Punch Biopsy

Do not rotate the cutting edge on a gingival biopsy.

Figure 6. The Punch Biopsy.
ce481-fig06-punch-biopsy
Usually the selected instrument is 4-6 mm in diameter.
Figure 7. Steps in a gingival punch biopsy.
ce481-fig07a-gingival-punch-biopsy
ce481-fig07b-gingival-punch-biopsy
ce481-fig07c-gingival-punch-biopsy
ce481-fig07d-gingival-punch-biopsy
The instrument is placed and gently rotated until bone is reached. The separated tissue must then be undermined for removal.

Punch biopsy techniques have been suggested by Eisen and others as a useful technique for gingival biopsies, possibly because there is only a minimal lateral shearing force applied when using this method.24,50,81,85,97 However, the described technique recommends a rotational force during the instrument insertion which may inadvertently exert a lateral shearing force. Using the punch technique for DG biopsies is probably suitable since it may be possible to avoid the rotational movement due to the thinnest of the gingiva and the ease of penetration to bone. To date, however, there are no studies that confirm the punch technique is superior to conventional scalpel techniques on gingiva.