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ePaper created 2016-07-20, 11:29:31 | version 1.38.0
12 Dental Tribune United Kingdom Edition | 6/2016 TRENDS & APPLICATIONS The little surgical magic box hf Surg® is essential for every dental practice By Dr Deborah Horch, Germany The most valuable resource for dentists is time, captured aptly by Benjamin Franklin’s phrase of “Time is money”. In this respect, we constantly have to critically assess our workflows. Innovative solu- tions that help to save time, reduce costs and improve the comfort of patients, as well as treatment outcomes, are in high demand. In this regard, the affordable hf Surg (Hager & Werken) makes a valuable contribution to everyday practice. The hf Surg is the little brother of the last-generation of proven high-frequency electrosurgical devices that are used in daily practice. Long gone are the days when patients had to endure the unpleasant side-effects of this technology. Unfortunately, since old devices are still present in many practices, some patients are still exposed to these effects. State-of-the-art equipment such as the hf Surg work at a frequency of 2 MHz, which lies in the frequency range of a BBC broadcast. That is why it is often referred to as “radio surgery”. I have never received complaints from patients or came across disadvantages when using modern high-frequency devices. The technology is simple and clin- ically proven. A thin electrode made from a special metal alloy transmits electromagnetic waves into the tissue. This way, the tissue cells collapse on a macroscopic level, which appears as a mini- mally invasive cut from the outside. This cutting procedure is performed without pressure and allows a precise and almost non-thermal cutting of the soft tissue. The accompanying hand- piece is extremely lightweight and boasts extraordinary haptics, allowing the depth of penetration to be precisely determined. Saving time Unfortunately, modern prac- tice management is increasingly hampered by regulatory inter- ventions and as a result we have to achieve more in less time. Every minute lost by working with in- efficient tools is a minute we cannot afford to lose. The hf Surg works reliably and not only 20 times faster than a laser in my estima- tion but also significantly faster than a scalpel (Figs. 1 & 2). Of course, the laser has proven its value in many areas, but it is inferior in many respects when used in soft-tissue surgery. While laser can only remove layer by layer, an incision with the hf Surg is simultaneously performed over theentirepenetrateddiodelength. Scalpels and other instruments too have their limitations, includ- ing becoming blunt over time and needing to be replaced or sharpened, sometimes even dur- ing surgery, which is not only an- noying but also time-consuming and nerve-wracking. In contrast, an electrode always remains ready for use (Fig. 3). Moreover, the hf Surg has a coagulation capability, which allows cutting and stemming of bleeding simultaneously. The op- erating area stays free of blood and an unobstructed field of view is main- tained for fast treatment. Some of the indications for which this is of great importance are gingivo- plasties, the removal of hyper- plasias, the exposure of teeth, establishing haemostasis before impression taking and sulcular resection. Saving costs and safety considerations Single-use scalpels and con- ventional means of arresting ex- cessive bleeding cost money. Owing to the integrated coagula- tion functionality of the hf Surg, wounds can be reduced with-in secondsduringcutting.Theclean- cut edges and the precise alignment of incisions are impressive. Furthermore, the electrodes are du- rable and auto- clavable. Therefore, they are the more environmentally friendly and eco- nomical alterna- tive in the long term. In contrast to scalpels, the hf Surg elec- trodes can be individually ad- justed for different indications. The dimensionally stable wire can be bent according to the treatment. The included loop electrode is optimally suited for operculec- tomy of third molars or removal of fibromas (Figs. 4 & 5). The vari- ety of electrodes is comprehen- sive (Fig. 6). Furthermore, there is the con- sistent danger of injuries from conventional instruments, such as scalpels. The hf Surg electrode is activated only when the foot pedal is depressed; hence, it offers greater safety. Patient comfort and treatment success In most of the cases I have treated with the hf Surg, there was no need for sutures, as I was able to perform direct coagulation. The shortened treatment time is beneficial to the clinician and pa- tient, particularly in the case of surgically demanding procedures. Compared with other methods, the duration of healing is shorter as well, often completed after 72 hours. The painless treatment and the aesthetic result too are pleasing for both the patient and clinician. In summa- ry, the maintenance of the tissue turgor and necrosis-free cutting with simultaneous optional coagulation allows better and faster treatment. The small and handy unit permits easy transfer between dif- ferent treatment rooms. Before the hf Surg became an integral part of myeverydaypractice,Ihaddoubts, but these were allayed after a per- sonal demonstration and my sub- sequent use of the device. Dr Deborah Horch is a practising dentist in Kor- schenbroich in Germany. She can be contact- ed at de.horch@ gmx.de. Fig. 1: Preoperative diagnosis: a patient with gingival hyperplasia.—Fig. 2: Precise and bleeding-free removal using the loop electrode.—Fig. 3: Exposure of the preparation margin prior to impression taking.— Fig. 4: Removal of a fibroma from the lower lip.—Fig. 5: Results three days after surgery.—Figs. 6: Overview of commonly used electrodes. 1 2 3 4 5 6 123 456