Dental Anesthesia Techniques and Devices

Advances in Local Anesthesia

• Advances in local anesthesia are under the supervision of Prof. Hany Saber.

Outline

• Recent topical anesthesia
• Vibrotactile devices
• Cryoanesthesia
• Transcutaneous electrical nerve stimulation & laser analgesia
• Jet injection & safety dental syringe
• Computerized local anesthesia
• Nanotechnology in local anesthesia & reverse.

Our Team

• Toqa Hisham Fathy (Recent in topical anesthesia)
• Doha Ahmed Khalil (Vibrotactile devices)
• Mayven Refaat (Cryoanesthesia)
• Sarah Bahr Hussein (Transcutaneous electrical nerve stimulation & laser analgesia)
• Mariam Mahmoud Salah (Jet injection & safety dental syringe)
• Naira Essam Farouk (Computerized local anesthesia)
• Maha Ahmed Mansour (Nanotechnology in local anesthesia & reverse)

EMLA Cream

• EMLA cream contains a unique blend of lidocaine and prilocaine.
• The blend works together to provide deep, long-lasting numbness.
• EMLA is extensively studied and considered a gold standard in topical anesthesia.

Lidocaine Patches

• Lidocaine patches deliver localized pain relief directly to the affected area.
• The patches are easy to apply and can be left on for several hours, ideal for managing chronic pain.
• Topical application minimizes the risk of systemic side effects.

TAC 20 Alternate

• TAC 20 contains tetracaine, a powerful local anesthetic.
• Adrenaline constricts blood vessels to prolong the numbing effect.
• Cocaine is replaced by a safer alternative.
• TAC 20 is not regulated by the FDA.

Oraqix

• Oraqix is a non-injectable topical anesthetic gel that numbs gums without a needle.
• It's formulated for dental procedures, such as scaling and root planing.
• The gel numbs the area within 30 seconds of application.

Cetacaine

• Cetacaine is a topical anesthetic spray that's easily applied.
• The anesthetic ingredients quickly numb the skin or mucous membranes.
• The numbing effect lasts up to an hour.
• Do not use on infants or children under 2 years old.

Vibrotactile Devices

• Vibratory stimulation is used to reduce pain.
• The "Gate Control" theory suggests the neural gate can be closed during pressure and vibration, reducing pain and itch perception.
• Vibrating the area around the injection site distracts the brain from the discomfort.

Vibraject

• Vibraject is a small, battery-operated device that attaches to a standard dental syringe.
• It delivers high-frequency vibrations to the needle, making the injection less painful.

Dentalvibe

• Dentalvibe is a rechargeable, cordless handheld device that delivers injections with microoscillations.
• It uses a microprocessor-controlled vibrating tip to stimulate sensory receptors, closing the pain gate.

Accupal

• Accupal is a cordless device that uses vibration and pressure to condition the oral mucosa.
• Vibrates the injection site at 360º to shut the pain gate.
• Moderate pressure is applied during the injection.

Buzzy Device

• The Buzzy device is bee-shaped, with two components (body vibration and detachable ice wings).
• It uses the gate control theory to block pain receptors.
• The vibration produced by the device results in pain reduction.

Cryoanesthesia

• Cryoanesthesia involves cooling a constricted area with ice or refrigerant sprays, preventing nerves from transmitting pain signals.
• Precooling the treatment area before dental work decreases pain perception.

Advantages

• Advantages of the discussed techniques include pain reduction, minimized tissue damage, faster injection, and faster drug absorption.
• These methods are useful for patients who have needle phobia.

Disadvantages

• Disadvantages may include the cost and technique sensitivity, as well as the patient's cooperation requirements. Certain conditions (e.g., pacemakers, mental disability) may also be contraindications to some methods.

Laser Analgesia

• Laser analgesia is a non-invasive, non-thermogenic biomodulation of the dental pulp.
• Low-level laser therapy (LLLT) is used.
• LLLT does not provide profound anesthesia; it's used as an adjunct with other anesthetic methods.
• LLLT temporarily disrupts sodium-potassium pumps in neuronal cells, preventing impulse conduction to the brain.
• Recently, RCTs have shown LLLT to be effective in reducing injection pain compared to topical anesthesia.

Jet Injection

• Jet injection uses a high-pressure mechanical source to push liquid medication through a small orifice.
• The force of the liquid penetrates the submucosa tissues for quick medication delivery.

Safety Dental Syringe

• These syringes prevent accidental needle stick injuries by locking over the needle to prevent accidental needle stick injuries after anesthetic administration.

Computer-Controlled Local Anesthesia

• Computer-controlled devices administer anesthetic solutions slowly and precisely.
• These devices typically include a computer, handpiece, foot pedal, and pen-like handpiece for comfortable injection administration.
• Improved patient comfort is a key advantage.

STA

• STA anesthesia, performed with the wand, uses real-time dynamic pressure-sensing technology to guide the needle to the periodontal ligament.
• Audible and visual feedback inform the clinician on pressure levels.

Ezject

• Ezject provides four-step injection speed control to minimize pain.
• It features three-step pressure sensing and an ampule indicator.

Dental Pen

• A dental pen is a small device with various controllable parameters including power on/off, sound adjustment, injection speed, and LED status indicators.

Nanorobotics in Local Anesthesia

• Nanorobots, in form of analgesic colloidal suspensions, can potentially overcome issues with conventional anesthetic administration by improving the precision and minimizing complications arising from overdosing, cardiotoxicity, neurotoxicity, and tissue lesions.
• Nanorobots are hypothesized to migrate to the treatment area without causing pain, effectively blocking nerves.

OraVerse (Phentolamine Mesylate)

• OraVerse is a topical anesthetic that accelerates the return to normal sensitivity in the lips and tongue.
• It works by increasing anesthetic diffusion.
• Indicated for faster recovery in children and adults.
• Contraindicated in patients under three years old or with cardiovascular disease.

Onset Onpharm (Sodium Bicarbonate)

• Onset onpharm is a buffering system using sodium bicarbonate to raise the pH of the local anesthetic.
• This raises pH and increases analgesia onset, consequently reducing injection pain.

Additional Notes

• The text discusses multiple types and methods of local anesthesia, each with pros and cons.