Dental Tribune U.S. Edition

Solving one of dentistry’s challenges: fear of injections 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 after spend- ing the past decade responsibly and methodically studying this problem, now believes that with the introduc- tion of its new product, the Wand/ STA System instrument, it has final- ly 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 created and defined a new category of dental instruments called C-CLAD (Com- puter-controlled Local Anesthetic 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 rigors of clinical testing that has been performed in numerous universities and research centers throughout 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 Holding the Wand handpiece, with a pen-like grasp allows the clinician to easily rotate while simultaneously moving the needle forward, increasing accuracy by decreasing needle deflection.15 Added to the ability to use the new multi-cartridge injection fea- ture, the Wand/STA instrument provides numerous advantages when performing traditional injec- tion techniques. The introduction of the Wand/ STA System instrument represents a material improvement over previ- ous versions of this technology. Numerous innovative new fea- tures are available in the Wand/ STA System. They include auto- matic purging of anesthetic solution that primes the handpiece prior to use, automatic plunger retraction after completion of use, a multi- cartridge feature allowing multi- cartridge injections and reduction of anesthetic waste. Milestone Scientific has devel- oped a novel training feature in the Wand/STA System instrument, providing clinicians with spoken instructional guidance on the use of the instrument, thereby substan- tially reducing the initial learning curve. The Wand/STA System instru- ment is today’s most advanced C-CLAD technology and represents the next generation of computer- controlled drug delivery instru- ments for dentistry. DT References 1. Hochman MN. Single-Tooth Anesthesia: Pressure sensing technology provides innova- tive advancement in the field of dental local anesthesia. Com- pendium 2007;28(4):186–193. 2. Ferrari M, Cagidiaco MC, Vichi A, Goracci C. Efficacy of the Computer-Controlled Injec- tion System STA, the Ligama- ject, and the dental syringe for Intraligamentary anesthesia in restorative patients. Intern. Dent SA 2010;11:4–12. 3. Ashkenazi M, Blumer S, Eli I. Effect of computerized deliv- ery intraligamental injection in primary molars on their cor- responding permanent tooth buds. Intern. J of Paed Dent 2010;20:270–275. 4. Murphy D. Ergonomics and the Dental Care Worker. ISBN: 0-87553-0233-0. Washington D.C., American Public Health Association. 1998. 5. Kudo M. Initial injection pres- sure for dental local anesthesia: effects on pain and anxiety. Anesth Prog 2005;52:95–101. 6. Ashkenazi M, Blumer S, Eli I. Effective of Computerized Delivery of Intrasulcular Anes- thetic in Primary Molars. JADA, 2005;136:1418–1425. 7. Allen KD, Kotil D, Larzelere RE, Hutfless S, Beiraghi S. Compar- ison of a computerized anes- thesia device with a traditional syringe in preschool children. Pediatr Dent. 2002;24:315–320. 8. Ram D, Kassirer J. Assessment of a palatal approach-anterior superior alveolar (P-ASA) nerve block with the Wand in paedi- atric dental patients. Intern J of Paediatr Dent 2006;16:348–351. 9. Jalevik B, Klingberg G. Sensa- tion of pain when using com- puterized injection technique, the Wand. IADR Pan Federa- tion, Sept 13, 2006. Abstract # 0070. 10. Malamed SF. Handbook of Local Anesthesia. 5th Ed. St. Louis: ElsevierMosby, 2004. 11. Friedman MJ, Hochman MN. The AMSA injection: A new concept for local anesthe- sia of maxillary teeth using a computer-controlled injec- tion system. Quintessence Int. 1998:29;297–303. 12. Palm AM, Kirkegaard U, Paulsen S. The Wand versus traditional injection for man- dibular nerve block in children and adolescents: perceived pain and time of onset. Pediat- ric Dent 2004;26:481–484. 13. Friedman MJ, Hochman MN. P-ASA block injection: A new palatal technique to anesthetize maxillary anterior teeth. J of Esthetic Dentistry 1999;11:63– 71. 14. Aboushala A, Kugel G, Efthi- miadis N, Korchak M. Effi- cacy of a computer-controlled injection system of local anes- thesia in vivo. IADR Abstract. 2000;Abst#2775. 15. Hochman MN, Friedman MJ. In vitro study of needle deflection: A linear insertion technique versus a bidirectional rotation insertion technique. Quintes- sence Int. 2000;31:33–39. Industry News DENTAL TRIBUNE | May 201124A (Photos/Provided by Milestone) CDA BootH no. 1651