How does electrosurgery help in periodontics?

Electrosurgery has been used for gingival curettage, both deep and shallow, very effectively for many years. It does not damage enamel which can happen with laser treatment nor does it require white hot incandescent fiber-optics to effect deep curettage. Electrosurgery has even been used effectively for donor graft harvesting. Reducing edentulous ridges is another common adjunct in periodontics, as is managing flap reflections and reshaping.

FAQ Gingivectomy illustrations

Gingivectomy 1Gingivectomy 2

Probing to determine biological width prior to gingivectomy for clinical crown lengthening. Note sub-optimal gingival tissue health.

Gingivectomy 3Gingivectomy 4

Mild hemorrhagic response is evident immediately post-op. Slight weepage is still evident after lavage. This example represents sound clinical judgment since concurrent hemostasis was compromised out of respect for the sub-optimal state of tissue health. The final healing is expected to be sans circatrix due to good thermal control.

Gingivectomy 5Gingivectomy 6

Optimal thermal artifact control is evidenced by the patency of the excised tissue suggesting good energy dose titration and adequate technique. The negligible hemorrhagic response is typical of normal healthy gingival tissue. Note orthodontic tension wire removal.

FAQ Illustration inter-proximal tissue reduction

inter-proximal tissue reductioninter-proximal tissue reduction 2

Inter-proximal granulation tissue developed because patient delayed seeking treatment for fractured cusp and sub-gingival carie. Initial approach to this tissue was conservative. Tissue detritus adhering to the loop electrode suggests inadequate dose titration for this circumstance.

inter-proximal tissue reduction 3inter-proximal tissue reduction 4

Sound clinical judgment was exercised by selecting the conical electrode in lieu of the loop electrode rather than retitrate energy dose out of respect for the limited inter-proximal tissue capacity to withstand therapeutic current. Completed preparation for matrix restoration : note freedom from thermal artifact and good hemostasis affording negligible risk of interference with matrix placement.