The Armamentarium

THE ARMAMENTARIUM

4 PARTS: 1) The Syringe 2) The Needle 3) The Cartridge 4) Preparation

THE SYRINGE

Standard of Care  aspirating dental syringes are the standard of care due to their ability to aspirate blood if the tip of the needle is located intravascularly

ADA Standards for Injection Syringes They must be durable and able to withstand repeated sterilization without damage 2. They should be capable of accepting a wide variety of cartridges and needles from different manufacturers and permit repeated use 3. They should be inexpensive, self-contained, lightweight and simple to use with one hand 4. Provide aspiration so blood can be seen through the glass cartridge


Breech-Loading, Metallic, Cartridge-Type, Aspirating Used Syringe In Dentistry -breech loading implies that the dental cartridge is loaded from the side -a needle is attached to the barrel of the syringe at the needle adaptor -the needle passes into the barrel and pierces the diaphragm of the local anesthetic cartridge

ASPIRATING SYRINGE

-the needle adaptor is sometimes inadvertently discarded along with the disposable needle -the harpoon is a sharp tip attached to the piston and is responsible for penetrating the thick silicone rubber stopper (bung) at the other end of the cartridge


- negative pressure is applied to the thumb ring by the administrator, if blood enters the glass local anesthetic cartridge (carpule) so the tip of the needle is inserted into the lumen of a blood vessel chrome-plated brass and stainless steel

SELF-ASPIRATING SYRINGES

-Major factor for aspiration is the gauge of the needle being used -Most doctors using the harpoon-type syringe, retract the thumb ring back too far and with excessive force which frequently disengages the harpoon from the silicone rubber stopper of the cartridge

PRESSURE SYRINGES

-PDL (intraligamentary) injections

JET SYRINGES

-needle-less injection -liquids forced through very small openings, called jets, at very high pressure can penetrate skin or intact mucous membrane -Syrijet is the most popular used today -Syrijet holds any 1.8 ml cartridge of local anesthetic

SAFETY SYRINGE

-Aspiration is possible -some brands come with an autoclavable plunger and disposable self-contained injection unit -all dental safety syringes are made to be single use items

CCLAD (COMPUTER CONTROLLED LOCAL ANESTHETIC DELIVERY

-designed to improve ergonomics and precision of injection technique -foot activated delivery of solution using finger tip precision -pen-like grasp offers increased tactile sensation

-flow rates of solution delivery are computer controlled and remain consistent operator is able to focus attention on the position of the needle tip while the motor of the machine delivers local anesthetic at a preprogrammed rate of flow
The Wand


-The Wand is less threatening to the patients visually -allows two rates of delivery: 1) Slow: .5 ml/minute 2) Fast: 1.8 ml/minute -releasing the foot rheo-stat will tell the machine to aspirate automatically; the aspiration cycle is approximately 4.5 seconds


-extremely high pressure in non-resilient tissues cause (traditional syringe) moderate/severe pain in most patients The Wand eliminates a lot of this discomfort by maintaining constant pressure delivery of the solution -less painful PDL, palatal, attached gingiva injections