Treatment of Amalgam Tattoo With a New Technique: Mucoabrasion and Free Connective Tissue Graft

Aguirre-Zorzano, Luis Antonio; García-De-La-Fuente, Ana M; Estefanía-Fresco, Ruth

doi:10.1002/cap.10058

Cited by 6 publications

(8 citation statements)

References 9 publications

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“…The novel modality EL-MIKS is different from the previously reported procedure combined with periodontal plastic surgery [7][8][9][10]. It is much less invasive, results in less intraoperative and postoperative pain, and has a short treatment time followed by fast and favorable wound healing, as well as excellent esthetic improvement.…”

Section: Difference From Conventional Methodsmentioning

confidence: 99%

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Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery

et al. 2022

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Purpose: This article describes a novel, minimally invasive procedure called Er:YAG laser micro-keyhole surgery (EL-MIKS) that removes metal or amalgam tattoos in the gingiva adjacent to prosthetic teeth without gingival deformity and recession. We aimed to evaluate the clinical efficacy of EL-MIKS for removing metal tattoos and present its long-term treatment outcomes. Methods: The EL-MIKS procedure consists of several steps that are all performed under a microscope. First, a micro-keyhole (1-2 mm diameter) was prepared using an Er:YAG laser in the center of the metal pigmentation. The connective tissue was evaporated in the deep layer, where metal debris was deposited. Second, within the accessible range, the irradiation angle was changed in various directions to ablate the metal pieces and discolored connective tissue without enlarging the keyhole. Finally, after blood filled the space created by the tissue evaporation, the surface of the blood clot at the entrance of the micro-keyhole was thermally coagulated with defocus laser irradiation. Pigmentation that could not be successfully removed from a single micro-keyhole was treated by forming new micro-keyholes at a distance of 3 mm or more from each previously created hole. Depigmentation over an extended area was completed over a few sessions every 4 weeks without gingival recession after surgery. Conclusions: EL-MIKS, a novel depigmentation technique, was able to successfully remove an extended area of metal tattoos in the gingiva using a simpler, easier, and less invasive procedure than conventional periodontal plastic surgery. Esthetic restoration was successfully achieved without postoperative alteration of the gingival contour.

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Section: Difference From Conventional Methodsmentioning

confidence: 99%

“…However, few studies have been conducted on the removal of metal tattoos. Furthermore, while studies on periodontal plastic surgery have reported methods, such as the use of free gingival grafts [7] and connective tissue grafts [8][9][10] to remove metal tattoos, optimal treatments have not been well studied or established.…”

Section: Introductionmentioning

confidence: 99%

Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery

et al. 2022

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“…Despite awareness about this phenomenon for many years, 10 treatment methods are yet to be established, because of difficulties associated with treatment procedures and the lack of suitable instruments. Previous case studies' findings have shown that surgical treatments to remove pigmented gingiva, namely, connective tissue grafts (CTGs) 11‐13 and free gingival grafts (FGGs), 14 are invasive, complicated, and not always effective at removing tattoos, and these procedures are associated with risks, including postsurgical gingival recession and defects.…”

Section: Introductionmentioning

confidence: 99%

A novel minimally‐invasive approach for metal tattoo removal with Er:YAG laser

Mikami

Mizutani

Nagai

et al. 2021

J Esthet Restor Dent

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Objective: Few effective and established treatment methods can remove gingival metal or amalgam tattoos. With this case series, we aimed to demonstrate the use of a novel minimally invasive technique to remove metal tattoos using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Materials and Methods:We retrospectively collected clinical data from 18 patients who had undergone Er:YAG laser treatment to remove metal tattoos. Minimal gingival ablation using an Er:YAG laser directed towards the pigmented area was performed, which exposed metal debris within the connective tissue that was carefully removed. A dental microscope was employed to identify the metal debris, for accurate irradiation, and to minimize wounding by reducing invasion. Postoperative gingival color and morphology, and visual analog scale as a patient-reported outcome assessing postoperative pain were evaluated.Results: All patients' metal tattoos were removed completely and safely during short procedures. Considerable esthetic improvements and favorable wound healing were achieved with almost no postoperative pain or complications. Conclusion:The findings from this case series suggest that this novel minimally invasive therapy for metal tattoo removal that involved the Er:YAG laser is effective and safe, is associated with successful outcomes, and contributes greatly to patients' esthetic satisfaction.Clinical Significance: Metal tattoo removal using an Er:YAG laser safely and successfully improved gingival esthetics. This novel technique is much simpler and less invasive than conventional periodontal plastic surgery, and it may be more reliable regarding esthetic gingival improvements as it is associated with favorable wound healing, and it could offer significant benefits to patients by alleviating physical and mental stresses via reduced chair time and postoperative pain.

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“…Two techniques to address this problem will be discussed: Masking of the tattoo with a keratinized gingival graft (KGG), 16 and removal following treatment with a connective tissue graft (CTG). [17][18][19][20]…”

Section: Introductionmentioning

confidence: 99%

“…Usually these pigmentations are only a concern for the patient when the tattoo is in their smile zone. Two techniques to address this problem will be discussed: Masking of the tattoo with a keratinized gingival graft (KGG), 16 and removal following treatment with a connective tissue graft (CTG) 17‐20 …”

Section: Introductionmentioning

confidence: 99%

Treatment of the amalgam tattoo in the esthetic zone

Mathews

2020

J Esthet Restor Dent

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Objective: When pigmentations appeared in the esthetic zone and were visible during the patient's smile, they were very disconcerting. There are multiple techniques to eradicate or ameliorate these discolorations. This article will address those pigmentations caused by amalgam particles. Clinical considerations: Keratinized gingival grafts were used to cover and mask these pigmentations. In addition, connective tissue grafts were used to aid in the elimination of the external pigmentation. Conclusions: Both techniques were shown to be very effective in masking or eliminating these unesthetic pigmentations. Long-term follow-up has shown these results to be stable with no recurrence of the pigmentation. Clinical significance: Unesthetic pigmentations in the esthetic zone that are visible during a patient's smile are very disconcerting. Elimination of these unesthetic discolorations can make a dramatic improvement in the patient's smile.

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Treatment of Amalgam Tattoo With a New Technique: Mucoabrasion and Free Connective Tissue Graft

Cited by 6 publications

References 9 publications

Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery

Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery

A novel minimally‐invasive approach for metal tattoo removal with Er:YAG laser

Treatment of the amalgam tattoo in the esthetic zone

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