604 The use of retraction paste to simplify impression and cementation of ceramic veneers and crowns: 3-year follow-up report Rafael Ferrone Andreiuolo, DDS, Ms, PhD/João Luiz Bittencourt de Abreu, DDS, Ms/ Ronaldo Hirata, DDS, Ms, PhD Proper gingival displacement is an important prerequisite to obtain good quality impressions. Retraction pastes could elim- inate the need for retraction cords, as they have advantages such as comfort reported by patients, faster technique, ease of use, no need for anesthesia, and reduced tissue trauma. The objective of this paper was to present a clinical case of ceramic veneers and crowns in which a retraction paste was used for gingival displacement during both the impression and cemen- tation stages, with 3 years of follow-up. Treatment planning consisted of the replacement of preexisting crowns and ce- ramic veneers on the anterior teeth. After finishing the prepar- ations, gingival displacement with Astringent Retraction Paste was performed without anesthesia or the use of cords and the impression was taken. Before cementation of the crowns and veneers, the Astringent Retraction Paste was applied. Avoiding the use of cords during cementation prevented trauma. The soft tissue margins remained stable and healthy after a period of 3 years. It can be concluded that retraction pastes could be indicated for displacement of soft tissue when preparation margins are at the gingival level or slightly intrasulcular prior to impressions, restoration cementations, direct restorations, and before relining provisional restorations. Clinical significance: The impression appointment can be traumatic to some patients. The use of cords for gingival displacement usually requires local anesthesia and is time consuming. Retraction astringent pastes instead of cords seems to be a good option for some cases in gingival tissue displacement. (Quintessence Int 2019;50:604–610; doi: 10.3290/j.qi.a42694) Key words: dental ceramics, dental impression materials, dental impression technique, prosthetic procedure, prosthodontics, restorative dentistry Ceramic restorations are highly esthetic restorations with pre- dictable results when executed within correct planning. 1,2 Veneers and crowns can be used to correct tooth shape and position, close diastemas, replace old composite restorations, restore teeth, and mask or reduce tooth discoloration. 3-5 Marginal adaptation is crucial to the longevity of ceramic restorations. Marginal overhangs may trigger gingival inflam- mation, and increase the risk of secondary caries, especially in the region of root cement. 6 Although supragingival prepar- ations are associated with more consistent indexes of periodon- tal health, it is a consensus in the literature that most situations require margins positioned at the gingival level, or intrasulcu- larly. 6 These situations include: the need for greater retention, esthetic reason to hide the restoration interface, refinement of preexisting margins, root caries, non-caries cervical lesions. 6 In this context, it is necessary to promote lateral and vertical dis- placement of the gingival tissue, along with moisture control and hemostasis to ensure acceptable impressions. 7,8 In other words, soft tissue management for indirect restorations re- quires gingival displacement and hemostasis. Despite the advances in flow, hydrophilicity, and ability of impression materials to reproduce details, a good impression RESTORATIVE DENTISTRY QUINTESSENCE INTERNATIONAL | volume 50 • number 8 • September 2019