References

Sumit S, Gambhir R, Singh S Radiosurgery in dentistry – a brief review. Ann Dent Res. 2012; 2:8-20
Bashetty K, Nadig G, Kapoor S. Electrosurgery in aesthetic and restorative dentistry: a literature review and case reports. J Conserv Dent. 2009; 12:139-144 https://doi.org/10.4103/0972-0707.58332
Krejci RF, Kalkwarf KL, Kruse-Hohenstein U. Electrosurgery – a biologic approach. J Clin Periodontol. 1987; 14:557-563 https://doi.org/10.1111/j.1600-051x.1987.tb01516.x
Williams VD. Electrosurgery and wound healing: a review of the literature. J Am Dent Assoc. 1984; 108:220-222 https://doi.org/10.14219/jada.archive.1984.0468
Vilos GA, Rajakumar C. Electrosurgical generators and monopolar and bipolar electrosurgery. J Minim Invasive Gynecol. 2013; 20:279-287 https://doi.org/10.1016/j.jmig.2013.02.013
Kalkwarf KL, Krejci RF, Edison AR, Reinhardt PA. Lateral heat production secondary to electrosurgery incisions. Oral Surg Oral Med Oral Path. 1983; 55:344-348 https://doi.org/10.1016/0030-4220(83)90186-x
Rathofer SA, Gardner FM, Vermilyea SG. A comparison of healing and pain following excision of inflammatory papillary hyperplasia with electrosurgery and blade-loop knives in human patients. Oral Surg Oral Med Oral Path. 1985; 59:130-135 https://doi.org/10.1016/0030-4220(85)90003-9
Liboon J, Funkhouser W, Terris DJ. A comparison of mucosal incisions made by scalpel, CO2 laser, electrocautery and constant voltage electrocautery. Otolaryngol Head Neck Surg. 1997; 116:379-385 https://doi.org/10.1016/s0194-5998(97)70277-8
Kalia V, Siddiqui N, Kalra G. Comparative analysis of radio surgery and scalpel blade surgery in impacted third molar incisions: a clinical trial. J Maxillofac Oral Surg. 2018; 17:458-465 https://doi.org/10.1007/s12663-017-1071-2
Sherman JA. Oral surgery simplified with radiosurgery. Dent Today. 2008; 27:123-124
Wilcox CW, Wilwerding TM, Watson P, Morris JT. Use of electrosurgery and lasers in the presence of dental implants. Int J Oral Maxillofac Implant. 2001; 16:578-582
Tom J. Management of patients with cardiovascular implantable electronic devices in dental, oral and maxillofacial surgery. Anesth Prog. 2016; 63:95-104 https://doi.org/10.2344/0003-3006-63.2.95.
Sherman J. Oral Radiosurgery: An Illustrated Guide, 3rd edn. London: Martin Dunitz; 2006
Waljee JF, Malay S, Chung K. Sharps injuries: the risks and relevance to plastic surgeons. Plast Reconstr Surg. 2013; 131:784-791 https://doi.org/10.1097/PRS.0b013e3182818bae
Lorenzi C, Arcuri L, Lio F Radiosurgery in dentistry: a review. Clin Ter. 2019; 170:e48-54 https://doi.org/10.7417/CT.2019.2107
Noble WH, McClatchey KD, Douglass GD. A histologic comparison of effects of electrosurgical resection using different electrodes. J Prosthet Dent. 1976; 35:575-579
Kalkwarf KL, Krejci RF, Shaw DH. Histologic evaluation of gingival response to electrosurgical blade. J Oral Maxillofac Surg. 1987; 45:671-674 https://doi.org/10.1016/0278-2391(87)90305-3.
Yalamanchili PS, Surapaneni Davanapelly P Electrosurgical applications in dentistry. Sch J App Med Sci. 2013; 1:530-534
Kalkwarf KL, Krejci RF, Shaw DH. Subjacent heat production during tissue excision with electrosurgery. J Oral Maxillofac Surg. 1983; 41:653-657
Buzina DS, Lipozencic J. Electrosurgery – have we forgotten it?. Acta Dermatovenerol Croat. 2007; 15:96-102
Robertson PB, Luscher B, Spangberg LS, Levy BM. Pulpal and periodontal effects of electrosurgery involving cervical metallic restorations. Oral Surg Oral Med Oral Path. 1978; 46:702-710 https://doi.org/10.1016/0030-4220(78)90467-x
Krejci RF, Reinhardt RA, Wentz FM Effects of electrosurgery on dog pulps under cervical metallic restorations. Oral Surg Oral Med Oral Path. 1982; 54:575-582 https://doi.org/10.1016/0030-4220(82)90197-9
British Cochlear Implant Group. Safety for cochlear implant users. 2020. http://www.bcig.org.uk/safety/ (accessed March 2021)
Pisano P, Mazzola JG, Tassiopoulos A, Romanos GE. Electrosurgery and ultrasonics on patients with implantable cardiac devices: evidence of side effects in dental practice. Quintessence Int. 2016; 47:151-160
Roedig JJ, Shah J, Eli CS, Miller CS. Interference of cardiac pacemakers and implantable cardioverter-defibrillator activity during electronic dental device use. J Am Dent Assoc. 2010; 141:521-526
Ochsenbein C, Ross S. A re-evaluation of osseous surgery. Dent Clin North Am. 1969; 13:87-102
Ahmad I. Anterior dental aesthetics: ginigival perspective. Br Dent J. 2005; 199:195-202 https://doi.org/10.1038/sj.bdj.4812611
Gargiulo A, Wentz F, Orban B. Dimensions and relations of dentogingival junction in humans. J Periodontol. 1961; 32:261-267
Baba N, Goodacre C, Jekki R, Wom J. Gingival displacement for impression making in fixed prosthodontics. Contemporary principles, materials and techniques. Dent Clin N Am. 2014; 58:45-68 https://doi.org/10.1016/j.cden.2013.09.002

Radiosurgery: A Forgotten Tool?

From Volume 48, Issue 5, May 2021 | Pages 369-376

Authors

Timothy Brown

BDS, MJDF

Specialty Dentist, Dundee Dental Hospital and School

Articles by Timothy Brown

Email Timothy Brown

Martin Donachie

BDS, MDS, FDSRCS, DRDRCS, MRDRCS, FDS(Rest Dent)RCS

Consultant Restorative Dentistry, Aberdeen Dental Hospital and Institute of Dentistry

Articles by Martin Donachie

Abstract

Radiosurgery allows precise tissue cutting with simultaneous haemostasis, providing a clearer surgical field. Variation in waveform, power settings and handpiece tip shape allow for a wide variety of clinical applications, making it one of the most versatile pieces of surgical equipment in the dentist's arsenal. However, it is one of the most underused, and probably misunderstood, areas of surgery in dentistry. This may be due to conflicting literature concerning healing, overshadowing of the value of the technique by interest in dental lasers, misuse of terminology and a general lack of knowledge regarding the science underpinning its action.

CPD/Clinical Relevance: This article aims to outline the mode of action, adjustable parameters and considerations for the safe use of radiosurgery alongside clinical examples of its applications.

Article

Despite improvements and advances in radiosurgery equipment over the years, the use of this surgical technique has remained relatively static in the dental community.1 Some reasons suggested for this have included the rise of the laser in dentistry, which has overlapping uses, but higher initial costs, along with historically conflicting literature over post-operative wound healing following radiosurgery.2 However, later research has demonstrated that concerns regarding adverse healing results were unwarranted when radiosurgery was used appropriately (Figure 1a, b).3,4

The authors of this article also feel that confusion with terminology, and a general lack of understanding of the mode of action, are other potential factors contributing to the reluctance to use radiosurgery. Limited knowledge of the scientific theory behind radiosurgery is common, and is not limited to dentists, with surgeons of all disciplines also admitting a lack of understanding of this technology despite its widespread use in operating theatres.5 This is not aided by the misuse of terminology, with diathermy, electrocautery, electrosurgery and radiosurgery being used synonymously, despite their having distinct modes of action, clinical properties and applications.

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