Owners Guide
104 Pages
Preview
Page 1
Owner’s Guide
Table of Contents 1. Introducing PerFect Tissue Contouring System How does monopolar electrosurgery work?...4 2. Preparing PerFect TCS II for use Unpacking and setting up the unit...4 Activating the unit...4 Preoperative practice...5 Cutting practice...5 Coagulation practice...5 General principles of electrosurgery technique...5 Placement of equipment...5 The dispersive electrode...5 The cutting stroke...5 3. Clinical Guide to PerFect TCS II Bleeding control...6 Access to caries...6 Gingival contouring: Creating a gingival trough...6 Gingival contouring: Removing redundant tissue...6 Gingival contouring: Aesthetic contouring...7 4. Technical Information PerFect TCS II Electrosurge...7 General...7 Classification...7 Electrical...7 Transport and storage conditions...7 Operational ambient conditions...7 5. Special Notes and Precautions Maintenance and service...7 Electrosurge Analyzer...8 Anesthesia...9 Control of odor and viral plume...9 Product markings...9 Accessories... 10 Bibliography... 101 6. Figures Figure 1 – Figure 8... 102 Figure 9 – Figure 14... 103
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PerFect® TCS II Tissue Contouring System
The PerFect® TCS II is intended only for use by licensed dental practitioners who have received appropriate training in the application of electrosurgery. This guide is not intended as a substitute for formal instruction. The unit should only be operated in locations where the standard nominal mains voltage is indicated for use with the equipment.
Caution: Federal law restricts this device to sale by or on the order of a licensed healthcare practitioner.
1. Introducing System
PerFect
Tissue
Contouring
Few technologies have a potential equal to that of electrosurgery for enhancing the efficiency and improving the results of soft tissue management. With a reasonable investment of time to acquire the necessary skills, electrosurgery can pay considerable dividends to both practitioner and patient. With this in mind, Coltène/Whaledent has developed the PerFect Tissue Contouring System - an advanced, affordable monopolar electrosurge designed to appeal to both the new and experienced user of electrosurgery. PerFect TCS II can simplify and enhance the results of a variety of everyday procedures performed by virtually every dentist, including the control of bleeding, gaining access to caries and aesthetic contouring of gingiva. How does monopolar electrosurgery work? Electrosurgery is a proven technology that has been used for many years in both dentistry and medicine. It uses radio-frequency (RF) energy, similar to that used in radio broadcasting, to volatilize, cut and coagulate soft tissue. The radio-frequency energy used by PerFect TCS II is able to sever and coagulate tissue because it focuses the heat energy at the small, active electrode. While the active electrode remains cold, sufficient heat energy is generated in its path to sever and coagulate effectively. The high frequency energy focused at the active electrode returns to the electrosurge through the large dispersive electrode, which is placed on the back of the dental chair against the patient’s back during use. The dispersive electrode provides an efficient and predictable completion of the energy path. Depending on the intended use, the energy output of an electrosurge may be either partially or fully rectified. A fully rectified output is appropriate for cutting, while coagulation is best achieved with a partially rectified output. For these reasons, PerFect TCS II has two output modes: “Cut’’ and “Coag.’’ The intensity of these modes can be adjusted by the operator as required. Cutting with the scalpel crushes and cleaves tissue. Electrosurgical cutting volatilizes tissue in the path of the electrode. When the power output is adjusted properly, the electrode cuts without resistance, permitting an extraordinary degree of control and precision.
2. Preparing PerFect TCS II for use Unpacking and setting up the unit Remove PerFect TCS II from the shipping carton and inspect for possible damage during shipping. Check the serial number of the unit (Figure 2) against the serial number on the shipping carton to make sure they agree (if they don’t agree, contact your dealer). Fill out the warranty card and mail to Coltène/Whaledent within 10 days of receipt.
See Figures 1 and 2 and follow the steps below to prepare your PerFect TCS II for operation. The unit and accessories are pictured in Figure 3. • Before connecting the unit to the AC power supply, check that the Coag/Cut output intensity control is set at the center (“0”) position and that the power switch is in the “Off” (“O”) position. This product has been manufactured with an IEC 320 power cord inlet connector using a detachable cordset (line cord) to plug in at the rear of the unit. Please be sure to plug the cordset into the inlet connector before the next step. • Plug the line cord plug into a three-wire grounded AC power outlet. • Plug the handpiece cable BNC connector into the handpiece jack on the right side of the unit. • The handpiece holder can be placed on either side of the unit by snapping it into the placement grooves under the side lip of the unit. Once the handpiece holder is attached, it cannot be removed. • This unit performs monopolar electrosurgery. A dispersive electrode must be placed against the patient’s back to provide a safe return path for the high frequency current. • Insert the dispersive electrode cable plug into the dispersive electrode jack on the right side of the unit. • Select one of the three electrode sheaths supplied with the unit (Straight Knife, Long Loop, or Coag Ball). To assemble the handpiece, hold the swivel connector and thread the electrode into the handpiece cord assembly. To disassemble, simply reverse rotations.
CAUTION: Electrode sheaths must be sterilized before use. (See sterilization section.) Activating the unit The power switch is located in the rear alongside the IEC 320 power cord inlet connector. With the power switch in the “On” position (“1”) the green power indicator light should be on and all other indicator lights should be off. If the red indicator light is on, the dispersive electrode is not properly connected or is defective and should be replaced. First, rotate the output intensity control to the left (Coag) or right (Cut). Output intensity is increased by moving the control away from center in either direction. It may be necessary to move past the “1” position before an output will be generated. PerFect TCS II is now in the “ready” position. No warm-up time is required for the unit. To energize the electrode, depress the footswitch before applying the electrode to tissue. The electrode should only be energized for short, intermittent periods - just long enough to perform the required procedure. The unit should emit a tone while the output is energized. A yellow indicator should be “On” to indicate cut mode or a blue indicator should be “On” to indicate coagulate mode.
CAUTION: A warbling sound indicates that the dispersive
electrode is not connected or is defective. In this situation, the unit is automatically deactivated and will not operate. Verify the dispersive electrode connector is fully inserted. If it is, the dispersive electrode may be defective and should be replaced. If the replacement does not correct the situation, the unit requires servicing. When the procedure has been completed, remove the electrode from tissue and deactivate the footswitch. Rotate the intensity
Owner’s Guide control to the center “0” position and unscrew the electrode sheath from the handpiece cord assembly for sterilization. Please Note: In compliance with IEC 60601-2-2, requirements for the safety of high frequency surgical equipment, this unit generates an audible tone when operated. Preoperative practice This guide is not intended to be a substitute for formal instruction. The new user of electrosurgery is strongly urged to undertake adequate study before performing clinical operative procedures. After receiving instruction, practicing on raw, lean beef can help the practitioner acquire the necessary dexterity to achieve superior clinical results. Select a piece of fresh, lean beef (round steak or shin beef) and allow to reach room temperature. Cutting practice
1. Place the meat on the dispersive electrode. 2. Thread the Straight Knife electrode sheath onto the handpiece swivel connector.
3. W ith the power switch “On,” rotate the Intensity Control to position “1” in the Cut mode (to the right).
4. Depress the footswitch to activate the electrode. 5. Using a smooth, rapid, brush-like motion, make several incisions
of varying length and depth (Figure 4). You may find it helpful to use a finger rest to achieve precise control. Observe that the electrode either fails to cut or does so only with considerable dragging. Note also that cutting, if it occurs, causes tissue shreds to adhere to the electrode tip.
6. Repeat the procedure above at successively higher intensity settings. If the electrode encounters appreciable resistance, the setting is too low. Increase the setting until there is no resistance to cutting and there is no sparking and no discoloration along the incision. This point is the lowest effective intensity setting for a practice procedure. Allow 10–15 seconds for the tissue to cool before cutting again in the same area.
7. Increase the intensity setting one position above that which provided optimum results. Observe sparking and discoloration in the form of charring and tissue blanching along the cutting track. Continue to practice a variety of incisions using different electrodes and with the intensity setting at different levels. Observe the cutting results and the action of the electrode tip when settings are too low, too high, or correct. For best results, use the lowest effective output intensity; this is the proper setting for most procedures. Coagulation practice With a little practice, coagulation is easily achieved with the PerFect TCS II. Use the same specimen of lean beef on the dispersive electrode. Simulation of effective coagulation is achieved when the treated area shows a blanched spot of approximately 2 mm or less in diameter.
1. Insert the Coag Ball electrode and rotate the Output Control to position “1” on the Coag scale (to the left).
2. Activate the electrode and, with a dabbing motion, place the ball tip in light contact with the specimen, maintaining contact for approximately 1 second. Allow 10–15 seconds for the tissue to cool and repeat the procedure until a blanched spot indicates that coagulation is achieved.
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3. Repeat this technique at successively higher output intensity settings until blanching occurs after one or two applications of the electrode: this is the proper setting for most coagulation procedures.
4. Also practice coagulating with the Straight Knife electrode, which is particularly useful in hard to reach areas. However, since the Straight Knife electrode focuses energy in a smaller area, the intensity setting should be lower than that used with the Coag Ball electrode. General principles of electrosurgery technique The following guidelines will help you benefit from the advantages of electrosurgery. For additional important information, please refer to the Special Notes and Precautions section. Placement of equipment It’s important to place the PerFect TCS II unit so that the controls, handpiece, electrodes, and accessories are readily accessible for use with a minimum of motion and wasted time. The unit should be plugged in at all times and the console should be within arm’s reach of the operator. All of the functions, controls and settings should be controlled by the dentist. The dispersive electrode The dispersive electrode ensures that the energy flow from the small, active electrode is predictable and uniform. It must be used during all electrosurgical procedures. The entire area of the dispersive electrode should be placed in firm, nonconductive contact with the patient, preferably against the patient’s upper back, contacting the maximum possible area.
CAUTION: Do not place the dispersive electrode in contact with bare skin. Hand-held or hand-worn dispersive electrodes should not be used.
The patient, operator or assistant should not come into contact with metal parts, such as metal arm rests of chairs. Use only non-conducting (plastic) instruments (mirror, retractor, saliva evacuation tube, etc.) when performing procedures. The cutting stroke Your cutting stroke should be smooth, rapid and brush-like. Before each cut, you may find it helpful to try several practice strokes with an inactive electrode, much as a golfer takes practice strokes before putting. This will help you assume a comfortable grasp on the handpiece and will enable you to plan the position and length of the actual cutting stroke. Remember to use the lowest effective output setting for best results. When cutting, use several short strokes rather than a single long stroke. Rather than commit to a single irreversible cut (as you must do with a scalpel), you may find it preferable to shave tissue in very fine layers to achieve a more precise, aesthetically pleasing result. Cutting precision can also be enhanced by using a finger or hand rest to steady your stroke.
CAUTION: If your cutting stroke is too slow, or if you leave
the electrode too long in one area, a build-up of lateral heat may cause necrosis and sloughing of tissue.
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PerFect® TCS II Tissue Contouring System
CAUTION: Begin with as low a power setting as will properly
3. W ith the Output Control setting in the cutting mode and
• To allow heat to dissipate safely, you should always wait 10–15 seconds between cuts in the same area.
at the predetermined output setting, shave off the gingival tissue covering the lesion with a few strokes of the Long Loop electrode (Figure 7). Allow 10–15 seconds for the tissue to cool before cutting again in the same area.
perform the procedure.
• After each cutting stroke, deactivate the electrode and wipe it on an alcohol-soaked pad. Charred or carbonized electrodes should not be used; they should be restored by cleaning with alcohol and a very fine emery cloth. • Electrosurgery healthy tissue.
should
• Tissue should operative area.
be
only
moist,
be
but
performed
on
wet,
the
not
in
• In addition, the electrode should not be activated in a pool of blood.
3. Clinical Guide to PerFect TCS II Bleeding control The improved bleeding control you achieve with PerFect TCS II saves chair time, simplifies procedures and improves patient comfort. Bleeding is virtually absent during electrosurgical procedures because the electrode coagulates as it cuts. If bleeding does occur, coagulation is a relatively simple procedure.
1. Attach the Coag Ball electrode sheath to the handpiece cord assembly (or use the Straight Knife electrode if the area to be coagulated is difficult to reach).
2. Rotate the Output Control to the coagulation output setting you have established from previous experience or during preoperative practice. Remember to use the lowest effective output setting for best results.
4. W ith the caries exposed (Figure 8), restorative procedures can begin immediately. Gingival contouring: Creating a gingival trough Gingival troughs are created to provide a space into which a sufficient amount of impression material can flow. You will find PerFect TCS II to be exceptionally useful in this procedure, either as an alternative to a retraction cord or in conjunction with it. For example, you may create a partial trough in an area where the retraction cord does not provide space for a sufficient amount of impression material to flow. Gingival troughs can be made either before or after tooth preparation. If they are made before tooth preparation, visibility and access are improved and margins can be finished readily. When the trough is completed and the tooth is prepared, the impression can be taken immediately. Gingival troughs should not be made in aesthetically critical areas with thin marginal gingiva because of the possible loss of gingival height on healing.
1. When creating a complete gingival trough, use the Long Loop electrode (for shoulderless preparations with a thin gingival mucosa, the Straight Knife electrode may be used).
2. Electrode position is especially important during this procedure: the angle between the electrode and the tooth should be minimal. Too wide an angle may result in a reduced height of the marginal gingiva. Figure 9 shows the proper angle of the Loop electrode in relation to the tooth. If the resulting trough is too narrow, retrace the trough (after waiting 15 seconds) while increasing the electrode angle slightly.
3. Rinse and air dry the operative field to visualize the bleeder.
3. Begin troughing on the lingual surface, so the output intensity,
4. Touch the bleeding area intermittently with the electrode
stroke speed and cutting depth can be adjusted before operating on the facial surfaces. Do not attempt to create a gingival trough with one continuous sweep around the circumference of the tooth. Instead, the troughing should be performed in four separate, short cutting strokes (Figure 10), each sweeping a quadrant of the gingival sulcus. The following cutting stroke sequence is recommended: (1) the palatal (lingual) surface, (2) the labial (buccal) surface, (3) the mesial surface, and (4) the distal surface. As shown in Figure 10, the last two (shorter) excisions join the first two to create a continuous and uniform gingival trough. Figure 11 shows the immediate postoperative condition of a gingival trough.
(Figures 5 and 6). Duration of contact should be approximately one second, with a 10–15 second pause between contacts. Bleeding cessation indicates a successful coagulation. One or two applications of the electrode are usually sufficient to stop bleeding.
5. Use postoperative dressing if necessary. Access to caries The benefits of the PerFect TCS II will be readily apparent when it is used to gain access to caries. The PerFect TCS II makes it possible to remove occluding tissue in a matter of seconds and complete restorative procedures immediately. The procedure is usually blood-free and provides a clean, dry and highly visible operative field for the removal of caries and the placement of restorations during one visit.
1. The Long Loop electrode is well suited for obtaining access to most carious lesions. For caries occurring in tight interproximal areas, the Straight Knife may be more appropriate.
2. Explore the extent of the tissue to be removed with a periodontal probe.
Gingival contouring: Removing redundant tissue Prior to impression-taking or cementation of restorations, PerFect TCS II may be used to remove redundant tissue that may interfere with the procedure and help control bleeding.
1. Thread the Long Loop electrode sheath onto the handpiece swivel connector of the handpiece cord assembly.
2. W ith the electrode loop parallel to the tissue being removed, (Figure 12), slice the tissue off in thin layers until the desired result is obtained.
Remember to allow 10–15 seconds for the tissue to cool before cutting again in the same area.
Owner’s Guide
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Gingival contouring: Aesthetic contouring
Electrical
PerFect TCS II pays special dividends in tissue contouring for aesthetic purposes. Frequently a minor procedure can greatly enhance the patient’s appearance. With care and practice, it is possible to attain precise control of the amount of tissue removed to ensure superior results, both aesthetically and therapeutically. In addition, the smooth, pressureless cutting stroke reduces the time necessary for most aesthetic contouring procedures. You may use either the Straight Knife or the Long Loop electrode for aesthetic contouring. Shave or “plane’’ away tissue in successive thin layers until the desired appearance is achieved.
Maximum Power Consumption 135 Watts
CUT Maximum Power Output
55 Watts, ±10%
Remember to allow 10–15 seconds for the tissue to cool before cutting again in the same area.
COAG Maximum Power Output
33 Watts, ±10%
In Figures 13 and 14, the operator has easily corrected a patient’s crooked smile resulting from a marked asymmetry of the gingival levels of the incisors.
Output Impedance
600 Ohms
Nominal Operating Frequency
3.68 MHz
Coag Modulation Frequency
120 Hz
4. Technical Information
Coag Modulation Waveshape
Square wave
PerFect TCS II Electrosurge
Transport and storage conditions
Coltène/Whaledent Inc. Catalog Nos. S8230CE, S8230UK, S8240, S8115 and S8100 (Additional suffixes are used to indicate differences in types and quantity of included electrodes.)
Temperature -40°C to +70°C (-40°F to 158°F)
General Dimensions:
108 x 159 x 222 mm
AC Line Voltage S8100:
100 VAC ± 10%, 50/60 Hz
S8115:
115 VAC ± 10%, 50/60 Hz
S8230CE, S8230UK:
230 VAC ± 10%, 50/60 Hz
S8240:
240 VAC ± 10%, 50/60 Hz
Relative Humidity 10% to 100% including condensation Atmospheric Pressure 500 hPa to 1060 hPa (7.25 psi to 15.4 psi) Operational ambient conditions Temperature
-10°C to +40°C (14°F to 104°F)
Weight (unit and attached footswitch): 2.4 kg (5.29 lbs.)
Relative Humidity
30% to 75%
This unit complies with the following: MDD/93/42/EEC
Atmospheric Pressure
700 hPa to 1060 hPa (10.2 to 15.4 psi)
(4 1/8 x 6 1/4 x 8 3/4”)
Safety Standards
IEC60601-1/1988, A1 and A2
EMC Standards
IEC60601-2-2/2001
5. Special Notes and Precautions
IEC60601-1-2
CAUTION: Remove AC power by disconnecting line cord
S8115 and S8100 Flat Blade USA style three prong AC plug (NEMA 5-15P) S8230CE Continental European style AC plug with earth contact (IEC 60884-1 CEE7 VII) S8230UK British style three prong AC plug with fuse (BS 1363) S8240 Australian style three prong plug (AS 3112:2000, NZS 198) Classification Electrical: Class I, protective earth conductor utilized in power cord Applied Part: Type BF
before performing any maintenance on the unit. Maintenance and service
PerFect TCS II has been carefully designed and constructed to ensure reliability and long life. Other than protecting the unit from misuse or damage, minimum maintenance is required. Should your PerFect TCS II fail to perform in accordance with specifications, if any component is dropped or mishandled, or if any evidence of damage is found, the unit should not be used. Return it to your dental dealer or to Coltène/Whaledent for servicing. We urge you to periodically examine your unit and accessories for visible signs of damage or wear. Yearly verification of performance characteristics is recommended.
CAUTION: Disconnect the PerFect TCS II from AC power source before performing the following maintenance.
Equipment not suitable for use in the presence of a FLAMMABLE ANAESTHETIC MIXTURE WITH AIR or WITH OXYGEN OR NITROUS OXIDE. <10s Equipment Limitation >30s Intermittent operation maximum: 10s output energized, 30s minimum de-energized. In other words, for continuous repetitive use do not operate for more than 10 seconds followed by a 30 second resting period.
Sterilizing electrode handpiece cord
sheaths/cleaning
unit
and
For safety and optimum performance, sterilize each electrode sheath before initial use and after each subsequent use.
1. Remove all debris from the electrode sheath by scrubbing with brush and soap and water. Do not bend wire.
2. Clean in an ultrasonic cleaner, (such as Coltène/Whaledent’s BioSonic® Ultrasonic Cleaner), with general purpose, non-ammoniated solution diluted in accordance with manufacturer’s directions. Remove and rinse thoroughly.
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PerFect® TCS II Tissue Contouring System
Owner’s Guide
7. When high frequency surgical equipment and physiological monitoring equipment is used simultaneously on the same patient, all monitoring electrodes should be placed as far as possible from the surgical electrode. Needle monitoring electrodes are not recommended. In all cases, monitoring systems incorporating high frequency, current limiting devices are recommended.
9 Control of odor and viral plume Odors and viral plume caused by electrosurgery must be minimized by using a high speed, high volume evacuator between the patient’s mouth and nose, such as Coltène/Whaledent’s VacEjector® System with a high speed suction tip. Product markings
8. Position cables to the surgical electrodes in such a way that
Type BF equipment
contact with the patient or other leads is avoided.
9. Store electrodes out of reach of the patient. 10. Apparent low output or failure to function correctly at the normal operating settings may indicate faulty application of the neutral electrode or poor contact at its connections.
Neutral electrode referenced to earth
11. The use of flammable anesthetics or oxidizing gases such as nitrous oxide and oxygen should be avoided. Non-flammable agents should be used for cleaning or disinfecting. Solvents of adhesives should be allowed to evaporate before the application of high-frequency electrosurgery. Some material may be ignited by sparks produced in normal use of the equipment (for example, cotton wool and gauze when saturated with oxygen). Endogenous gases may be ignited by electrosurgery.
12. Interference produced by the operation of the high frequency
Attention, consult accompanying documents
Foot Switch
Footswitch cable
surgical equipment may adversely influence the operation of other electrical equipment. In case of interference, de-energize or increase distance to susceptible equipment. Connection to a different power circuit may also reduce interference.
13. Regularly inspect the accessories, particularly the electrode
Handpiece
Handpiece connector
sheaths and cables, for possible insulation damage.
14. Allow a 10–15 second cool down period between cuts in the same area for heat to dissipate safely.
15. The electrode sheaths used with the electrosurgical device have a limited life expectancy and should be replaced after twenty (20) autoclave cycles or sooner, upon the appearance of any signs of wear or erosion.
Cut mode
16. Use only accessories supplied by Coltène/Whaledent intended for use with this equipment. The active electrode and handle is 100% hi-pot tested to 3000 VAC. Peak voltage to the active electrode may reach 450V and must be rated to 675V at 3.68 MHz. The dispersive electrode normally does not receive significant voltage but must be insulated to 4000 VAC.
Coagulate mode
17. Failure of HF (high frequency) surgical equipment or excessive
Non-ionizing electromagnetic radiation
electrical interference could result in an unintended power output increase, decrease or activation. In the case of electrical interference, de-energize or increase distance to the equipment causing interference. Connection to a different power circuit may also reduce interference.
This product complies with MDD/93/42/EEC
18. Where HF (high frequency) current could flow through a relatively small cross section of the body it may be desirable to use bipolar techniques not available with this equipment. Anesthesia Local or general anesthesia must be used with all electrosurgical procedures. As with any other surgical device, the patient may experience temporary post-operative pain from the use of electrosurgery after the anesthetic effect has diminished.
<10s >30s
Intermittent operation maximum: 10s output energized, 30s minimum de-energized.
European Directive 2002/96/EC (Waste Electrical and Electronic Equipment - WEEE)
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PerFect® TCS II Tissue Contouring System
Accessories S213 Dispersive Electrode S6000CE Complete Handpiece System S6008CE Handpiece Cord Assembly S6010A 8 Sterilizable Electrode Sheaths (1 of each type) S7001 Handpiece Holder S7010A 3 Sterilizable Electrode Sheaths (1 Straight Knife, 1 Long Loop, 1 Coag Ball)
S6011A Coag Ball (2) S6011A
S6012A 45° Straight Knife (2) S6012A
S6013A 45° Tapered Knife (2) S6013A
S6014A Straight Round Loop (2) S6014A
S6015A 45° Long Loop (2) S6015A
S6016A Straight Long Loop (2) S6016A
S6017A 45° Diamond Loop (2) S6017A
S6018A 90° AP 1 1/2 (2) S6018A
Owner’s Guide
101
Bibliography 1.
Azzi R et al: The effect of electrosurgery on alveolar bone. J. Periodontal 54(2):96-100, February 1983.
2.
Bouchier G et al. Round table: Electrosurgery in daily practice. Rev Odontostomatol (Paris) 12(6):432-440, November/December 1983.
3.
Clark JW: Use of electrosurgery in restorative and related dental procedures. Oral Health 73(8):63-71, August 1983.
4.
Conroy CW: Electrosurgery as an aid in periodontal procedures for the general practitioner. NYS Dental Journal 50(6):352-353, June/July 1984.
5.
Feinberg E: Electronic surgery for improved esthetics. Dental Clin North Am 26(4):891-898, October 1982.
6.
Goldstein AA: Radiosurgery in dentistry. Oral Health 68(11):32-39, November 1978.
7.
alkwarf KL: Epithelial and connective tissue healing following electrosurgical K incisions in human gingiva. J Oral Maxillofac Surg 41(2):80-85, February 1983.
8.
Kalkwarf KL: Lateral heat production secondary to electrosurgical incisions. Oral Surg 55(4):344-348, April 1983.
9. K alkwarf KL: Subjacent heat production during tissue excision with electrosurgery. J Oral Maxillofac Surg 41(10):653-657. 10. Kelly WJ Jr et al: Electrosurgery in restorative dentistry. NYS Dental Journal 50(6):345-347, June/July 1984. 11. Miotti M et al: Comparative study on the healing of intra-oral surgical wounds and on the formation of postoperative edema. G Stomatol Ortognatodonzia 2(1):39-40 (Engl Abstr) January/ March 1983. 12. Oringer MJ: ColorAtlas of Oral Electrosurgery (Chicago, Il., Quintessance Books, 1984). 13. Pezzoli M et al: Technics of gingival retraction: a comparative study. Iiíiv Ital Stomatol 51(2):147-153, 1982. 14. Pipko DJ: Preclinical exercises in electrosurgical techniques. Dent Clin North Am 26(4):693-697, October 1982. 15. Pollack BF: Understanding dental electrosurgery. NYS Dental Journal 50(6):340-341, June/July 1984. 16. Poster A: Efficient placement and usage of dental electrosurgical equipment. NYS Dental Journal 50(6):342-343, June/July 1984. 17. Schon F: Electrosurgery In the Dental Practice (Berlin and Chicago, Die Quintessance Publishers, 1974). 18. Schon F: Threatened intra- and post-operative bleeding. Scalpel or electrome? ZWR (Ger) 91(9):28-31, September 1982. 19. Strong D et al: Esthetics enhanced with electrosurgery. Dent Clin North Am 26(4):781-798, October 1982. 20. Tillis BP: Electrosurgery: A valuable Alternative. NYS Dental Journal 50(6):323, June/July 1984. 21. Trice WB: Electrosurgery, the universal modality in dental practice. CDS Rev 76(5):38-40, June 1983.
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Perfect® TCS II Tissue Contouring System
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