Periodontal dressing|Purpose, Uses, Materials and removal

Periodontal dressing|Purpose, Uses, Materials and removal

The periodontal dressing protects wound insult during eating and speaking and stabilizes the surgical site after periodontal surgery. Dressing components may include eugenol, resin, zinc oxide, tannic acid, cocoa butter, paraffin, olive oil, and an antibiotic. Periodontal dressings also play a key role in local pharmacotherapy of periodontal diseases.

What purpose does a periodontal dressing serve

Periodontal dressing applicators perform therapeutic and isolating functions. "Large plasters" of a soft consistency provide the delivery of healing substances to the gums and pockets, protect tissues from food and the acidic environment of the oral cavity. Dressing do not interfere with the mobility of the gums, and does not create discomfort.

Therapeutic periodontal dressings are used to prolong the action of drugs in periodontal pockets during drug treatment and after surgery, accelerating the regeneration of epithelial and connective tissue structures.

Classification of periodontal dressings

Periodontal dressings used in dentistry are of two types:
medicinal ;
insulating .
Therapeutic periodontal dressings prevent the leaching of drugs from the periodontal pockets (in particular, during the drug treatment of periodontal diseases). In addition, they usually contain drugs themselves, which makes the treatment more effective.

Isolating periodontal dressings protect the periodontal tissues from external mechanical and chemical irritants: solid or overly spicy food, hot drinks, etc. Most often, they are necessary after various types of surgical interventions (for example, curettage of periodontal pockets).

A periodontal dressing usually has a paste-like consistency, which can be easily modeled at the junction of tooth and gum and develops good adhesive strength so that the wound area is safely covered for healing. The dressing then sets and protects the wound.commonly used Periodontal dressings are based on cellulose, which is able to absorb fluid and blood and has good adhesive strength. As a further ingredient, myrrh has a calming and pain relieving effect on the gums.

The good absorption capacity of fluids (including blood) not only has advantages. If bleeding occurs after an open periodontal treatment (flap surgery) , the blood is absorbed, but the volume of the dressing can increase in a disturbing way.

How periodontal dressing material should be?

Periodontal dressing material should be slow-setting to allow manipulation and to create a smooth surface causing no irritation, should be flexible enough to withstand distortion and displacement, should be adhesive and coherent without being bulky, and must have dimensional stability to prevent salivary leakage and plaque accumulation.

How long should periodontal dressing stay in mouth

Periodontal dressing is applied for a period of 7 to 10 days depending upon severity and size of wound. In minor procedures, periodontal dressing should be kept from 2 to 5 days

The duration of wearing a particular gingival dressing depends on the indications and the therapeutic effect.
Features of applying different types of gingival dressings:
To achieve a therapeutic effect, the bandage is applied for 2-3 hours, or for 1-3 days. The drug is applied to a bandage or gauze.

Solid and semi-solid dressings are shown after surgery, since they are made of materials that can fix the application for a day. Duration of use is 3-7 days.

The ex tempore dressings are applied after professional cleaning of periodontal tissues and after stopping bleeding. Adhesive compositions can last up to 5 days. They are fixed with medical glue. Before the procedure, the mucous membrane is dried and degreased.

Collagen films can be applied for 7 to 20 days. One strip should cover no more than three dental units. Excess material is quickly absorbed.

How to care for periodontal dressing?

Periodontal dressing are fragile in strength and patient are advised to to care by.
Eating should be avoided dressing side.
Brushing of teeth should be done carefully not to damage th dressing.
Hard and solid food should be avoided for few days.

How to remove periodontal dressing

Usually periodontal dressing is removed by the dentist and an appointment is fixd for its removal on the day of dressing. Periodontal dressing materials are plastic in nature and can breakaway in weaker portions but patients should not be encouraged to remove it by itself. As the thick portion of dressing is quite hard to remove from interdental spaces without the aid of special dental instruments.

If interdental spaces are not involved in dressing then the removal can be easy and non painful. Anesthesia application also required some time for removal to laminate pain during the process.

What to do if perio dressing fell away

No need to worry if the dressing falls away after a few days of removal. However if the wound is quite large and no suture was used then it's better to call the dental office for an appointment to ensure the success of treatment. Pus discharge, bleeding from wound, dislocation of flap and symptoms of pain also necessitate to contact dentist.

Wounds in the oral cavity are subject to extremely good self-healing, but situations arise in which the risk of germ colonization must be removed. There is a wide range of specific indications.

What are periodontal dressing made of?

The composition of gum dressings is mostly based on zinc oxide eugenol and / or methyl methacrylates to set or solidify the material. Such a bandage is held mechanically in the respective wound area on residual teeth and their spaces, on threads of the wound or on prosthetic restorations and orthodontic devices.

The dressing materials usually harden after mixing on their own or in the presence of saliva. The disadvantage of the well-fixed gum bandages is that due to the hardness of the set material, considerable difficulties often arise during removal, which on the one hand inflicts pain on the patient and on the other hand endangers the wound area.

Uses of Periodontal Dressing

1. Closure of an endangered extraction wound , e.g. after surgical tooth removal or in the case of heavy smokers 2. Wound care as part of anticoagulant treatments, e.g. for ASA

3. Securing of an endangered suture, e.g. after plastic covering of an MAV
4. Placeholder after exposure of retained ones Teeth
5. Securing the marginal periodontium after gingivectomies
6. Adaptation of the gingiva after flap operations
7. Wound closure after deep periodontal curettage

Clinical application

When treating simple extraction wounds, one can argue whether a covering with the gum bandage is needed. If it is to be expected that oral care will not be carried out adequately, this may be indicated, as well as in the case of heavy smokers, in whom the extraction wound is to be removed from the tar load for the first postoperative period or who have some sort of bleeding tendency is to be expected. After exposing the impacted teeth, the wound or the access must be kept open by a placeholder for the later attachment of the brackets.

The wound dressing is also suitable here. At the time of the orthodontic restoration, the material dissolved without leaving any residue; the bleeding had stopped.

With the increasing number of patients receiving anticoagulant therapy, there is a risk of rebleeding. So it happens more and more frequently that undesirable postoperative bleeding occurs, which can be brought under control with the material. ResoPac is an ideal addition to the range of gum dressings and can be meaningfully integrated into everyday oral surgery practice.


References

Effect of periodontal dressing on non-surgical periodontal treatment outcomes: a systematic review
Periodontal dressing materials Trevor L. P. Watts, Edward C. Combe
To pack or not to pack: the current status of periodontal dressings
Periodontal Probe in the examination of periodontal diseases.
How to examine the periodontium? Paul Mattout

Den Tim


Practicing Dentistry for 20 years