Evaluation of alpha-adrenomimetic agents for gingival retraction: A randomized crossover clinical trial

CONTEXT: The displacement of the gingiva around the tooth allows proper access during preparation, precise impression taking, and cementation procedures that has a direct bearing on the health of the periodontium. Several methods and agents are used for this purpose. AIMS: The primary aim of the study was to clinically evaluate the efficacy of naphazoline as a gingival retraction agent. The secondary aim was to compare it with tetrahydrozoline and aluminum chloride. SETTINGS AND DESIGN: Fifteen patients participated in a randomized crossover clinical trial at the Army College of Dental Sciences, Secunderabad, Telangana, India. SUBJECTS AND METHODS: Preliminary maxillary impressions were made with irreversible hydrocolloid for all patients to fabricate custom trays. After that, baseline impressions and cast for control group measurements were prepared. Gingival displacement was carried out in the right maxillary central incisor for all, with retraction cord soaked in three agents, either, aluminum chloride, tetrahydrozoline, or naphazoline. These agents were used in all patients with a washout period of 14 days. Elastomeric monophase impressions and die stone casts were recorded for each group. The central incisors were sectioned, and gingival retraction was measured using a measuring stereomicroscope. STATISTICAL ANALYSIS USED: The gingival displacement was statistically analyzed using one-way ANOVA and post hoc Bonferroni. RESULTS: Naphazoline had the highest retraction (138.160 μm) followed by tetrahydrozoline (136.039 μm) and aluminum chloride (130.759 μm). CONCLUSIONS: Naphazoline, tetrahydrozoline, and aluminum chloride show a clinically and statistically significant amount of displacement when compared to control. Among the three agents, naphazoline showed maximum displacement and maybe a good alternative with fewer side effects.