Comparison of Monopolar Cervical Loop Electrocautery and Conventional Scalpel Biopsy for Oral Mucosal Lesions in Patients With Reduced Mouth Opening

Introduction: Biopsy of oral mucosal lesions can be technically challenging in patients with reduced mouth opening because restricted access may affect tissue manipulation, visualization, and bleeding control.This study compared the postoperative and procedural outcomes following monopolar cervical loop electrocautery and conventional scalpel biopsy in this patient population.Materials and methods: This prospective comparative observational study included 42 patients with reduced mouth opening who underwent oral mucosal biopsy in the Department of Oral and Maxillofacial Surgery, Karpaga Vinayaga Institute of Dental Sciences, India, between March 15, 2026, and August 16, 2026.The participants were classified into a monopolar cervical loop electrocautery group (n = 21) or a conventional scalpel biopsy group (n = 21).Postoperative pain was assessed on days 1 and 3, swelling on day 3, and bleeding severity, medication requirement within 24 hours, incision difficulty, and wound healing on day 3 were recorded.Between-group differences were analyzed using appropriate parametric and non-parametric tests, with statistical significance set at p < 0.05.Results: Postoperative pain was significantly lower with monopolar electrocautery on days 1 (median, 4.0 vs. 6.5;p < 0.001) and 3 (median, 2.0, 4.0; p < 0.001).Mild bleeding occurred in 15 (71.4%) patients in the monopolar cervical loop electrocautery group compared to six (28.6%) in the conventional scalpel group, whereas severe bleeding occurred in one (4.8%)and five (23.8%) patients, respectively (p < 0.001).Postbiopsy analgesics were required in 11 (52.4%)patients in the monopolar cervical loop electrocautery group compared to 17 (81.0%)patients (p = 0.048) in the conventional scalpel group, and incision difficulty was reported in five (23.8%) and 16 (76.2%)patients (p = 0.048), respectively.Swelling was greater with monopolar cervical loop electrocautery (5.2 ± 2.1 vs. 3.1 ± 1.5 mm; p < 0.001).Day 3 healing also differed significantly (p = 0.008), with complete healing in three (14.3%)patients in the monopolar cervical loop electrocautery group compared to seven (33.3%) patients in the conventional scalpel group.Conclusion: Monopolar cervical loop electrocautery was associated with favorable pain, bleeding, medication, and incision-related outcomes, whereas conventional scalpel biopsy was associated with less swelling and more favorable early healing.