Single tooth anesthesia versus conventional anesthesia: a cross-over study

Original Article

First Online: 10 March 2018

I have been using the STA Wand for over a decade. It just works! MJ



The aim of the present study was to compare an electronic device, the Wand Injection System (Milestone Scientific Livingstone), with conventional anesthesia in terms of the following: pain sensation during anesthetic injection; effectiveness in achieving adequate anesthesia for a complete painless dental treatment; post-operative discomfort; and patient’s anxiety toward dental treatment.

Materials and methods

Eighty adults from 18 to 70 years were enrolled in this cross-over study. Each patient served as his/her own control being subject to two anesthesia techniques: conventional and Single Tooth Anesthesia (STA) performed with the Wand. A split-mouth design was adopted in which each tooth undergoing conservative restorative or endodontic treatment received anesthesia with both techniques at 1-week interval. Before anesthetic administration, the patients’ anxiety levels were determined. Physiological parameteres were measured before, during, and after the two injection procedures, and the Visual Analogue Scale (VAS) was used to assess pain of injection, discomfort, and anesthetic efficacy. Differences in assessment of pain’s injection, discomfort, anesthetic efficacy, vital parameters (heart rate, blood pressure, and oxygen saturation), and state anxiety levels were analyzed using Student’s t test (p value < 0.001).


The mean injection pain and post-operative discomfort ratings with Wand were lower than those with conventional syringe (p = 0.022 and p < 0.001, respectively). No differences were found in the assessment of anesthetic efficacy. Blood pressure and heart rate mean values were lower during the anesthesia performed with the Wand than with the conventional syringe (p < 0.001). The anxiety level was higher during the first appointment, independently from the device used for the injections.


The STA technique resulted in lower pain, discomfort, and lower intensity of physiological parameters.
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Risk factors associated with post-loading implant loss of removable and fixed implant-supported prostheses in edentulous jaws

Original article



This study analyzed risk factors for post-loading implant loss in cases of implant-supported prostheses applied to edentulous jaws of Japanese patients.


In total, 245 dental implant fixtures placed in 54 edentulous jaws of 46 patients performed at Niigata University Hospital were retrospectively analyzed. Kaplan–Meier curves were used to estimate the cumulative survival rate (SR) of implants, and multiple Cox regression analysis was used to identify predictive factors of implant loss. The following risk factors for implant failure were examined: age, sex, survival time, implant length, implant location, smoking habit, bone density, bone augmentation, opposing dentition, loading period, and type of final restoration. The Cochran–Mantel–Haenszel test was used to examine difference in survival curves of the extracted predictors.


Sixteen implants failed during the observation period (SR = 92.8 %). Multiple Cox regression analysis revealed that male sex [hazard ratio (HR) = 16.1; p = 0.007] and use of maxillary removable restorations (HR = 12.7; p < 0.000) were risk factors for implant failure. Other factors had no significant effect on implant failure. The SR of implants for males (SR = 86.9 %) was significantly lower than that for females (SR = 99.1 %). The SR of implants for maxillary removable restorations (SR = 76.4 %) was significantly lower than for maxillary fixed restorations (SR = 99.1 %) and mandibular fixed restorations (SR = 97.8 %).


Maxillary implants with removable restorations and male sex were risk factors for implant failure among Japanese edentulous patients.

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Carestream Dental Introduces All-New Care Management Platform

There have been many transitions in the oral healthcare industry during the 21st century; the transition from analog to digital and a transition to whole body care, to name just a few. Carestream Dental’s all-new care management platform reflects yet another critical transition in the industry—shifting the focus from practice management and placing it on care management.
Launching at the Chicago Midwinter Meeting, Carestream Dental’s new care management platform follows a software-as-a-service (SaaS) model, providing anytime, anywhere access through a modern web browser. For busy practices where multitasking is a daily reality, users can quickly and easily manage multiple records when answering the phone or performing tasks. Key patient information, consolidated into a single view and accessible from anywhere, allows users to handle the most common questions and requests without having to abandon their current work. This seamless navigation enhances overall staff productivity and allows for better patient interaction.
“The new platform takes into consideration how practices coordinate care for patients, from scheduling to check-in to charting and all the way to payment processing and insurance,” Edward Shellard, D.M.D., chief dental officer, Carestream Dental, said.
Of course, no modern cloud-based solution would be complete without analytics that allow practices to track their progress and make smart business decisions. The new care management platform provides actionable reporting that shows how a practice is performing. Important business decisions can be made based on a number of key performance indicators, including outstanding insurance claims, unscheduled treatment, recall statistics and new patients per month.
When building out the platform, Carestream Dental designers and developers personally visited and consulted dental practices to observe their actual workflows and gather insight into the most common challenges of the modern dental office. As a result, the new care management platform focuses on improving the most important and frequent tasks that real dental professionals complete every day.
“The concept of empathy drives everything we do,” Shellard said. “By interacting face-to-face with software users, whether in their practices or at trade shows, we gained a better understanding of what really matters to them and their workflow. We then incorporated their feedback into the software to ensure we’re delivering meaningful updates that really make a difference.”
Since the platform exists solely in the cloud, practices can also benefit from better security, protection against data loss and access to files from anywhere with an Internet connection. Plus, all backups and updates are maintained and supported by Carestream Dental.
For help at any time, users can access Carestream Dental’s free online software users’ community, The Exchange, from within the platform. On The Exchange, users can connect with other practices and post questions, pick up tips and tricks and participate in polls and discussions about the platform.
Carestream Dental is also announcing CS 3600 Access for doctors looking for an affordable entry into digital impressions, or those who want to add a second scanner to their workflow. It offers monochromatic intraoral scanning with the same proven accuracy as the CS 3600. Users can upgrade their CS 3600 Access to full-color capability via a one-time software upgrade if desired, as both scanners utilize the same hardware and scanning technology.
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