Comparison of monopolar and bipolar electrosurgical modes for restorative dentistry: a review of the literature.

This review of the literature was undertaken as part of a wider investigation of effective hemostasis in vital pulp therapy. Two general types of electrosurgical units are available: monopolar and bipolar. This review compares the features of both systems. An important hazard referred to as channeling, funneling, or current crowding is described and associated with pulp therapy injury for the first time. Important safety features of bipolar electrocoagulation are identified and applied to dental procedures. Articles were selected by means of a search of MEDLINE, the U.S. National Library of Medicine's bibliographic database, for literature published between 1966 and 2001 on the topics of electrosurgery, electrocautery, electrolysis, and lasers. A search also was completed from a pulp therapy perspective to determine the use of electrosurgery on the pulp. Numerous articles and texts published between 1900 and 1965 had been reviewed previously; their bibliographies were explored and cross-referenced for pertinent reports. Laparoscopic applications of electrosurgery were reviewed for general background information and for clarification of safety and hazard issues; no exclusionary criteria or date limitations were imposed. Beyond the literature review, numerous authors and developers in the field of electrosurgery were contacted for clarification of concepts and controversies. More than 120 articles and texts related to electrosurgery were reviewed, and another 100+ articles were reviewed in the area of pulp therapy.