PERIODONTAL

DRESSINGS
Definition

Periodontal dressing or
periodontal packs is a productive
materials applied over the wound
created by periodontal surgical
procedures
Uses
1. To protect the wound postsurgically

2. To obtain and maintain a close adaptation

of mucosal flaps to underlying bone

3. Comfort to the patient

4. Prevents post-operative bleeding

5. Prevents formation of excessive granulation

tissue
 Properties
1. The dressing should be soft, but still
have enough plasticity and flexibility to
facilitate its placement in operated
area and to allow proper adaptation

2. Should harden with in a reasonable

period of time
3. After setting the dressing should be
sufficiently rigid to prevent fracture
and dislocation
4.The dressing should have a smmoth
surface after setting to prevent
irritation to cheeks and lips

5.The dressing should preferably have

bactericidal properties to prevent
excessive plaque formation

6.Dressing must not detrimentally

interfere with the healing
 TYPES
1. Zno eugenol packs packs based on
reaction of zno & eugenol include –
wondr pak developed by Ward
The addition of accelerators such as
Zinc acetate gives the dressing a
better working time
It is supplied as a liquid and a powder
thet are mixed prior to use.
Eugenol may produce allergic reaction
(reddening of area and burning pain )
 Non eugenol packs
 Reaction between metallic oxide and fatty acid
is basis for coe-Pak
Supplied in two tubes
One tube contains oxides of various metals
(Mainly zinc oxide) and lorothidol (a fungicide) and
second tube contains non ionized carboxylic
acids and chlorothymol (bacteriostatic agents)
Equal parts of both mixed together immediately
prior to insertion
Setting time is prolonged by adding a retarder
 Other non eugenol packs
1. Light curing dressing e.g

Barricaid
Useful in anterior tooth region and
particularly following mucogingival
surgery because it has favorable
appearance and it can be applied
without dislocating soft tissues age
Disadvantage
It is not the choice of dressing to be
used in situations where flap has to
be apically retained due to its soft
state before curing
2. Cyanoacrylates

It is applied in a liqiud directly on to

the wound or spread over the wound

3.Tissue conditioners ( methacrylate

gel)
 Retention of packs
 Periodontal dressing are kept usually in place
mechanically by interlocking the interdental
spaces
&
Joining lingual and facial portions of pack
In isolated teeth or when several teeth in arch
are missing --- retention of pack may be
difficult
So numerous reinforcement and splints and stents
placement of dental floss tied loosely around
the teeth enhances retention of packs
 Application techniques
 Ensure that the bleeding from
operated tissues has ceased before
the dressing material is inserted

 Carefully dry teeth and soft tissues

before the application for optimal
adherence of dressing
 Moistened the surgical gloves to avoid
the material sticking to finger tips

 Zinc oxide packs are mixed with eugenol

or non eugenol liquids o a wax paper pad
with a wooden tongue depressor

 The powder is gradually incorporated

with the liquid until a thick paste is
formed
 Coe-pack is prepared by mixing equal
length of paste from tubes containing
the accelerator and the base until
the resulting paste is a uniform colour

 The pack is then placed in a cup of

water at room temperature in 2-3
minutes the paste loses its tackiness
and can be handled and molded
 The pack is then rolled into two strips
and placed on the surgical wound

 the dressing should not be covered more

than the apical third of tooth surface

 Excess pack irritates the mucobuccal

fold and floor of mouth and interfere
with the tongue
 Pack that interfere with the
occlussion should be trimmed away
failure to do this cuases discomfort
and jeopardized the retention of pack

 The pack is kept on for one week

after surgery
Instructions for the patients after the
packs are placed

1. The pack should remain in place until it is

removed in the office at the next
appointment

2. For the first three hours after the

operation avoid hot foods to permit the
pack to harden

3. Do not smoke

4. Do not brush over the pack

References

1. Periodontics-medicine surgery and

implants by Louis F Rose and Brian L
Mealey

2. clinical Periodontology and implant

dentistry by Jan Lindhe