Incision Versus Coagulation

“Without the Versus”

THE OSCILLATION CURRENT –INCISION

The oscillation or “double effect current” is coagulation reduced, refined and blended with incision. The two, in one current, in one electrode, acting simultaneously, with the ability to “pick up,” shred out or scoop tissue in minute particles or with a cutting movement (just a change of motion only in fingers) producing the effect of incising tissue. The incision current was absolutely an after development following the limited showing of coagulation in the field o surgery. The newer current has made amazing advances, and attained high efficiency especially since the years of 1928 and 1929, and is so far in advance of coagulation, that they should not be compared for results or action. So you see, it’s simple New to Dentistry.

THE COAGULATION CURRENT

Any surgeon will tell you the restrictions of coagulation have been known for years, in fact, this is exactly what brought about the production of the oscillation or incision current. This current is capable of doing so many things in the oral tissues that you cannot do with coagulation. It will accomplish everything that you can with the other current, and will give a much better result with a nicer healing period, without bother at the time of operating or following. Coagulation goes deeper into tissue that the incision approach (coagulation effect of latter) because there is no denying- “Coagulation is Coagulation”, where the “side flare” of coagulation has been brought into a straighter line and better controlled in the oscillation or incision type.

OPERATING FOR PYORRHEA

Patients will not care for coagulation (boiling tissue in its own juice) when the other current is better known and can be had, and pronounced by World Lead Surgeons to be less of a surgical insult to tissues than coagulation, and causes a wound healing by first intention. There is practically no initial bother to the patient, to speak of, and it gives absolutely no after trouble with the size needle and technique I employ. Neither will they care for grinding and chiseling away of additional bone support with scalpel operating (knife) plus removal of so much good healthy outer unaffected gum tissue, when the electro incision method cuts this procedure down to the vanishing point. It limits the operating to the diseased area entirely –the disease itself.

I would like to see brought out from any source, a comparison to parallel this article, and by preceding issues, in defense of any point of merit of operating that the coagulation current for a pyorrhea pocket has, to compare with the newer application, the incision current, and its procedure as brought out by myself covering a similar phase, in the oral tissue region, as well as others.

AND HERE

We have one dental surgeon of note, Dr. Joseph Anthony Hopkins, D.D.S., of Rockford, III., of whom I wish to state, that he discarded the coagulation current for Pyorrhea and Oral Surgery in the year 1929, after a very extensive try out of both the coagulation and Radio Knife currents. He did not write it up, though Dr. Webb came out in 1935 as a new technique or “discovery”. Dr. Hopkins immediately took up the Radio Knife (incision current) and has employed it ever since. He greatly prefers it over coagulation. Dr. Hopkins showed it at the National meeting along with the knife at the Chicago Meeting August 12, 1933. The Dental Digest of August, 1934 contained his surgical technique with the Radio Knife. Dr. Hopkins uses the typical Radio Knife blade, some what parallels the Black or Ward methods, in his technique. My operating from the Radio Knife lead differs from all others, in that in 78% average or so, I “conceal” or confine al effects of the needle between the two gingivae of that pocket. I am absolutely in the pocket itself; therefore an “inside job”. This full technique and other phases (Chapman) are shown in the March, 1937 issue of The Dental Digest. This is the first suggestion of real surgery confined to the pocket, contents, as you operate. There is no bone curettage required, and in deep pockets (flap removal) all you do is lightly scrape out just the inner pocket contents.

Wait until you have experienced the feel of the oscillation current which “speaks for itself”. Would you go back today to a crystal set, peanut tube, earphones, black rubber horn? I’ll say you wouldn’t, because we have something better now. Well, this is my third attempt to tell you of Something Better. Yes –The Radio Knife –and a very tiny curved needle point electrode. And think of the “daring”, reminds you of “The Man On The Flying Trapeze”. Imagine, touching a bit of gum tissue with the same instrument, current, or electrode that a surgeon would use to operate the brain, cornea and retina. Take your choice, double or single point. My preference is a single point. My preference is a single needle point. Any needle that I have seen so far is much too large. I take the needle, as supplied by the manufacturer, and taper it down so finely, that even as it pierces a gingiva to the inner side, it still will be surrounded by soft tissue. The incision current picks up tissue quickly, you must cleanse the needle now, as you have no further action with a clogged needle point. Its action is thus “self limited”. I’ve “single pointed” with electric modalities for some fifteen years (can furnish any proof desired) right into the ginival crevice.

ADVANTAGES OF INCISION OVER COAGULATION

In using incision current, by needle puncture, into space (into the pocket itself), my method of operating.

  1. Patients do not complain of an “uncomfortable first night”. I would practically claim 100% on this point.
  2. The patient does not really experience anything, to speak of, at the time of operating and gets no after discomfort. I usually apply short wave Ultra Violet after operating areas, though this can be disregarded.
  3. Absolutely never have I encountered any percussion soreness of tooth biting afterwards,

WHAT IS COAGULATION’S RECORD! On points a, b, c?

THE FLARE

You do not get that “flare” is well controlled incisions work or “scooping “ technique that give trouble a, b, and c. In my work so tissue is bothered beyond the actual area worked on. To subdue the flare, you use the finest of currents, one applicable to the Brain and Eye as this incision current is used. This current has been purposely designed to lower and narrow the lane or line of coagulation, bring it back more into the straight line effect, increasing the precision. The incision point stays cold in using oscillating current, differing this from the days of fulgeration, dessication, etc.

WHAT INCISION CURRENT IS DOING

Its use is very rapidly and steadily increasing amongst our surgeons for the most difficult baffling operation in every sections of the body. The increasing case of the its surgical entry and the sealing of the vessels in the passage preventing hemorrhage, is something to marvel at, and it does not touch cells beyond your decided operating areas.

WHAT IS COAGULATION DOING TO COMPARE

Outside of recent introduction to dental profession?

THE FUTURE

The incision current will eventually come nearer to producing a standardization of Pyorrhea Technique than anything brought out yet, because it’s sensible, has no restriction (under competent handling) and will give “a much better interpretation in average hands” than any step so far suggested covering this phase of work –Pyorrhea pocket removal. The needle operates “just the infected part”, that’s all –that’s enough, and it lets surrounding tissue alone to the greatest degree of any technique shown yet. Avery good cosmetic effect is retained throughout, and a pocket can be removed in a few seconds with no bother and no hemorrhage. Dentistry heard of coagulation “Almost Over Night” and did not hear of the oscillation current, this application, until now, you might say.

IONIZATION TECHNIQUE

As a preliminary to any system of Electro Incision or Electro Coagulatory removal of pyorrhea pockets, you must, for good end results and proper healing period, observe these precautions: They all come, really long before you should consider touching a gingiva for pocket removal by either current. there is something that should be warned against, absolutely, and that is –

DO NOT INCISE OR COAGULATE GUMS BY ANY SYSTEM

When in the condition shown at A., figure I. A., shows hypertrophied, congested, inflamed gingiva, blood engorged to such an extent and infected that they are really sick gums or gingivae. If they are “that sick”, do you suppose in their lowered vitality they need an additional “surgical insult,” electrical or otherwise, or don’t you think a bit of preliminary periodontal help is needed to build up vitality so they can “stand an operation”, the same as a person? You must do this. Well, then, relieve and build up the locale your way with what peridontal knowledge you possess, viz: remove tartar, do a perfect prophylaxis, remove all overhanging fillings and ill fitting crowns, etc., relieve ma-occlusion, supply vitamin C., vitamin D., calcium, and any and all other measures, also those that might suggest the aid of the physician counselor, etc., etc. Now, until you display reasoning powers equal to the above, do not ask Pyorrheal Surgery to do for you WHAT IT CONTINUALY DOES for others who apply the above points, and then the surgery feature, BECAUSE PHYORRHEAL ELECTRO SURGERY of either type does not in any way take the place of anything in the above list, but in the hands of an expert it is the most amazing advance ever given the Dentistry along the surgical route. My practice limited to Pyorrhea and Oral Prphylaxis, I must look to my confrerers to do the operative corrections of “metal”, as outlined. As I said before, relieve this condition your own way as outlines, or embrace my Ionization steps and Ultra Violet Technique, etc., if you wish. B., represents Talbot’s Heavy Iodine introduced a few times, my procedure, directly into pocket contents, inside gingiva, with a Ritter Ionization Modality, for a few minutes, until gingiva and pocket is impregnated (dark, as in cut I) negative electrode for iodine impregnation. Repeat two or three treatments, and meanwhile have the patient employ Kuroris holder and discard the brush temporarily. One recent research report given out by a California University in tests of ten well-known germicides and bactericidal agents proved iodine still in the lead over all others for efficiency. R. Talbot’s Heavy –

Iodine crystal ……………25.0
Zn Iodide ……………………15.0
Water ………………………….10.0
Glycerin ………………………50.0

I also employ an aniline dye, to alternate as find conditions favoring one or the other technique (from experience ) RX.

Crystal violet ………………1.0
Brilliant green …………….1.0
Ethyl alcohol ……………….50.0
Distilled water …………….50.0

I paint gum thoroughly with RX 2 (inside pocket and outside gingiva

as at B. Fig. I.) and give Ultra Violet Short Wave (Water cooled Radiation), beginning with half minute up to a minute or so, to start. The dye makes the tissue photographically sensitive to Ultra Violet, and the Ultra Violet wave penetrates the depth of the dye, giving forty-eight to seventy-two hours action. Another very clever preliminary preparation not using ionization, not using Ultra Violet, is to pak your pocket or gingivae irritation, which ever you have, with a Richmond small round cotton pellet impregnated with Fletcher’s carbonized resin, remove excess by pressing with another pellet, thus you have two impregnated (do this on a Ward Wonder Pak Pad –grand for this) and work these up with Dr. Goodfriend’s Plastic Pak Powder. Leave in forty-eight hours and note improvement of pocket condition, then electrically pierce and shred or scoop out inner pocket contents (now depressed between the gingivae of that area). You can use the same type of pak again if you wish. There is no question whatsoever but what “pak protected” pockets show the nicest healing periods, though they can be disregarded “if you wish”, but why? In anterior areas, incisors, laterals, and the like where the area affected is smaller, use Caulk Mercitan Tampons (silken thread paks) and “medicate” them as above and trim them to properly compress and pak the space. The latter paks will run small and inconspicuous, if properly inserted and sized.

SWOLLEN GUMS

For those painful puffy swollen gums so vexing to both patient and operator, nothing offers so clever a solution as 5% Mag. Sulphate applied with rubber cup electrode (cotton pellet center) positive pole from the Ritter Ionizer. When you have gingivae normalized for color, circulation and relieved puffiness and

congestion as at c. in cut II, Then, And Then Only, should you apply My of Any One Else’s Electrical pocket removal procedures, or regular surgery. If operators would go at this subject a little bit slower, study the minor effects of the current, rather than the major, and increase their “daring” more slowly, better results would follow eventually from either coagulation or incision.

 

VINCENT’S ANGINA

“Trench Mouth”.

Cut III. A., shows infected gingiva and tissue. B., shows tissue painted with aniline dye as above RX. Water cooled Burner Ultra Violet, quartz electrode applied to gums plus the dye, relieves very quickly (corrects).

Cut IV. C., gingivae normalized, swelling gone, infection under control. For a good end result, remove all Pyorrhea Pockets electrically as these are always an initial or initiating feature of every case as the implanting or impregnating base feature.

NOW IN CONCLUSION

Let me say that a dentist who cannot demonstrate a beautiful well timed and carefully scaled and polished prophylaxis, who cannot detect overhanging margins (fillings) and ill fitting crown bands is indeed an optimist, if he thinks that coagulation, double point, or oscillation current (single point), or any other surgical procedure will get, and preserve good gum tissue and bone conditions regardless of the above. You must get or achieve an underlying periodontal knowledge, so as to know the factors governing the success of electrical or any other pyorrheal surgical steps. Surely! I will admit electricity is spectacular in its quick local effect, but let’s have a general awakening or flare toward better operating and better hygiene in our gold and silver work, and our crown fittings, etc., before we expect to become “Pyorrhea Workers” to any successful degree, and believe me, Pyorrhea is waiting for you to tackle it.           1831 Medical Arts Building.

July 15, 2017 · jagdish1 · No Comments