Journal of Cutaneous and Aesthetic Surgery

INNOVATIONS
Year
: 2021  |  Volume : 14  |  Issue : 2  |  Page : 220--221

Precision dermabrasion of small areas of vitiliginous skin using dental diamond burs


Sanjeev Gupta1, Ravi S Jangra2, Somesh Gupta3,  
1 Department of Dermatology and Venereolgy, Maharishi Markandeshwar Institute of Medical Sciences and Research, MMDU, Mullana, Ambala, India
2 Sun Skin Clinic, Ambala City, Haryana, India
3 All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Sanjeev Gupta
#B2, Maharishi Markandeshwar Medical College Residential Campus, Mullana, Ambala, Haryana.
India

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.



How to cite this article:
Gupta S, Jangra RS, Gupta S. Precision dermabrasion of small areas of vitiliginous skin using dental diamond burs.J Cutan Aesthet Surg 2021;14:220-221


How to cite this URL:
Gupta S, Jangra RS, Gupta S. Precision dermabrasion of small areas of vitiliginous skin using dental diamond burs. J Cutan Aesthet Surg [serial online] 2021 [cited 2022 May 29 ];14:220-221
Available from: https://www.jcasonline.com/text.asp?2021/14/2/220/323537


Full Text



 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 1]A and [B]. These burs are available for both straight and contra-angle handpiece of micromotor [Figure 1]C 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 2]A, [B] and [C]. After dermabrasion, suction blister epidermal graft or melanocyte suspension is applied [Figure 2]D. We have used these burs in many patients with good pigmentation, and none of them had any untoward event.{Figure 1} {Figure 2}

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

1Gupta S, Gupta S, Kumar A. The hypodermic needle as a dermabrading device for recipient area preparation for skin grafting in vitiligo. J Am Acad Dermatol 2015;72: e105-6.
2Kahn AM, Cohen MJ. Vitiligo: treatment by dermabrasion and epithelial sheet grafting. J Am Acad Dermatol 1995;33:646-8.