Dental Tribune U.S. Edition

Solving one of dentistry’s challenges: fear of injections Industry News DENTAL TRIBUNE | March 20118A Of all the procedures performed on a routine basis, the one proce- dure that is universally perceived by patients as the most fear- and anxiety-provoking is the dental injection. In spite of the significant advances made during the past 100 years, our profession has yet to con- quer one of the greatest challenges of dentistry — or has it? Milestone Scientific, Inc., after spending the past decade responsi- bly and methodically studying this problem, now believes that with the introduction of its new product, the Wand/STA System instrument, it has finally conquered this age-old problem. The Wand/STA System instru- ment represents the world’s first and only technology that uses the patented Dynamic Pressure Sensing (DPS) technology that accurately and safely performs a pressure- regulated intra-ligamentary dental injection.1 The new Wand/STA System can also perform all traditional den- tal injection techniques, i.e., infe- rior alveolar block, supra-periosteal infiltration, etc. All techniques are performed more efficiently, more effectively and virtually painless- ly.2,3 Milestone’s new technology incorporates visual and audible real-time feedback, giving clini- cians an unprecedented level of control and information when per- forming a dental injection. The Wand/STA replaces the anti- quated heavy metal dental syringe with an ultra-lightweight dispos- able handpiece weighing less then 10 grams for superior ergonomics and tactile control.4 The experience for both patient and dentist is one that is significantly less stressful.5 Milestone Scientific, Inc. creat- ed and defined a new category of dental instruments called C-CLAD (Computer-controlled Local Anes- thetic Delivery) systems. These are the only dental injec- tion instruments that have the pub- lished scientific data that substan- tiate the claim of eliminating or reducing pain perception when per- forming a dental injection.6–9 This technology has undergone the rig- ors of clinical testing that has been performed in numerous universi- ties and research centers through- out the world for more then decade. According to the company, these studies are published in some of the most highly respected dental journals in the profession. No other instrument, technology or device developed specifically to reduce pain and anxiety while perform- ing a dental injection can currently make that statement. With the introduction of C-CLAD technology, several newly defined injections were also introduced to dentistry.10 The Wand/STA Sys- tem has been optimized to perform these new dental injections. The first of these techniques, the anterior middle superior alveolar (AMSA) nerve block, published in 1997 by Friedman and Hochman, is a contemporary technique to achieve maxillary pulpal anesthe- sia of multiple maxillary teeth from a single palatal injection without producing the undesired collateral anesthesia to the lip and face.11 Subsequently, Friedman and Hochman introduced a second injec- tion, named the palatal-approach anterior superior alveolar (P-ASA) nerve block, in12 which pulpal and soft-tissue anesthesia of the central and lateral incisors are achieved by a single palatal injection.13 The general reduction in pain perception for all injections has led to innovative ways to producing more efficient and effective dental anesthesia. In addition to the new dental injection discussed above, The Wand/STA System instrument improves the success rate of tradi- tional injections such as the inferior alveolar nerve block.14 Subgingival application of the Air-Flow method allows smooth, efficient removal of bacteria in the periodontal pocket Air-Flow kills biofilm Biofilm is a dirty word Thousands of bacteria strains deep down in the periodontal pocket are responsible for the development of various diseases. The magnitude is enormous and so is the need for periodontal disease management. No need to mention the increased risk factor on systemic diseases such as diabetes, stroke or premature birth. Swiss-based Electro Medical Systems (EMS) is well known for Air-Flow® , the original method for supragingival air polishing. Yet, too few dental professionals are aware of the unique subgingival application of this mix of powder and air. “Air-Flow goes subgingival,” says EMS, and brings the point home. A unique nozzle delivers the air-powder mixture deep into the pocket where rinsing water wash- es out the eliminated biofilm. The device and consumables go hand in hand for extraordinary results without any stress or risk for the patient, according to the company. The patented single-use Perio- Flow nozzle has been especially designed for use in deep periodon- tal pockets (up to 10 mm). Accord- ing to EMS, it creates optimum but gentle turbulence in subgingi- val areas and prevents soft-tissue emphysema via three horizontal Fig.2: Wound surface of moderate periodontitis in the entire oral cavity. Fig. 3: Implants are a poor invest- ment without regular periodontal disease management. nozzle outlets for air-powder mix- ture and one vertical nozzle outlet for water. Abrasive — a bad idea? There is also the Perio Flow Meth- od, and the company has specific features for its periodontal use. The glycine-based grain is extra- fine (25 µm). In addition, the grains have a particularly low specific density (d 50). As a result, the original Perio- Flow Method is highly effective when it comes to abrading harm- ful biofilm, but will not do any harm to the tooth surface or den- tin, explains the company. According to EMS, it is impor- tant to lay this misconception to rest: abrasion is not wrong, as long as, from the gingival crest to the deepest periodontal pockets, it has no adverse effects on the tooth. A representative from EMS said that the company is very enthu- siastic about the growing mar- ket acceptance of the Perio-Flow Method and that the company is proud to go beyond the boundaries of conventional periodontal dis- ease management. If your patients only knew The wound surface of moderate periodontitis in the entire oral cav- ity equals the size of the palm of a hand. No wonder it affects the entire immune system, often with dramatic effects on the body as a whole. Four out of five patients suffer from a form of periodontitis (30 percent severe).* If they knew that periodontitis is the most common cause of tooth loss, wouldn’t they ask for a way to prevent it? Implants, too, come loose with the withdrawal of bone tissue. According to EMS, regular pro- phylactic treatment with the origi- nal Perio-Flow Method is proven to prevent peri-implantitis and its costly aftermath. Thus, the implant patient is and continues to be a patient, too. DT * German Oral Health Survey, 2006 Fig.1: Perio-Flow hand- piece and nozzle for subgingival use. (Photos/ Provided by EMS)