Histologic Effects of Electrosurgery Device on Dental Soft Tissue

Objectives: To evaluate the soft tissue histologic cutting and coagulation effects of radiosurgery in comparison to historical laser data.   Methods: Cutting and coagulation using a porcine tongue in vitro model was achieved using a radiosurgery device at different settings.  Independent variables were mega hertz (mHz), tip type, setting, and power (watts, W).  3.8mHz and 4.0 mHz, cut, cut/coag or coag settings between 1.75 and 5.75W, with straight wire, ball and loop tips were tested (n=39) (Dento-Surg Radiolase II, Ellman International, Oceanside, NY).  Utilizing fresh porcine tongue, a trained radiosurgery practitioner performed incisions with the objective to remove epithelium to the basement membrane.  The tissue was bioprepared, sectioned and stained with hematoxylin and eosin.  Quantitative measurements were made on representative sections (n=3 for each parameter), using light microscopy and a measuring microscope to determine the width and depth of tissue removed, the lateral and deep coagulation effects of the borders of the incision. Statistical analysis was performed using multifactor randomized ANOVA design (p≤0.05).  Data was also plotted with 95% confidence intervals so that trends comparing to our extensive histologic data base for lasers could be made.  Results:  There was no significant difference between 3.8 and 4.0 mHz for width and depth of cut and coagulation.  As expected, the ball and loop tips had wider cutting than the straight wire tip and fiber optic delivered lasers.  Cut depth correlated to the length of the exposed wire tip.  The mean pool effect for radiosurgery depth: cut<coag<cut/coag. In comparison with our historical laser data, the radiosurgery device had a depth of cut approximately 2 times deeper with the same degree of coagulation.  Conclusions:  Radiosurgery cuts deeper and wider than lasers related to tip size, with the same degree of coagulation.  This study supported in part by a grant from Ellman International.