Clinical Guide To Perfect Tcs; Indications For Use; Bleeding Control; Access To Caries - Coltene PerFect TCS II Manuel De L'utilisateur

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If your cutting stroke is too slow or if you leave
the electrode too long in one area, a build up
of lateral heat may cause necrosis and slough-
ing of tissue.
WARNING
TO REDUCE THE RISK OF UNINTENDED
TISSUE DAMAGE, ALWAYS 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
WARNING
by cleaning with alcohol and a very fine
emery cloth.
• Electrosurgery should only be performed on
healthy tissue.
• Tissue should be moist, but not wet, in the
operative area.
• In addition, the electrode should not be
activated in a pool of blood.
3. Clinical Guide to PerFect TCS II

Indications for use

The PerFect TCSII is intended to cut or remove soft tissue or to
control bleeding during dental and periodontal surgical procedures
in the oral cavity.

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.
EN PerFect

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.
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

Gingival troughs are created to provide a space into which a sufficient
amount of impression material can flow. You will find PerFect TCS II
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.
TCS II Tissue Contouring System
®