ITL Dental Blog

2011-02-01T09:39:00.000-08:00

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

2010-11-17T08:13:00.000-08:00

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

2010-08-20T15:13:00.000-07:00

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

2010-08-20T12:56:00.000-07:00

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

2010-06-10T12:44:00.000-07:00

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.

___________________________________________
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

2010-06-10T10:26:00.000-07:00

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

2010-03-16T07:11:00.003-07:00

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.

Botox/Dermal Filler Injections

2010-03-16T07:11:00.001-07:00

Botox injections can be used for dental treatments such as TMD and Implantology. Dermal fillers can be used when dealing with asymmetrical lips, minimizing underlining skeletal discrepancies and many other uses. To administer Botox and Dermal Filler injections, the mouth and lip area need to be anesthetized. A common method is to give an infra orbital nerve block injection. This can be a painful injection if a device such as VibraJect is not used to block the pain. Dr. Louis Malcmacher, a leading opinion leader for Botox and Dermal Filler injections for dentistry, has used VibraJect and provided this endorsement: "infraorbital and VibraJect is great for that and any regular dental injections."

You Tube Channel for VibraJect

2010-03-16T07:10:00.003-07:00

ITL Dental has established a You Tube Channel, http://www.youtube.com/itldental , where the VibraJect Dental Needle Accessory and VibraShield Needle Capping Protector usage videos can be readily viewed. These videos are the same videos as on the ITL Dental web site but upload much quicker on the You Tube Channel.

Torque Wrench Maintenance

2010-03-16T07:10:00.001-07:00

Proper maintenance of the torque wrench requires lubrication of the spring prior to autoclaving. A drop of lubricating oil is placed into the slot where the head breaks away from the shaft of the wrench. The wrench is autoclaved in the open position. It is not recommended that the wrench be autoclaved in a sealed pouch and left remaining in the pouch. After autoclaving and prior to use, snap the head back into place a couple of times. This action will deliver consistent torque preloads.

Torque Wrench Recalibration

2010-03-16T07:09:00.005-07:00

Dellinges and Curtis, 1 subjected torque wrenches to 100 autoclave sterilization cycles. Their study showed that steam sterilization increased the preload 17% above the control value. Chemiclave cycles had increases as high as 71%. The study concluded that the sterilization cycle was a more significant factor in the altering of the control value than part wear. Prior to 100 cycles, the torque wrenches did not demonstrate significant increases as a result of autoclaving. From this study, one can see that a torque wrench is altered around 100 sterilization cycles. The wrench should be recalibrated after this approximate period of use. Additionally, the wrench, if 100 cycles has not been reached, should be reviewed for part wear and corrosion within 2 years of purchase or recalibration. 1 Dellinges and Curtis. Effects of infection control procedures on the accuracy of a new mechanical torque wrench system for implant restorations. J Prosthet Dent 1996;75:93-98

Comparison of Electric and Mechanical Torque Wrenches

2010-03-16T07:09:00.003-07:00

A common question asked is how do electric motors with torque control compare with mechanical torque wrenches. An article "Comparison of Torque Measurements and Clinical Handling of Various Surgical Motors" was published in the International Journal of Oral & Maxillofacial Implants, Vol. 24, Number 3, 2009. This study measured the deviation of several surgical motors to the selected torque settings. The study concluded that the average percentage of deviation for all selected torque settings with the surgical motors was -20.5% to +54.6%. This deviation is substantially larger than the deviation for mechanical torque wrenches which are from -10% to +10%. Since accuracy and repeatability is essential in torque control, it can be concluded that the mechanical style of torque wrench is the better option.

Precise Adjustable Torque Wrench

2010-03-16T07:09:00.001-07:00

We are interested in your comments about the Precise Adjustable Torque Wrench. Please share your experience with this product.

Anesthetic Agents and Computer-Controlled Local Anesthetic Delivery

2010-03-16T07:08:00.003-07:00

An article, "Anesthetic Agents and Computer-Controlled Local Anesthetic Delivery (CCLAD) in Dentistry" by Dr. Stanley Malamed is available on the ineedCE.com web site. In this article sponsored by Milestone Scientific Inc. included a section on VibraJect. Dr. Malamed wrote" The VibraJect has been found to reduce pain during local anesthesia procedures and is not restricted to one injection technique. The article does not compare the effectiveness of CCLAD to other devices. A study "VibraJect vs. the Wand for the Control of Injection Pain" by Dr. Fred Quarnstrom, Dr. Sun Hee Bang-Pastore, Dr. Ruth Woldemicael and Dr. David Chen can be reviewed on the ITL Dental web site, www.itldental.com, under VibraJect. The conclusion of this study was: " This study tends to indicate there is little difference in the pain perceived by a dental patient when injected using the VibraJect as opposed to injecting with the Wand."

Questions about what torque wrenches and drivers you need

2010-03-16T07:08:00.001-07:00

The ITL Dental website, www.itldental.com, includes a chart of torque wrenches and drivers used by the major implant systems. These charts were updated on May 1, 2009. If you do not see the system that you use, please call ITL Dental at 800-277-0073 and we will help to answer your torque wrench or driver question. ITL Dental offers 43 different drivers to meet the needs of most implant systems. Torque wrenches are offered with fixed torque settings or an adjustable torque wrench with 9 torque settings that requires no lubrication or disassembly to clean.

1.5 Volt Batteries

2010-03-16T07:07:00.001-07:00

The question has been asked as to what series of 1.5 volt batteries are recommended for the VibraJect. We recommend the following series: NV-AG-13 / L1154 / LR44 / 357 / A76. Series 357 is most common for the US.