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Precision Dermabrasion of Small Areas of Vitiliginous Skin Using Dental Diamond Burs
Address for correspondence: Dr. Sanjeev Gupta, #B2, Maharishi Markandeshwar Medical College Residential Campus, Mullana, Ambala, Haryana, 133207, India. E-mail: sanjeevguptadr@gmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
Abstract
Abstract
Dermabrasion is important step in any vitiligo surgery. Unfortunately, it is not possible to derma abrade very small area with conventional burs available. The present paper highlights the use of dental burrs in such situations.
Keywords
Dental burs
dermabrasion
precise
vitiligo
SURGICAL CHALLENGE
It is not often possible to achieve complete and uniform repigmentation after vitiligo surgery after one session, and some islands of depigmentation persist. In subsequent transplantation, done with a purpose to achieve complete repigmentation of residual vitiligo, precise dermabrasion of depigmented areas without disturbing the pigmented area is not possible with manual or conventional dermatology diamond burs because of their large size and poor availability and high cost. Needle dermabrasion[1] and CO2 laser dermabrasion[2] have been suggested to overcome this problem, but the former is a crude method and the latter causes coagulation of capillaries and adds to the overall cost.
SOLUTION
We propose the use of dental burs, which are freely available in a wide variety of shapes and sizes. There are two types of dental burs—carbide and diamond. Carbide burs are used for cutting, whereas diamond burs are used for fine dental abrasion. The shape and size of the bur can be chosen according to the shape and size of the depigmented area [Figure 1A and B]. These burs are available for both straight and contra-angle handpiece of micromotor [Figure 1C and D]. Fine dermabrasion is done with these diamond burs attached to micromotor at a speed of 2000–3000 rotations per minute (RPM) until the pinpoint bleeding is achieved [Figures 2A, B and C]. After dermabrasion, suction blister epidermal graft or melanocyte suspension is applied [Figure 2D]. We have used these burs in many patients with good pigmentation, and none of them had any untoward event.
- (A) Different shapes and sizes of diamond dental burs for contra-angle handpiece of micromotor. (B) Different shapes and sizes of diamond dental burs for straight handpiece. (C) Diamond bur attached to contra-angle handpiece. (D) Diamond bur attached to straight handpiece
- (A) Vitiligo lesion over abdomen. (B) Vitiligo lesion being dermabraded with diamond bur. (C) Vitiligo lesion after dermabrasion. (D) Suction blister graft applied after dermabrasion
An average conventional dermatology bur is not available at less than Rs 500, whereas a dental burr is freely available at Rs 40–50 at dental shops. So, to conclude, these dental burs are very precise, freely available, economical, and can be sterilized by autoclaving, and are ideal for special situations where conventional dermatology burs can not be used.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
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