by Dr Marcus Matear, Palm Square Dental Care, Bendigo, VIC
I use Thermacut burs when doing gingivectomies that require a deep filling. They are also very effective at removing excess gutta percha.
What’s good about it
I saw a webinar by Dr Oliver Pope, an endodontist, who suggested using Thermacut burs on the gums instead of lasers. I tried the technique and it was a fast and easy alternative. Lasers can take more time as they need to be set up properly before use. The Thermacut bur is easy to fit and you can begin cutting immediately. If you have the right technique, it can be very effective.
It’s important to first check the bone level to ensure you don’t cut into the bone with the bur. I also use a local anaesthetic with adrenaline to help prevent bleeding. The bur is used on a high-speed handpiece without water. It will effectively cut and seal the gums similar to a laser.
Afterwards, I apply a haemostatic agent, like ViscoStat, and leave that on for five minutes while I prepare the rest of the cavity. I can then go ahead and restore the tooth.
Thermacut burs come in multiple sizes but I recommend a smaller size in order to allow better access to the gum when there are tight contacts between the teeth.
What’s not so good
There are occasions when you need to be a bit patient and wait for the bleeding to stop. The burs can be sterilised but it’s easy for them to get mixed up and lost. There needs to be a system in place that prevents them from getting misplaced or thrown out.