Histologic evaluation of gingival response to an electrosurgical blade

Comparative Analysis of Radiosurgery and Scalpel Blade Surgery in Impacted Mandibular Third Molar Incisions: a Clinical Trial

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.

Application of platelet rich fibrin for management of an electrosurge induced osteonecrosis involving maxillary alveolus

BACKGROUND

Application of principles of electrocautery for hemostasis dates back to prehistoric times. Its modern implementation in various fields of general and head and neck surgeries have been well documented. However its usage in minor oral surgical procedures has gained popularity only recently. Complications associated with electro-surgery in the dental field are relatively rare and there is insufficient literature on its management.

CASE REPORT

We present a case report on management of an electrosurgery induced osteonecrosis involving maxillary alveolus of left premolars.

DISCUSSION

Inadvertent contact of the electrosurgery tip on bone can result in necrosis making it necessary to remove the sequestrum and graft the defect. Platelet rich fibrin in combination with bone grafts have been well documented to provide successful periodontal regeneration.

CLINICAL IMPLICATIONS

Our aim of presenting this report is to create awareness among the health care providers regarding electrosurgical injuries. To our knowledge, this is the first time platelet rich fibrin has been used in the management of intraoral electrosurgical injury. Combining bone grafts with platelet rich fibrin is a good alternative as it can be done with relative ease and predictable outcome.

Comparison between electrosurgery and cold blade in tongues of rats: a preliminary experimental study

PURPOSE

To compare tissue cicatrization in the tongue of rats using electrosurgery and the cold blade.

METHODS

Ten adult male Wistar rats were divided into two groups of 5 animals each, according to the time of sacrifice (3 and 7 days). Each animal had two incisions, one made with a cold blade and the other with an electric blade, both of which were approximately 0.5 mm in length. Following sacrifice of the animals, the tongues were submitted to a histological study in order to classify the presence of angiogenesis, fibroblastic proliferation, epithelial proliferation and inflammatory cells as good, moderate and weak.

RESULTS

The wound made with electric blade presented a delay in the healing process and a greater inflammatory response as compared with the cold blade, despite the fact that there was no statistically significant difference (p<0.05).

CONCLUSION

There were no significant statistical differences between electrosurgery and the cold blade in relation to angiogenesis, fibroblastic proliferation, epithelial proliferation or the presence of inflammatory cells at any time of evaluation.

Favorable Tissue Effects of Quantum Molecular Resonance Device (Vesalius®) Compared with Standard Electrocautery

BACKGROUND

Electrosurgical devices are largely employed in thoracic surgery but their use is burdened by extensive necrosis and second intention healing.

METHODS

A rat model of thoracotomy was performed on 46 adult male rats using a standard electrocautery or a new quantum molecular resonance (QMR) instrument called Vesalius. Skin, muscle and lung specimens were obtained immediately and 2 weeks after surgery to evaluate acute and late effects.

RESULTS

Both in the short- and long-term study, Vesalius produced less severe tissue damage than that of standard electrocautery.

CONCLUSIONS

The use of the QMR device may provide an alternative to gold-standard electrosurgical devices in thoracic surgery.

Patient "grounding"

Dispersive electrodes are often neglected or misused in electrosurgery. A dispersive electrode can increase electrosurgical safety and effectiveness. If misused, however, it can become the source of patient injury. The following article summarizes the proper use of dispersive electrodes and differentiates them from actual grounding.