682 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No.

Operculectomy Using Electrocautery-A Case Report

S. Sindhuja1, Bagavad Gita2

1
Post Graduate, Department of Periodontics, Sree Balaji Dental College, Chennai, 2Head of the Department,
Sree Balaji Dental College, Chennai

Abstract
Electrosurgery is an application of electrically generated heat energy to tissue to alter it for therapeutic
purposes. Electrosurgery has been used in dentistry for many purposes such as for, gingivectomy, pulpotomy,
frenectomy, operculectomy and hemostasis. The main advantage of the electrocautery is coagulative effect
that provide bloodless area and clear view of the operative field. With any device that creates thermal energy
to cut or ablate tissue, heat may be dissipated by diffusion into adjacent tissues (conduction), or into the
circulating blood.(convection) This paper highlights its application and usage in dentistry.

Keywords: Electrosurgery, Hemostasis, Electrocautery, Pericoronal

Introduction pulpotomy, frenectomy and operculectomy

Electrocautery, also known as thermal cautery, Case Report

refers to a process in which a direct or alternating
An 18 year old male patient reported with a chief
current is passed through a resistant metal wire
complaint of pain in lower left back tooth region for past
electrode, generating heat. The heated electrode is then
1 week. On examination an inflamed pericoronal flap
applied to living tissue to achieve hemostasis or varying
was found in relation to lower left mandibular molar(fig
degrees of tissue destruction.[1] In electrocautery, unlike
1) The flap was soft, erythematous in nature and tender
electrosurgery, the electric current does not pass through
on palpation. Removal of pericoronal flap was done
the patient; therefore, the technique can be safely applied
using electrocautery with an uneventful postoperative
with patients with pacemakers, ICDs, and deep-brain
healing(fig 2) Patient was called after 1 week for follow
stimulators.[2] In electrocautery, electricity is used to heat
up and there was no recurrence found(fig 3)
an object and to burn a specific site. It has been used in
dentistry for many purposes such as for, gingivectomy,

Fig1-inflamed pericoronal flap in mandibular left third molar region

 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 683

Fig2-Removal of pericoronal flap using electrocautery in mandibular left third molar region

Fig-3-Mandibular third molar region after removal of the pericoronal flap

Discussion surgery, electrosurgery, cautery, C02 laser, or hot-

The painful and/ or inflamed/ infected operculum
can be removed by operculectomy-the surgical excision
or ablation of the operculum via a wide variety of
techniques: scalpel, caustic agents, radiofrequency
tip diode surgery.[3][4] The main advantage of the
electrocautery is coagulative effect that provide bloodless
area and clear view of the operative field. Electrocautery
requires no safety glasses and can remove large amounts
of tissue quickly. In electrocautery heat is produced
684 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3
when the electrode contacts the tissue and due to this
pain is produced, anesthetic must be used.
Disadvantages of electrocautery include need of
anesthetic agent for cutting, unavoidable burning-flesh
odor, low tactile sense, does not allow for their use
around implants, bone can be damaged, dangerous in an
explosive environment, contraindicated in pacemakers,
poor postoperative healing who have undergone
irradiation, diabetes or blood dyscrasias.
Conclusion
Thus electrocautery often does not require sutures
and typically ensures scar-free healing. One of the
potential disadvantages of operculectomy is that it
may prove to be a temporary measure, because an
operculum can regrow, which may lead to new trauma
and inflammation.[5] In such cases the removal of the
offending molar may be indicated.[5][6]
Ethical Clearance – Not required since it is a case
report
Source of Funding – Nil
Conflict of Interest – Nil
References
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