Thursday, January 19, 2017

Oral Radiosurgery: CSI--no13

Centers for Oral Care
No. 13 -- 19Jan2017
Fellow of the Academy of Veterinary Dentistry

Oral Radiosurgery: CSI
As veterinary oral surgeons we face "CSI" situations within the oral cavity each and every day of our clinical lives. There is no subjective pain and not always a direct pathway to the pain site. We must use all of our senses, diagnostic tools, and history data from the client-advocate to make a diagnosis and treatment decision.
The main diagnostic tool of the oral surgeon is oral radiology1 . Detailed extra and intra oral exams must also be completed to elucidate areas of pathology.
Once a treatment algorithm is initiated and surgery is found to be indicated, the best technology must be on site to provide both excellent cutting and coagulation with rapid local hemostasis. The surgical-cutting technology must be versatile with minimal trauma to the patient. Radiosurgery produces a virtually bloodless incision. The Ellman 4.0 MHz Dual-Frequency Surgitron Radiowave Radiosurgery patented Technology2 accomplishes all of these tasks. This high frequency-low temperature equipment is fully digital and allows the veterinarian to change wavelengths with the touch of a button on the handpiece. A foot pedal control system is also available if desired by the operator.
Radiowave radiosurgery has been coined by some as 'the other laser.' I prefer to respect it, in my opinion, as 'better than' cold steel or lasers. First and foremost it is safe for the surgeon, staff, and patient. It is cost effective. Healing is accelerated with less swelling and edema occurring at the surgery site. With all new technology, there is a learning curve. Once this minimal period of understanding is accomplished, the operator will see the advantages, first hand, of Radiowave Radiosurgery in cutting, cutting and coagulation, and bipolar hemostasis. The clear field of vision provided with this cutting modality accelerates surgery time and therefore decreases the time of the patient under general anesthesia.
This Journal will feature oral technology advancements using Radiowave Radiosurgery but will also show non-oral procedures and the versatility of Radiosurgery technology. It will be showcased in general surgery, ophthalmic surgery, dermatologic techniques, avian and exotic applications, and ER and Critical Care situations.

Table One: Indications for Radiowave Radiosurgery in Dentistry and Oral Surgery
  • Simple Gingivectomy and Gingivoplasty
  • Oral Biopsy
  • Exodontal with Full Thickness Mucoperiosteal Flap creation
  • Epulis removal
  • Tonsillectomies
  • Frenectomy
  • Periodontal Surgery
  • Oral Tumors or Cyst Removal
  • Lingual Surgery and Biopsy
  • Palatal Surgery and Biopsy
  • Establishing Hemostasis in the Oral Cavity
  • Tissue Planing
  • Operculectomy-removal of overgrowth of fibrous tissue over the occlusal surface of an embedded tooth
  • Excision of Oral Granulomatous Tissue
  • Veterinary Prosthodontics-Crown lengthening and "trough" procedures for crown impressions
  • Oral Abscess incision and drainage
  • Subgingival Decay exposure and the placement of a class V-restoration
Table Two: Active Electrode or Insert Variety in Ellman Surgitron 4.0 MHz Dual Frequency Technology
  • Vari-Tip #118 Electrode-This electrode has the greatest versatility because the tungsten wire cutting length can be varied for the surgical application being performed. For the oral surgeon, the controlled cutting depth is critical in oral anatomy sites where cutting is in major juxtaposition to major blood vessels.
  • U Shaped Electrodes #104-108-these electrodes are excellent for gingival recontouring and in tissue planing
  • Loop electrodes and Loop Round Electrodes #121/122/126/129/130-excellent for biopsy techniques and in gingival collar planing techniques
  • Operculectomy electrode #132-used for impacted, embedded and/or entrapped dentition
  • Coagulation of soft tissues-electrodes #135-136-113F-117
  • J1 Bipolar Forceps-provides pinpoint coagulation; helpful in distal oropharynx, tonsillar area, or to control hemostasis in toy breeds and felines in difficult areas to approach in the oral cavity.
1 An Atlas of Veterinary Dental Radiology, Second Edition-DH DeForge, Editor-Sheridan Books, Inc.-Brooklyn BookWorks, LLC (Available at

2 Dr. DeForge is an independent clinical investigator and has no contractual commitments or relationship with any manufacturer, distributor, or corporation. He has been a leader in the veterinary application of Radiosurgery Techniques in Oral Surgery. He shares equipment information that is state of the art with other veterinary surgeons.

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