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Prosthodontics & Occlusion · patient case question

All of the following may be used for gingival displacement in a diabetic patient EXCEPT:

Patient case: Cranial nerves, radiation safety and the diabetic patient

Scenario: Three items spanning anatomy, radiology and medicine.

  1. Aluminium chloride
  2. Plain retraction cord with a mechanical technique
  3. Epinephrine-impregnated cord (1:50,000)
  4. Ferric sulfate
Show answer and explanation

Correct answer: C. Epinephrine-impregnated cord (1:50,000)

  • A. Aluminium chloride is a safe and widely used astringent that works by protein precipitation and local vasoconstriction without systemic effect.
  • B. Plain cord used mechanically causes displacement by physical pressure alone and carries no pharmacological risk.
  • C. Correct — this is the exception. Racemic epinephrine cord delivers a substantial systemic dose through the abraded sulcus. It is contraindicated in diabetes, cardiovascular disease, hyperthyroidism and in patients on certain antidepressants.
  • D. Ferric sulfate is also acceptable, with good haemostasis. Its only real drawback is transient tissue staining and its inhibition of resin polymerisation.

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