What is “fulguration”?

A term taken from the Latin for “lightning”, it is the application of electrosurgical therapeutic current by means of an arc, or spark. Commonly used in dermatology and general surgery for bleeding control over large areas, the effect of the technique is somewhat superficial and does not go deep into tissue. The treatment area is desiccated to about 1mm depth with an underlying coagulum. There may appear some eschar on the surface. This arcing represents a column of ionized atmospheric gasses and limits the flow of therapeutic current while spreading it out over an area under the electrode. High voltage is required for effective fulguration.

Fulguration has limited application in dentistry and is used primarily in conjunction with a pointed conical electrode to perform “soft” coagulation of tiny hemorrhagic areas in conjunction with crown preparation, for the treatment of enucleated cysts using a ball electrode, sometimes for pulpotomy in small teeth using an inter-proximal electrode, and for treatment of tumor beds to address remnant cells with a ball electrode. Since the Radiosurge MC6A and the MACAN MC-4A are low voltage units, an adaptor is required to step up voltage for fulguration.

In the past, due to the relatively limited current penetration, fulguration was used to control bleeding directly on bone, where direct forced coagulation is contra-indicated. However, this application has been largely supplanted by bipolar forceps coagulation, which is easier, safer, and more effective.