2. What is electrosurgery?
The Servotome is a High-Frequency (HF >100kHz – alternating current) device used for:
incision of soft gingival tissue,
coagulation of blood vessels, arteries …
Used by:
General practitioners (abscess incision, gingival eviction,…)
Prosthodontists (widening of sulcus, crown lengthening,…)
Periodontists (crown lengthening, gingivectomy, gingivoplasty…)
Implantologists (coagulation, impacted tooth exposure…)

3. What is electrosurgery?
The thermal effect created by the activation of an electric current generates the incision and the coagulation of tissue through high frequency amplitude oscillations.
The human does not feel the harmful effect of current from 100kHz. There is only a thermal action. « d’Arsonval 1891 »

4. What is electrosurgery?
With over 30 years of experience in this field, SATELEC® has mastered the electrosurgery technology.
The section action is determined by the important and quick increase of heat produced which will induce cell explosion.
The coagulation action generates an electric discontinuous wave which will create less heat (+/- 70°C).
That is why current quality has an important impact on cutting or coagulating effects.

5. Incision
Coagulation
The current quickly generates a strong heat which explodes the cellular membrane when it is applied to the tissue.
Slower heating shrinks the tissues but does not destroy the cellular membrane.
Pulsed
Constant

6. Techniques comparison
Electrocautery
Scalpel
Electrosurgery
Laser
“Light Amplification by stimulated Emission of Radiation”
Incision & coagulation
Incision only
« Hot » surgery
(heat conduction)
Filament heated to incandescence by electric current
« Cold » surgery
Manual pressure
high frequency current
CO2
Heat and tissue burning
Tissue dilapidation
Good healing
Cell volatilization
Prevents the transmission of bacteria. Whenever the current is on, the electrode is sterile.
Cell volatilization and carbonization
Burn the upper surface to slowly go deeper
Induces local 3rd degree burning = irritation, bad healing, tissue carbonization, etc)
Precise but creating tissue dilapidation and no coagulation effect performed. Bacteria transportation.
Good-quality healing
An extreme precision
Less bleeding
High price
Slow penetration in the tissues (water absorption)

7. Monopolar versus bipolar technology
Electrosurgery:
Monopolar versus bipolar technology
Extract from: Implementing AORN Recommended Practices for Electrosurgery  Original Research Article. AORN Journal, Volume 95, Issue 3, March 2012, Pages , Lisa Spruce, Melanie L. Braswell.
“The monopolar electrosurgical circuit is composed of the generator, the active electrode, the patient, and the patient dispersive electrode”.
“In bipolar electrosurgery, current flows between the two poles and back to the electrosurgery unit without the need for a dispersive electrode”.

8. Composition Servotome is composed of: Unit,
Electrode holder and its cord,
10 electrodes,
Single footswitch,
Conductive bracelet.

9. Setting up

10. Do we need current return path?
A common objective: Monopolar electrosurgery (such as Servotome®) units require
current return path to obtain good performances. Indeed, current concentration
will create much better results than current dispersion in the entire body.
Limiting leakage current

11. Impedance Capacitive plate Conductive bracelet (Old generation)
When current is applied on the body, tissues create a corporal resistance also called
impedance. In high frequencies, current is not going around but through cells. To get
a reproducible protocol, we should limit resistance factors .
On return path zone: strong hair zones, bony prominences, fat, scar tissues, etc
On treated area: excess of saliva , etc.
Capacitive plate
(Old generation)
Conductive bracelet
(New generation)
Should be placed behind patient’s right shoulder to get maximum efficiency.
Should be placed on right wrist, in direct contact with the patient’s skin.

12. Plate/Bracelet comparison
Capacitive plate
(Old generation)
Conductive bracelet
(New generation)
Higher leakage current than with the bracelet,
Recommended placement not often respected,
Can move easily on the chair which will increase the resistance and decrease performances,
Placed between chair and patient’s clothes. Clothes thickness can create a resistance and have an impact on the yield.
Focus the return of the current at a given point ,
Limits leakage current and resistance as it is in direct contact with the patient,
Compliant with the latest safety certifications
(IEC ).

13. Bracelet benefits
The bracelet system is the best compromise for safety and convenience:
- Easy to install to enhance patient acceptance,
- Conductive (in direct contact with the patient’s skin),
- Easily disinfected,
- Adjusted to a contact region with a low resistance,
Perfect size to avoid concentration of heat.

14. 30 Watts is enough!
With higher yield compared to the capacitive plate, the bracelet system needs less Wattage (30Watts instead of 50Watts) providing more safety and less risk of burning the tissues.
Decreased Wattage for greater efficiency.
This bracelet can concentrate the current at a given point offering:
- Controlled power,
More reliable and reproducible
settings,
High performance and better
yield,
- Less energy loss.

15. Techniques of use The Servotome allows independent
activation of incision and coagulation from 1 to 10.
2 potentiometers (incision ; coagulation )

16. Incision Control of cutting power from 1 to 10 (Max 30W / 600Ω)
The incision depends on:
the power chosen,
the strength applied,
the tissue,
the speed of the surgical movement,
the patient’s size,
the size of the electrode (the smaller it is,
the more the power is concentrated).
Incision

17. Coagulation
Control of coagulation from 1 to 10 with progressive increase of the temperature without damage to underlying tissues.
Coagulation

18. Effects of electrosurgery
Incision with coagulation
Incision: for a clean and smooth cut
Fulguration: for heating the superficial tissue
Coagulation: for a deep hemostatic effect
Cutting with coagulation: for an incision with better visibility, accompanied by deep and immediate coagulation.

19. SPARK (HEATING OF TISSUE)
Cutting advice
WHITENING
(SHRIVELLED TISSUE)
ELECTRODE STICKS
ELECTRIC ARC
(BURNT TISSUE)
SPARK (HEATING OF TISSUE)
POWER TOO LOW
POWER TOO HIGH 
Check and/or protect if the patient for any conductive
element on him.
Place the bracelet.
Insert an electrode on the electrode
holder.
Avoid excess saliva.
Adjust the potentiometers according
to the clinical act, the electrode
chosen, the patient size, etc.
Exert an easy and smooth movement.
CORRECT POWER
MOVING SMOOTHLY
(NO SPARK) 

20. Recommendations for use
Aspiration of excess saliva for optimal efficiency.
Metal surfaces such as:
implants,
amalgams,
inlay, onlay,
brackets.
Should be insulated using plastic mylar.

21. INCISION/ FULGURATION FULGURATION/COAGULATION
Electrodes
INCISION
Ø mm (RODS)
INCISION
Ø 0.22 mm (NEEDLES)
EXCISION
Ø mm (LOOPS)
Abscess incision, exposure of impacted tooth, cutting of peri-coronary sac, hemostasis, exposure of crown lengthening, gingivoplasty, gingivectomy, frenectomy, tissue ablation before impression, stripping, etc.
INCISION/ FULGURATION
Ø 1 mm CONICAL)
FULGURATION/COAGULATION
Ø 2.5 mm - Ø 3.2 mm (SPHERICAL)

22. Clinical cases
Frenectomy
Gingival eviction &
gingivectomy
Plasty

23. Clinical cases Exposure of impacted tooth:
circular incision for a clean
and successful exposure
Dental neck exposure
Abscess incision
& drainage
Exposure of fractured tooth

24. Gingivectomy
Crest plasty
Gingival eviction
Soft tissue eviction

25. Accessories Electrode-holder is lightweight and handy.
A broad choice of electrodes which are all insulated (only the active part touches the soft tissue).
A fast and safe assembly of electrodes on the electrode-holder.

26. Accessories
An orange light and an audible alarm (conform to the norm ) indicate when the HF is activated.
Controlled by means of a footswitch.
Hand button activation can create a
lack of precision.

27. Table settings The settings depends on: Recommended settings:
the clinical act,
the electrode chosen,
the patient’s size,
etc.
Recommended settings:
Incision electrodes:
Incision button: 6-8
Coagulation button: 3-4
Coagulation electrodes:
Incision button: 5-6
Coagulation button: 1-2

28. Sterilization Clean with disinfectant wipes: the device,
the electrode-holder,
the cord.
Brush the electrodes with sandpaper or metallic brush
Place the electrodes in an ultrasonic tank
Place the electrodes and electrode-holder
in the autoclave
Note: for your information, even if the electrosurgery
allows an instant sterilization of the electrodes thanks
to HF current, you should sterilize them prior utilization.

29. SERVOTOME New impulse in Electrosurgery
SUM UP
SERVOTOME New impulse in Electrosurgery
Compliant with new standards and dental environment constraints
Main objective:
Decrease leakage currents for
more safety
What’s new?
A bracelet is replacing the
capacity coupler
Electronics modifications
Decreased Wattage (30 watts)
Safer with better performance!

30. THANK YOU!
Safer
with better
performance!