What's the True Cost for Injection Devices

There are several injection devices now in the marketplace. Some are computer controlled and others operate under the Gate Control Theory of Pain Management. All devices advocate painless injections for greater patient comfort. What is not advocated is the cost of the devices to the dental practitioner.

The STA device from Milestone Scientific has a cost of approximately $2000. The Dental Vibe has a cost of approximately $800. VibraJect has a cost of $289 or $359 depending if rechargeable batteries and a recharging unit are chosen. However, what is not presented clearly is the cost of disposable tips required for both the STA and DentalVibe.

A typical practice will perform at least 50 injections per week. The STA cost of dispoable tips is approximately $2 per usage and the DentalVibe has a disposable cost of $1.57 per usage. These devices are costing the dental practitioner $80-100 per week in disposable cost. When you calculate this cost over a year's time, the STA costs approximately $7000 in the first year and about $5000 each year thereafter. The DentalVibe will cost approximately $4900 in the first year and $4000 each year thereafter.

VibraJect has two models: with 1.5 volt replacement batteries or with rechargeable batteries and a recharging unit. The 1.5 volt replacement battery costs $2 each (uses 2 battereis at a time) and will give 75-100 injections before replacement is needed. The rechargeable batteries will give 1-2 years of service before replacement is needed. Replacement batteries are $14. There are no additional disposbles needed for the VibraJect device. The cost for a VibraJect device in year one is less than $400 and between $14 and $100 each year thereafter.

Over a five year period, STA will cost the clinician $27,000, DentalVibe $20,900 and VibraJect $800. Does providing painless injections have to be expensive?

Protocol To Administer Juvederm

INFERIOR NERVE BLOCK PROTOCOL TO ADMINISTER JUVEDERM-

FOR DENTAL PRACTITIONERS UTILIZING THE VIBRAJECT®

DENTAL NEEDLE ACCESSORY

By Stephen A. Pap, M.D.

PROTOCOL:
1. Discuss with the patient the areas of desired improvement,
pointing out the contour of the nasolabial fold (NLF) and upper and
lower lip volume, obtain consent.

2. With the VibraJect®, use a 5 cc syringe to inject 0.5 to 1 cc of
lidocaine with epinephrine in each superior gingival sulcus to block the
infraorbital nerve and in each inferior gingival sulcus to block the mental
nerve. This will anesthetize the nasolabial fold, superior and inferior lips.

3. After block is complete, proceed with the filler treatment to the
NLF and or lips.

4. Advise the patient that numbness may last a few hours, and to avoid
hot or cold beverages until the sensation returns.

Ridge Splitting Chisels

Two Sizes - Two Blade Thicknesses

More information under Ridge Splitting Chisels in the Our Products section of the ITL Dental Web Site.

Bone Expander Kit

Bone expander drills are an alternative to osteotomes for the expansion and condensing of the atrophic mandible and maxilla in preparation for dental implant insertions. The Bone Expander Kit from ITL Dental includes 5, bone expanders, ratchet wrench, pilot drill, ratchet wrench extender, hand piece driver and a thumb knob for finger usage. The cost of the kit is $495.

For more information about the Bone Expander Kit, visit the section under Our Products, Bone Expander Kit.

VibraJect for Endodontics

Sonic vibration is the practice of using sound to remove foreign materials from an object. Its effectiveness stems from the fact that all sound is the product of vibration. When vibration is directed towards an object, it has the ability to dislodge materials from the object. This procedure has been used to clean teeth for a number of years.


Endodontic procedures can also benefit from sonic vibration. Studies have shown that the root canal surface treated with NaOCl and a chelating agent such as EDTA with sonic vibration loosens the coherence of the smear layer and becomes thinner with more opened tubule orifices. Studies have concluded more smear layer removal and open tubules using sonic vibration with the solutions than without sonic vibration . Using only NaOCL has been shown in studies as to not remove the smear layer. Removal of the smear layer and the opening of the tubules provide a potentially tighter adaptation between the obturation materials and the dentin walls of the preparation.

It has also been reported that there is no performance difference between using sonic vibration and ultrasonic. The smear layer removal is basically the same.

Another advantage of sonic vibration is the removal of entrapped air and bubbles inside the root canal due to interactions between the irrigating solutions with the dentin cavity walls. Additionally, residual canal gases that cause postoperative pain can be reduced as well.

Sonic vibration needs a frequency of 100-200Hz. This is the equivalent of 6000-12000 revolutions per minute. VibraJect is a device that attaches to your current irrigation syringe and creates a needle frequency of 180Hz. There are no special parts needed and VibraJect does not require the additional purchase of disposable parts which can add an addition $1-2 cost to the procedure.

All in one vibrating syringes are available on the market for around $800 plus the cost of additional disposable parts. However, if you are a VibraJect user you need to purchase nothing to achieve the advantages of sonic vibration. If you are not a VibraJect user, VibraJect can be purchased for about $350.

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Caron G: Cleaning efficiency of the apical millimeters of curved canals using three different modalities of irrigant activation: an SEM study


Akveid NAE, Hiep STP: The efficacy of sonic irrigation and type of irrigant on removing artificially placed dentine debris from the apical root canal, Academic Centre for Dentistry Amsterdam ( Amsterdam, the Netherlands) in association with Department of Endodontology of University of La Sapienza (Rome, Italy)

Berutii,Marini and Angeretti, 1997; Mandel, Machtou andFriedman, 1990

Lambrechts et al, 2006;Spratt et al, 2001

Journal of Endodontics, Vol. 36, Issue 2, February 2010, Pages 308-311

Walmsley,Lumley and Laird, 1989; Van der Sluis et al, 2007; Pitt, 2005;Jensen et al, 1999

Single Tooth Anesthesia or Mandibular Block

The usage of giving a PDL injection with an intra-ligamental syringe in place of a mandibular block injection has gained popularity with a number of dentists. There are advantages for both the patient and dentist. For the patient, there is no tongue, lip or cheek numbness. For the dentist, the injection has a higher success rate and less set-up  chair time.

There is another reason to consider single tooth anesthesia; jury awards. Here are the results of two recent cases involving mandibular block injections.

Case 1:   Dentist administered mandibular block anesthetic through an injection to plaintiff's jaw in preparation of placement of dental bridge. Plaintiff loss sensation to right side of face. Paresthesia and neuropathy of right trigeminal nerve. Award: $840,000

Case 2:   Dentist began to administer mandibular block injection to lower left quadrant. Plaintiff immediately felt pain. Received numbness, burning and loss of taste on left side of mouth and tongue. Award: $285,000

VibraJect can be attached to an intra-ligamental syringe for single tooth anesthesia injections. The injection protocol can be downloaded on the ITL Dental web site under VibraJect and Single Tooth Anesthesia or under printable literature. It is not necessaryto spent $2000 on a device to achieve effective single tooth anesthesia. ITL Dental can also provide the intra-ligamental syringe if you need one at a low cost.

VibraJect Dental Office Counter Card

A full color, 8 x 5 inch dental office counter card entitled: "No Pain & Stress" is available to our VibraJect customers at no cost. These cards were designed to be placed on reception counters in the dental office. It will take the patient less than a minute to read and will briefly explain how they, the patient, will experience virtually no pain and stress from injections during their dental procedure due to the shots being administered with the VibraJect Dental Needle Accessory. The news of pleasant and comfortable dental injections travels fast with the dental office receiving new referral patients as well as satisfied patients.