Clinical Guide To Perfect Tcs; Bleeding Control; Access To Caries; Gingival Contouring: Creating A Gingival Trough - Coltene PerFect TCS II Manual De Usuario

6
CAUTION:
Begin with as low a power setting as will properly
perform the procedure.
• To allow heat to dissipate safely, you should always wait
10–15 seconds between cuts in the same area.
• After each cutting stroke, deactivate the electrode and
wipe it on an alcohol-soaked pad. Charred or carbonized
electrodes should not be used; they should be restored
by cleaning with alcohol and a very fine emery cloth.
• Electrosurgery should
healthy tissue.
• Tissue should be
operative area.
• In addition, the electrode should not be activated in a pool
of blood.
3. Clinical Guide to PerFect TCS II

Bleeding control

The improved bleeding control you achieve with PerFect TCS II saves
chair time, simplifies procedures and improves patient comfort.
Bleeding is virtually absent during electrosurgical procedures
because the electrode coagulates as it cuts. If bleeding does occur,
coagulation is a relatively simple procedure.
1.
Attach the Coag Ball electrode sheath to the handpiece cord
assembly (or use the Straight Knife electrode if the area to be
coagulated is difficult to reach).
2.
Rotate the Output Control to the coagulation output setting
you have established from previous experience or during
preoperative practice. Remember to use the lowest effective
output setting for best results.
3.
Rinse and air dry the operative field to visualize the bleeder.
4.
Touch the bleeding area intermittently with the electrode
(Figures 5 and 6). Duration of contact should be approximately
one second, with a 10–15 second pause between contacts.
Bleeding cessation indicates a successful coagulation. One
or two applications of the electrode are usually sufficient to
stop bleeding.
5.
Use postoperative dressing if necessary.

Access to caries

The benefits of the PerFect TCS II will be readily apparent when
it is used to gain access to caries. The PerFect TCS II makes it
possible to remove occluding tissue in a matter of seconds and
complete restorative procedures immediately. The procedure is
usually blood-free and provides a clean, dry and highly visible
operative field for the removal of caries and the placement of
restorations during one visit.
1.
The Long Loop electrode is well suited for obtaining access to
most carious lesions. For caries occurring in tight interproximal
areas, the Straight Knife may be more appropriate.
2.
Explore the extent of the tissue to be removed with a
periodontal probe.
only be performed
moist, but not wet,
3.
With the Output Control setting in the cutting mode and
at the predetermined output setting, shave off the gingival
tissue covering the lesion with a few strokes of the Long Loop
electrode (Figure 7). Allow 10–15 seconds for the tissue to
cool before cutting again in the same area.
4.
With the caries exposed (Figure 8), restorative procedures can
begin immediately.

Gingival contouring: Creating a gingival trough

on
Gingival troughs are created to provide a space into which a sufficient
amount of impression material can flow. You will find PerFect TCS II
in the
to be exceptionally useful in this procedure, either as an alternative
to a retraction cord or in conjunction with it. For example, you may
create a partial trough in an area where the retraction cord does
not provide space for a sufficient amount of impression material
to flow. Gingival troughs can be made either before or after tooth
preparation. If they are made before tooth preparation, visibility and
access are improved and margins can be finished readily. When the
trough is completed and the tooth is prepared, the impression can
be taken immediately. Gingival troughs should not be made in
aesthetically critical areas with thin marginal gingiva because
of the possible loss of gingival height on healing.
1.
When creating a complete gingival trough, use the Long Loop
electrode (for shoulderless preparations with a thin gingival
mucosa, the Straight Knife electrode may be used).
2.
Electrode position is especially important during this procedure:
the angle between the electrode and the tooth should be
minimal. Too wide an angle may result in a reduced height of
the marginal gingiva. Figure 9 shows the proper angle of the
Loop electrode in relation to the tooth. If the resulting trough is
too narrow, retrace the trough (after waiting 15 seconds) while
increasing the electrode angle slightly.
3.
Begin troughing on the lingual surface, so the output intensity,
stroke speed and cutting depth can be adjusted before operating
on the facial surfaces. Do not attempt to create a gingival
trough with one continuous sweep around the circumference
of the tooth. Instead, the troughing should be performed in
four separate, short cutting strokes (Figure 10), each sweeping
a quadrant of the gingival sulcus. The following cutting stroke
sequence is recommended: (1) the palatal (lingual) surface, (2)
the labial (buccal) surface, (3) the mesial surface, and (4) the
distal surface. As shown in Figure 10, the last two (shorter)
excisions join the first two to create a continuous and uniform
gingival trough. Figure 11 shows the immediate postoperative
condition of a gingival trough.

Gingival contouring: Removing redundant tissue

Prior to impression-taking or cementation of restorations, PerFect
TCS II may be used to remove redundant tissue that may interfere
with the procedure and help control bleeding.
1.
Thread the Long Loop electrode sheath onto the handpiece
swivel connector of the handpiece cord assembly.
2.
With the electrode loop parallel to the tissue being removed,
(Figure 12), slice the tissue off in thin layers until the desired
result is obtained.
Remember to allow 10–15 seconds for the tissue to cool before
cutting again in the same area.
PerFect TCS II Tissue Contouring System
®