intraosseous anesthesia delivery system

PROCEDURE: STEP 2 - Perforating through the cortical plate

    (a) Secure a Stabident perforator in a contra-angle handpiece (or in a straight handpiece designed for latching-type burs) and remove the cap from the perforator.

    (b) Hold the perforator perpendicular to the cortical plate and, without activating the handpiece, gently push the perforator through the attached gingiva until it is in contact with the bone.

    (c) Now activate the handpiece at full speed, while pushing the perforator with light pressure against the bone for about one second before slightly withdrawing the perforator out of contact with the bone, followed by once again pushing it with light pressure against the bone for about one second. The “pecking” motion should be repeated as many times as necessary until breakthrough into the softer cancellous bone is achieved, this usually taking place in about two to five seconds of total drilling time. Completion of the perforation is easily sensed because there is a sudden “give” when the cortical plate is perforated and the softer cancellous tissue is entered.

    It is very important to use the “pecking” movements rather than trying to drill through the bone in one long continuous movement because the latter may cause overheating of the bone. Overheating of the bone may result in postoperative soreness and/or some mild infection of the bone and overlying gingiva. Cases of bone overheating will have to be treated according to the severity of the reaction. Mild inflammation will usually heal uneventfully and will probably not require any treatment other than mild analgesics. More severely inflamed tissue may become infected and require antibiotic therapy. Severe reactions may involve necrosis of a small portion of bone and may necessitate the raising of a flap and the curettage of the necrotic area.
    Avoiding one long continuous movement is particularly important in the mandibular molar area where the cortical bone is thickest. Mandibular perforations will generally take a little longer than maxillary (i.e. perhaps five seconds or so of total drilling time).

    (d) Withdraw the perforator and dispose of it safely without recapping. If another Stabident perforation is required at the same site or at another site on the same patient, it is best to use a new perforator because the point may be “dulled” during the first perforation.

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    Step 2 - Example DVD Clip

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    There is a narration explaining what you are about to see before the DVD clip begins to play.

    This clip is taken from the Stabident DVD and is one of many different examples on how to effectively use the Stabident System.