registration
wax, or dental stone mixed with slurry water (water
from model trimmer).

60. INTERIM (TEMPORARY
CROWN) OR FPD
 The last step in this appointment is that a temporary crown or
FPD must be made to cover and protect the prepared tooth or
teeth while the permanent prosthesis is being fabricated.
 Temporary crowns or FPD's can be constructed from preformed
acrylic resin and aluminum shells.
 Plastic stints and alginate impressions can also be used with self-
curing acrylic resin to make an interim prosthesis.
 When the temporary is finished, a temporary cement such as zinc
oxide and eugenol is used to deliver the interim restoration onto
the prepared tooth or teeth.

61. CONCLUSION

62. BIBILOGRAPHY