Chemical Methods of Fluid Control in Dentistry: A Comprehensive Guide, Slides of Fluid Mechanics

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CHEMICAL METHOD

OF FLUID CONTROL

RAHUL A R PART II

CONTENTS

• (^) Introduction
• (^) Fluid control
• (^) Methods of fluid control
• (^) Chemical method
• (^) Antisialogogues
• (^) Local anesthetics
• (^) Chemo-mechanical methods
• (^) Conclusion

FLUID CONTROL

OBJECTIVE

• Primarily to remove fluids, isolate and retract oral tissues.
• To enhance operator visibility and patient comfort during tooth preparation.
• To prevent injury to the patient’s oral tissues.
• To prevent aspiration of fluids along with restorative debris.
• Isolate specific areas of the oral cavity and ensure a dry operating field in preparation for impression and cementation procedures.

METHODS OF FLUID CONTROL

• (^) Mechanical
• (^) Chemical

ANTISIALOGOGUES

• (^) Drugs may be used to provide fluid control by reducing salivary flow.
• (^) This is especially beneficial during impression making.

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 before procedure
• (^) Glycopyrrolate

• (^) Glycopyrrolate, a synthetic anticholinergic medication, is used in its injectable form (Robinul, Baxter) to reduce salivary secretions before surgery.
• (^) Glycopyrrolate in its oral form (Robinul, Shionogi Pharma) is indicated for adjunctive treatment of peptic ulcers.

DISADVANTAGES

• (^) Contraindicated in patients having hypersensitivity
• (^) Medication produce drowsiness, blurred vision
• (^) Caution should be exercised in the elderly and in patients with:
• (^) autonomic neuropathy, hepatic/ renal disease, ulcerative colitis, hyperthyroidism, coronary heart disease, congestive heart failure, tachyarrhythmias, tachycardia, hypertension, prostatic hypertrophy, and hiatal hernia associated with reflux esophagitis.¹

• (^) Pilocarpine (0.5mg/kg)-induced salivation was increased by lidocaine (80mg/kg), but phenylephrine(5mg/kg)-induced salivation was decreased by lidocaine(40 and 80mg/kg).
• (^) Isoprotereno1 (0.25mg/kg) induced salivation was decreased by a low dose(4mg/ kg)but increased by a large dose(80mg/kg) of lidocaine.
• (^) Lidocaine (80mg/kg)slightly increased NE levels only in the submandibular gland,but procaine did not influence NE levels in three glands.
• (^) Both lidocaine and procaine did not influence Ach levels in any of the three glands. These results indicate that lidocaine, but not procaine, influences salivation induced by sialogogues.

ADVANTAGES

• (^) More comfortable
• (^) Less sensitive
• (^) Patient is less anxious

GINGIVAL RETRACTION – CHEMICALS USED

• (^) These are generally local vasoconstrictors which produce transient gingival shrinkage.
• (^) + 8% racemic epinephrine

1. Aluminium chloride
2. Alum (Aluminium Potassium sulphate)
3. Aluminium sulphate
4. Ferric sulphate

NEWER GINGIVAL RETRACTION AGENTS ARE

Phenylephrine hydrochloride 0.25%

• (^) Oxymetazoline hydrochloride 0.05 %
• (^) Tetrahydrozoline hydrochloride 0.05 %

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