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Nagargoje GL, Badal S, Mohiuddin SA, Balkunde AS, Jadhav SS, Bholane DR. Evaluation of Electrocautery and Stainless Steel Scalpel in Oral Mucoperiosteal Incision for Mandibular Anterior Fracture. Ann Maxillofac Surg 2019; 9:230-234. [PMID: 31908999 PMCID: PMC6933970 DOI: 10.4103/ams.ams_158_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Traditionally, mucosal incisions are made by stainless steel scalpel due to its ease of use, accuracy, and minimal tissue damage effect, but these incisions are more bloody and painful. To obviate the inherent disadvantages of scalpel, surgical diathermy was introduced at the beginning of the 20th century. Aim and Objectives: The study aimed to compare the efficacy of electrocautery and stainless steel scalpel in oral mucoperiosteal incisions in terms of time taken for incision, blood loss, pain, edema, and healing for mandibular symphysis or parasymphysis fracture. Materials and Methods: Forty patients who reported to the Department of Oral and Maxillofacial Surgery between December 2015 and November 2017 with symphysis or parasymphysis fracture were divided into two groups by randomized envelope method. Results: The mean time taken and mean blood loss for electrocautery were less than that of stainless steel scalpel. The postoperative pain was significantly reduced at 24 h, 48 h, and 1 week in the diathermy group as compared to the scalpel group. At 24 h and 48 h, the extraoral edema measured was not significant. Wound healing at 24 h and 48 h was better in the scalpel group as compared to the electrocautery group. Conclusion: From present study, we can conclude that electrocautery is better than stainless steel scalpel in relation to time taken for incision, intraoperative blood loss and postoperative pain.
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Affiliation(s)
- Gopal Lahudas Nagargoje
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
| | - Sheeraz Badal
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
| | - Syed Ahmed Mohiuddin
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
| | - Arunachaleshwar Somnath Balkunde
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
| | - Swati Suresh Jadhav
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
| | - Dnyandeep Ramkrushna Bholane
- Department of Oral and Maxillofacial Surgery, Maharashtra Institute of Dental Science and Research Center, Latur, Maharashtra, India
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Comparative Analysis of Radiosurgery and Scalpel Blade Surgery in Impacted Mandibular Third Molar Incisions: a Clinical Trial. J Maxillofac Oral Surg 2018; 17:458-465. [PMID: 30344388 DOI: 10.1007/s12663-017-1071-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 12/08/2017] [Indexed: 01/09/2023] Open
Abstract
Aims This study aims to compare the outcome of radiosurgically assisted incision technique with the conventional scalpel blade technique in impacted mandibular third molar incisions. Methods On 100 patients (50 patients each in GROUP R and GROUP S) with impacted mandibular third molar, incisions were given using radio surgical and scalpel technique, respectively. Impacted third molars were classified according to Winter's classification. Two types of incisions (Ward's and modified Ward's) were performed. Results were evaluated considering various parameters like surgical ease, field of surgery, odour, bleeding, discomfort/pain, post-operative analgesic intake and healing in both groups. Results In our study, mean age of patient was 25.30 years, 54% were females and 46% males; mesioangular was the most common type of impaction, and the average length of incision was 3.105 ± 0.546 cm. There was a significant statistical difference (p < 0.01) in the five measure moments (field of surgery, surgical ease, intra-operative bleeding, odour and post-operative analgesic intake at 3-5th day) between the impacted molars operated with scalpel and the ones done with radiosurgery. There was statistically insignificant difference in pain/discomfort, healing and post-operative analgesic intake at 1st and 7-10th day. Conclusions Radiosurgery was very effective in providing clear field of surgery, surgical ease and created less intra-operative bleeding than scalpel blade surgery making day to day minor oral surgery less stress full and productive.
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Gual-Vaqués P, Jané-Salas E, Egido-Moreno S, Ayuso-Montero R, Marí-Roig A, López-López J. Inflammatory papillary hyperplasia: A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e36-e42. [PMID: 27918740 PMCID: PMC5217495 DOI: 10.4317/medoral.21405] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 11/03/2016] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. OBJECTIVES The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. MATERIAL AND METHODS A search was carried out in PubMed (January 2005 to October 2015) with the key words "inflammatory papillary hyperplasia", "denture stomatitis", "granular stomatitis" and "Newton's type III" The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. RESULTS Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. CONCLUSIONS IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among non-denture-wearers is extremely unusual.
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Affiliation(s)
- P Gual-Vaqués
- University Campus of Bellvitge, Pabellón de Gobierno, 2nd floor, office 2:29, Feixa Llarga, s/n 08907, L'Hospitalet de Llobregat, Barcelona, España,
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Hasar ZB, Ozmeric N, Ozdemir B, Gökmenoğlu C, Baris E, Altan G, Kahraman S. Comparison of Radiofrequency and Electrocautery With Conventional Scalpel Incisions. J Oral Maxillofac Surg 2016; 74:2136-2141. [PMID: 27424067 DOI: 10.1016/j.joms.2016.06.172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/10/2016] [Accepted: 06/12/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE The disadvantages of conventional scalpels, including insufficient control of bleeding, prompted us to search for new alternative methods such as electrosurgery and radiosurgery. In this study, the conventional scalpel was compared with radiosurgery and electrosurgery for wound healing with assessment of lateral heat production, inflammation, and instrument performance. MATERIALS AND METHODS Incisions were made in the palatal mucosa of 42 Wistar rats using a scalpel, electrocautery instrument, or radiofrequency instrument. Postoperative hemostasis, tissue coagulation, and tissue sticking were measured, and pain evaluation through weight loss was recorded. Gingival biopsy specimens from the surgical area were obtained at the time of surgery and 2, 4, 7, and 14 days postoperatively and were evaluated immunohistochemically for inducible nitric oxide synthase and heat shock protein 70. Kruskal-Wallis, 1-way analysis of variance, and Mann-Whitney U tests were used for statistical evaluation. RESULTS The rats in the electrosurgery and radiosurgery groups had aggressively greater weight loss when compared with the scalpel group in the first 7 days. Hemostasis was better in the electrocautery group, tissue coagulation was greater in the radiofrequency group (P < .001), and tissue sticking was lesser in the scalpel group (P < .001) compared with the other groups. Inducible nitric oxide synthase expression and heat shock protein 70 expression were similar in all 3 groups. CONCLUSIONS Electrosurgery performed better regarding hemostasis, whereas a scalpel was superior in terms of tissue sticking and tissue coagulation. Radiosurgery was superior regarding hemostasis when compared with a conventional scalpel, but it was not as successful as electrosurgery.
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Affiliation(s)
| | - Nurdan Ozmeric
- Professor, Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey.
| | - Burcu Ozdemir
- Associate Professor, Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Ceren Gökmenoğlu
- Assistant Professor, Department of Periodontology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Emre Baris
- Associate Professor, Department of Oral Pathology, Gazi University Faculty of Dentistry, Ankara, Turkey
| | - Gökçen Altan
- Specialist, Etimesgut Oral and Dental Health Center, Ankara, Turkey
| | - Sevil Kahraman
- Associate Professor, Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, Ankara, Turkey
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Manivannan N, Ahathya RS, Rajaram PC. Scalpel versus electrosurgery: Comparison of gingival perfusion status using ultrasound Doppler flowmetry. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2013; 5:S154-9. [PMID: 23956596 PMCID: PMC3740665 DOI: 10.4103/0975-7406.114317] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 05/24/2013] [Accepted: 05/24/2013] [Indexed: 11/20/2022] Open
Abstract
The main prerequisites of any surgical procedure are achievement of good visibility and access to the site with minimal bleeding and rapid and painless healing. With the advancement of technology the armamentarium for oral surgical procedures has also widened. The use of alternate methods to the traditional scalpel such as electrosurgery, laser, and chemicals has been widely experimented with. This article aims to report the gingival perfusion pre-operatively and post-operatively, comparing the use of scalpel and electrosurgery in different anatomic sites in patient. Since wound healing is influenced by its revascularization rate, which follows the pattern of new connective tissue formation, the perfusion status of the gingiva has been studied using ultrasound spectral Doppler. The results of our study show that there was 30% more blood flow by 7(th) day, 19% more blood flow by 15(th) day and 11% more blood flow by 30(th) day in sites where the scalpel was used compared with sites where electrosurgery technique was used.
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Affiliation(s)
- N. Manivannan
- Department of Oral and Maxillofacial Surgery, Vivekananda Dental College for Woman, Tiruchengodu, Namakkal, Tamil Nadu, India
| | - R. S. Ahathya
- Department of Periodontics, Vivekananda Dental College for Woman, Tiruchengodu, Namakkal, Tamil Nadu, India
| | - P. C. Rajaram
- Department of Radiology and Imaging, Meenakshi General Hospital, Chennai, Tamil Nadu, India
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Inflammatory papillary hyperplasia of the palate: Treatment with carbon dioxide laser, followed by restoration with an implant-supported prosthesis. Br J Oral Maxillofac Surg 2007; 45:658-60. [DOI: 10.1016/j.bjoms.2006.08.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2006] [Indexed: 11/23/2022]
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Salonen MA, Raustia AM, Oikarinen KS. Effect of treatment of palatal inflammatory papillary hyperplasia with local and systemic antifungal agents accompanied by renewal of complete dentures. Acta Odontol Scand 1996; 54:87-91. [PMID: 8739138 DOI: 10.3109/00016359609006010] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to estimate the effect of local and systemic antifungal treatment, accompanied by renewal of complete dentures, on palatal inflammatory papillary hyperplasia (PIPH). The treatment groups consisted of 26 subjects treated with a local antifungal agent (miconazole, 2% gel) for 4 weeks and 13 subjects treated with a systemic antifungal agent (fluconazole, 50 mg) for 2 weeks (test groups). Ten subjects fitted with new complete dentures served as a control group. Variables examined before antifungal and prosthetic treatment included estimation of the size and color of the affected palatal area, measurements of the lengths of the papillae, and salivary variables. Six months after the completion of prosthetic treatment healing was determined as disappearance or marked reduction of the redness of the PIPH. Healing was more often observed in test groups (64%) than in the control group (20%) (p = 0.012). Fifty-eight per cent of the subjects treated with a local (miconazole, 2%) and 77% of those treated with a systemic (fluconazole, 50 mg) antifungal agent were healed. Even though papillary hyperplastic tissue did not disappear, the treatment of PIPH with an antifungal agent without surgery before renewal of dentures might be an alternative treatment in mild cases.
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Affiliation(s)
- M A Salonen
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Oulu, Finland
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Abstract
Electrosurgery has been used in dentistry for more than 50 years. Both opponents and advocates of electrosurgery have presented a variety of clinical studies in favour of their respective opinions, which are discussed in the following review. In some studies, wounds created by electrosurgical techniques were observed through the healing stages, in comparison to those following incision by a surgical blade, with no significant difference being discovered. Other studies reported that the histologic response of oral connective tissue to electrosurgery was adverse in some animal and human models. However, neither of these groups used methods that allowed documentation or control of operating variables. A critical evaluation of controlled clinical studies shows that adverse responses of (connective) tissue, epithelium, bone, cementum, and periodontal attachment are related to an excessive lateral heat production during the procedure. With electrosurgery, the clinician can control the inherent variables. Waveform, frequency, size of the electrode, time of contact and cooling periods are some of those considered to be of importance in the studies. On the basis of the research reports, clinical guidelines have been developed to give practical advice to the clinician using electrosurgery. Providing that these safeguards are adhered to, scientific evidence supports the biological compatibility of electrosurgery for intraoral surgical procedures.
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Affiliation(s)
- R F Krejci
- Adult Restorative Dentistry, University of Nebraska Medical Center, College of Dentistry
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