Sameer Puri I'm a fan of cord. While I love lasers and all the different uses we have for them in our restorative procedures, I still think that using a nice piece of cord gives excellent retraction and visualization of the restorative margins. Another benefit of cord that often goes unrealized is the ability to control sulcular fluid and bleeding. Nothing worse than trying cement an adhesive restoration only to have blood oozing from the sulcus. This is not an issue if you have packed the sulcus with cord.
Cord for posterior restorations is a no brainer. Pack the cord, take your images, cement your restoration, remove cord. Here is a trick that you may not have used for anterior restorations. The single cord “Unicord” technique works well for not just prepping and imaging multiple veneer restorations but also for cementation. The Unicord technique involves using a single piece of cord and packing it for multiple restorations. The only disadvantage is that you cannot use this for full coverage restorations.
If for example you have six full coverage restorations, you would need 6 individual pieces of cord that would wrap all the way around the prep and retract the tissue. However, if you have veneers that do not wrap to the lingual, use a single piece of cord and keep your procedure simple. Take the single piece of cord, start at the most distal prep and tuck the cord in the sulcus and when you come inter proximally, tuck the cord to the lingual. This will allow you to use a single piece and pack it quickly instead of dealing with 6 different pieces. If you have broken contact, just make sure inter proximally you are putting the cord all the way to the lingual, away from the prep margins.
Prep your margins to the tissue and then pack the cord and when its done, refine your margins to be just below the tissue (about .1mm). The cord will not only retract tissue but also keep any bleeding in check when it comes time to cement the restorations.
I use the smallest cord possible and I soak the cord in an aluminum chloride solution - something like Hemodent - that will help with the bleeding. By using a single piece, you are efficient as well as having a great field of view to work with.
Try the “Unicord” technique and see if you can get the best retraction for your cases.
