ODONTOSURGE 1 was developed by Lennart Goof in 1977. Since then there have been four iterations of the device, with the latest one adding the unique automatic power adjustment – no need for neutral electrodes anymore.
The automatic power adjustment system of the current XO ODONTOSURGE is based on the concept of impedance matching. This means that the electrosurgery unit measures the impedance of the tissue being cut and adjusts the output power to match the impedance. When cutting deeper into tissue the impedance decreases and the unit increases its power. When the electrode touches a tooth or bone the unit automatically decreases its power, therefore minimizing the risk of necrosis.
There is no need for neutral electrodes because the operating frequency is much higher than in other electrosurgery devices. This makes the return path impedance low, thus creating a good feedback connection between the patient and the high-frequency generator.
The device is available with 23 different electrodes to suit the needs of every practitioner. It can be used for a variety of soft tissue procedures, among others:
- Subgingival caries
- Tooth fracture
- Crown lengthening
- Any gingiva corrections
- Impression taking
We have met with two extraordinary dentists from Scandinavia who both share a passion for documenting their dental achievements.
Flemming Brandt - Nyborg, Denmark
“For us dentists, seeing is essential, and with XO ODONTOSURGE the diagnosis comes within a few seconds of use.”
“How much time do you spend on a composite filling below the gingiva level, and how would you control the bleeding to obtain good composite bonding?”
A tooth fracture or cavity in or below a marginal area is a challenge for every dentist. You not only need to keep the area dry to obtain bonding between the composite and restoration area, but you also need to be able to evaluate the condition after you expose the treatment area. And that’s where XO OSU is brilliant.
First, if I have a fractured tooth, I would never extract a fragment because it would give me bleeding, and when it bleeds it takes a lot of time to work on it afterwards. Traditional removal of tissue also doesn’t work in this case because the tissue grows back very fast. Second, without a clear view I’m not able to tell the patient if I can save the tooth or if I must extract it. With XO OSU the diagnosis comes within a few seconds of use, and for us dentists, seeing is essential.
For example, when I have a tooth fracture, with XO OSU I can expose the fracture, evaluate the tooth condition, take an impression, do a rough preparation, make a provisional crown, and then let the patient go in less than 20 minutes.
Not using electrosurgery during some marginal gingiva corrections can also lead to inflammation, which may in turn result in gingiva retraction. However, if you treat the soft tissue correctly and use the proper electrodes, you’ll have absolutely no retraction of soft tissue in the long run. XO OSU will seal all the smallest vessels and will prevent any tissue infection. You also need to know which electrode to choose. If you cut with a thin electrode and you see that the tissue bleeds a little bit, don’t try to cut it again with the same electrode. Switch to a thicker one (0.8 mm), which will have enough power to close all the smallest vessels and cause the bleeding to stop.
When we do large soft tissue corrections we start by cooling down the tissue and electrodes with ice cold water. Remember to leave the tissue moist, or it will be difficult to cut. I recommend cleaning electrodes in cold water with ice cubes and gauze after each cut. This speeds up the process, the electrodes don’t stick and you keep the tissue temperature low. Also, if there is some tissue left on the electrode, it will burn, emit a smell and be difficult to remove later. You cut, you dip it and then you cut again.
Esben Kardel - Oslo, Norway
''I think that XO ODONTOSURGE is a must-have for any dentist.’’
When you do preparations you often go below the marginal line. Sometimes it’s difficult to use a retraction cord when the tooth is broken, and gingiva grows back in a few days.
For example, when I have a broken tooth where the gingiva has grown a lot around the tooth, it would be extremely difficult to treat without XO OSU. I would have to cut around with a scalpel, stop the bleeding, use a gingi pack to prevent gingiva from growing back. But even then, when I take out the gingi pack after a few days, it will start bleeding again. This causes a lot of problems because your environment needs to be dry. XO OSU is indispensable when you have some gingiva to remove because it is fast and provides instant homeostasis and a clean cut. The area is dry for taking impressions or composite restoration.
As an alternative to XO OSU I could use a diode laser, but it would be much more time-consuming as the laser cuts slowly, only with its tip, and you have to be careful not to touch the tooth or bone. With automatic power reduction on XO OSU you just don’t need to think about it. I’ve never had necrosis of a tooth that I treated with XO OSU, nor post-treatment pain caused by touching a tooth. So it’s also less painful than normal cutting. Laser is much more expensive, slower to work with, more time-consuming to start up (as you have to burn the tip), choose programs. With XO OSU you just turn it on and select an electrode, then you’re good to go. Another advantage is that you can see how deep you are cutting. My recommendation is to use the circular electrode as if it were a straight electrode. This way, when you cut into the tissue, you can see exactly how deep your cut is.
Usually, I use XO OSU for only part of the treatment. Sometimes, though, the whole treatment is performed with XO OSU. For example, when I have a patient with advanced periodontitis and total furcation where subgingival scaling didn’t help, I approach it differently. Bone loss around a molar tooth and gingiva formation around it often prevents proper hygiene in the furcation. In such cases I take the decision to open the furcation and teach patients how to clean in between the roots with an interproximal toothbrush. This procedure allows them to keep the tooth for many years more.
*Dr. Fleming Brandt
Prosthodontist and oral surgeon since 1977. Collaborated with Lennart Goof in the development of ODONTOSURGE 3 and ODONTOSURGE 4. Former teacher, now national and international lecturer. Author of several clinical articles. Founder and owner of the Center for Odontological Development, a company dedicated to postgraduate education in a wide range of subjects. Member of the DSOI and SPBT in Denmark and of the EAO, ESCD and ITI .
*Dr. Esben Kardel
Finished dental education in Copenhagen in 2000 and since then has worked in Mikkels Tannhus in Oslo city center, which was established by his father. Ever since he started at Mikkel’s Tannhus, Esben has been working closely with dental surgeons and focusing on prosthetic treatments.