Spangberg L S, Helldén L, Robertson P B, Levy B M
Oral Surg Oral Med Oral Pathol. 1982 Dec;54(6):678-85. doi: 10.1016/0030-4220(82)90083-4.
The pulpal effects of electrosurgery involving unrestored enamel, cementum, calcium hydroxide-copal varnish-based restorations and unbased restorations were evaluated in extracted human teeth and posterior teeth of cynomolgus monkeys. Electrosurgery for all studies was performed with a fully rectified filtered unit under conditions of normal clinical usage. Studies in extracted human teeth measured the voltage potential generated between a reference probe in apical pulp tissue and an activated electrosurgery electrode placed on enamel, cementum, based restorations, and unbased restorations. Placement of a base reduced but did not prevent passage of electrosurgical current, and no measurable potential was associated with activated electrode contact on cementum or enamel. Studies in three cynomolgus monkeys included electrosurgery of based and unbased cervical silver amalgam restorations, electrosurgery of unrestored enamel, restored teeth not subjected to electrosurgery and teeth that were neither restored nor subjected to electrosurgery. Electrosurgery of restored teeth, regardless of the presence of a base, consistently resulted in pulpal damage characterized by an altered dentin matrix, necrosis adjacent to the cavity preparation, and a transition zone between necrotic and apparently vital pulp tissue. By 8 weeks following electrosurgery, the majority of specimens showed replacement of the odontoblastic layer and adjacent pulp tissue by dense connective tissue with areas of irregular calcification.
在拔除的人类牙齿和食蟹猴的后牙中，评估了涉及未修复牙釉质、牙骨质、氢氧化钙-柯巴脂清漆基修复体和无基底修复体的电外科手术对牙髓的影响。所有研究中的电外科手术均在正常临床使用条件下，使用全波整流滤波装置进行。在拔除的人类牙齿上进行的研究测量了根尖牙髓组织中的参考探针与放置在牙釉质、牙骨质、有基底修复体和无基底修复体上的激活电外科电极之间产生的电压电位。放置基底可减少但不能阻止电外科电流通过，并且激活电极接触牙骨质或牙釉质时未检测到可测量的电位。对三只食蟹猴的研究包括有基底和无基底颈部银汞合金修复体的电外科手术、未修复牙釉质的电外科手术、未接受电外科手术的修复牙齿以及既未修复也未接受电外科手术的牙齿。无论是否有基底，修复牙齿的电外科手术始终会导致牙髓损伤，其特征为牙本质基质改变、洞形预备邻近区域坏死以及坏死与明显有活力的牙髓组织之间的过渡区。电外科手术后8周时，大多数标本显示成牙本质细胞层和邻近牙髓组织被致密结缔组织取代，并伴有不规则钙化区域。
