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Medical Forum / General / Dentistry / May 2005

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Wooohoo!  I'm buying made in USA again

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NOYB - 19 Apr 2005 16:37 GMT
Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
France by Septodont).
NOYB - 19 Apr 2005 16:38 GMT
> Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
> France by Septodont).

Forgot to mention...
Both are 4% articaine with 1:100,000 epi.
W_B - 19 Apr 2005 16:50 GMT
>> Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
>> France by Septodont).
>
>Forgot to mention...
>Both are 4% articaine with 1:100,000 epi.

Kewl, I am switching too !
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
NOYB - 19 Apr 2005 17:02 GMT
>>> Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
>>> France by Septodont).
[quoted text clipped - 3 lines]
>>
> Kewl, I am switching too !

Whoops!  Zorcaine...not Zorcor.
The Real Paul - 19 Apr 2005 17:21 GMT
Whats the pricing difference?

> >>> Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
> >>> France by Septodont).
[quoted text clipped - 5 lines]
>
> Whoops!  Zorcaine...not Zorcor.
NOYB - 19 Apr 2005 17:35 GMT
$2 more for 50 carps.  But the Zorcaine folks agreed to meet the lower price
for the first order.

> Whats the pricing difference?
>
[quoted text clipped - 8 lines]
>>
>> Whoops!  Zorcaine...not Zorcor.
Charlie  Oster - 19 Apr 2005 17:32 GMT
Good news, I live in Kodaktown.  Never used arti. - talk to me!
NOYB - 19 Apr 2005 17:40 GMT
Great stuff.  Helps on those "hard to numb patients". I use it exclusively
on the mandibular arch.  On the second bicuspid forward, I almost never need
to do a block, just infiltrate on the buccal (and sometimes a little on the
lingual). For scalings, I don't do a block either.  It dissipates very well
through the cortical plate.

I had one case of transient parasthesia that resolved completely in 2 weeks
with high-dose NSAIDS.  I bumped the nerve on insertion and the patient felt
the "electric shock" feeling.  I withdrew and repositioned, but it still
left some residual numbness.  I dunno if it was the needle trauma or the
articaine, but that was the only case I've had in a year and half of using
the stuff.

> Good news, I live in Kodaktown.  Never used arti. - talk to me!
Dr Steve - 19 Apr 2005 19:35 GMT
I have had that with Mepivicaine.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

> Great stuff.  Helps on those "hard to numb patients". I use it exclusively
> on the mandibular arch.  On the second bicuspid forward, I almost never
[quoted text clipped - 10 lines]
>
>> Good news, I live in Kodaktown.  Never used arti. - talk to me!
StovePipe - 30 Apr 2005 19:18 GMT
>  I had one case of transient parasthesia that resolved completely in 2 weeks
> with high-dose NSAIDS.  I bumped the nerve on insertion and the patient felt
> the "electric shock" feeling.  I withdrew and repositioned, but it still
> left some residual numbness.  I dunno if it was the needle trauma or the
> articaine, but that was the only case I've had in a year and half of using
> the stuff.

As SFawks would say: it is likely it was the 4% solution; higher
concentration does more damage, no matter what chemical it is.
SP
Signature

Finally: take out the TRASHH

Steven Fawks - 02 May 2005 14:17 GMT
Ken Reed views it as a significant risk factor for 4% anesthetic
solutions.  Stanley Malamed does not act like it is a big deal.
After two cases with Citanest Forte in less than 100 IANB's, I
tend to agree with Dr. Reed.

One respected endodontist that I know says it works better on
'hot' teeth.  No real research is cited.

JME,
Fawks

>> I had one case of transient parasthesia that resolved completely in 2 weeks
>>with high-dose NSAIDS.  I bumped the nerve on insertion and the patient felt
[quoted text clipped - 6 lines]
> concentration does more damage, no matter what chemical it is.
> SP
Dr Steve - 02 May 2005 19:12 GMT
According to:

Wynn, Bergman, & Meiller in JAGD  Nov/Dec 2003:

Conclusion:   "Although retrospective and prospective information suggest
that articaine has a slightly greater or equal incidence compared with other
local anesthetics regarding the incidence of parethesia, the authors are not
hesitant in using articaine in many situations."

They did a literature search and came to the conclusion that articaine
caries NO greater risk of complication than any other local anesthetic.  I
would be happy to share the entire article with any of the regulars here.

The only times patients of mine developed paresthesia after LA, I was using
Mepivicaine with no vasoconstrictor.

I had a case last summer while using Lidocaine with 1:100,000 epi, that the
patient developed an apparent hematoma within 2-3 minutes of the injection.
The patient swelled up drastically and immediately went into trismus.  It
resolved without incident in a few days.   I probably caught a vessel back
behind the maxillary while doing a SA injection.  Scary to the patient,
disappointing to the dentist.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>
> Ken Reed views it as a significant risk factor for 4% anesthetic
[quoted text clipped - 21 lines]
>> concentration does more damage, no matter what chemical it is.
>> SP
Stormin Mormon - 04 May 2005 14:42 GMT
Hypertonic -- lysis of cells. That's why the one dentist used a 1% solution
first.

Signature

Christopher A. Young
Learn more about Jesus
    www.lds.org
    www.mormons.com

>> I had one case of transient parasthesia that resolved completely in 2 weeks
>>with high-dose NSAIDS.  I bumped the nerve on insertion and the patient felt
[quoted text clipped - 6 lines]
> concentration does more damage, no matter what chemical it is.
> SP
Dr Steve - 04 May 2005 15:03 GMT
nonsense

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

> Hypertonic -- lysis of cells. That's why the one dentist used a 1%
> solution
> first.

How about confucianism?

>     www.lds.org
>     www.mormons.com
[quoted text clipped - 12 lines]
>> concentration does more damage, no matter what chemical it is.
>> SP
W_B - 19 Apr 2005 19:48 GMT
>Good news, I live in Kodaktown.  Never used arti. - talk to me!

IMO the best advantage of articaine is the rapid onset.
Downside is the 4% solution and lower maximum dose.

Good stuff.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Dr Steve - 19 Apr 2005 19:59 GMT
Agree fully

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>
>>Good news, I live in Kodaktown.  Never used arti. - talk to me!
[quoted text clipped - 8 lines]
> Take out the G'RBAGE
> wubbabubbazG@RBAGEyahoo.com
Charlie  Oster - 19 Apr 2005 21:28 GMT
Cool.  Gonna get me some.  OK for older pts.?
NOYB - 19 Apr 2005 22:17 GMT
> Cool.  Gonna get me some.  OK for older pts.?

I practice in God's waiting room (aka--Florida).  All I see are "older
patients".

Of course, the older patients aren't the ones who usually have a hard time
getting numb.
Dr. V OMFS, DMD - 30 Apr 2005 14:58 GMT
Be careful! Articane is an amide/ester combo, methemoglobinemia is possible
(and documented) if too much is used or it's injected into one of the big
red things.
StovePipe - 30 Apr 2005 19:18 GMT
> Be careful! Articane is an amide/ester combo, methemoglobinemia is possible
> (and documented) if too much is used or it's injected into one of the big
> red things.

Is this true of _ALL_ the manufacturers' versions (eg Septocaine,
Ultracaine)?
Thanks
SP
Signature

Finally: take out the TRASHH

StovePipe - 30 Apr 2005 19:18 GMT
> IMO the best advantage of articaine is the rapid onset.
> Downside is the 4% solution and lower maximum dose.

Yes: Iben (anesthesia dude from Toronto) says it should not be used on
children: somnolence. ONE CARPULE maximum on young children.
Ah... Soooo
SP

Signature

Finally: take out the TRASHH

Dr. V OMFS, DMD - 01 May 2005 17:43 GMT
Great for kids, no IAN blocks, just buccal infiltration. Works VERY will on
infected/abscessed teeth (infiltration). The lower Ph of the area doesn't
effect it as in other types of local anesthetics.
StovePipe - 01 May 2005 19:54 GMT
> Great for kids, no IAN blocks, just buccal infiltration.

Must be doin' somthin' wrong... I haven't found this to be the case.
I've had to block for deciduous MO and DO lesions; if I don't, they get
tears in their eyes. One dude said the trick is to aim for the mental
foramen and then massage the area so it diffuses in. I've tried that as
well; I still need to block. As an OMFS, I cannot for the life of me see
how you could remove lower molars without a block, even using articane.
Thanks
SP

>Works VERY will on
> infected/abscessed teeth (infiltration). The lower Ph of the area doesn't
> effect it as in other types of local anesthetics.

Signature

Finally: take out the TRASHH

Dr. V OMFS, DMD - 01 May 2005 23:39 GMT
Only on kids (up to 13) do I not have to do the block, also use nitrous.
Have to do the blocks on adults (use lidocaine for the block) but buccal
infiltration with Septo.(too afraid of prolonged anesth with a Septo block.)
Otherwise if the tooth isn't a third molar, can use the buccal
infiltration, but have to wait a good 10min for good anesthesia.

Wired together a 20 something young man who had a dentoalveolar fx, entire
anterolateral alveolus fractured from #6-9, teeth all in place. Gave one
carpule of Septo, patient stated that even his palate was numb! No other
anesthesia/sedation used, went great.

IMHO it seems to work better with a little longer waiting time.
StovePipe - 02 May 2005 02:42 GMT
> Only on kids (up to 13) do I not have to do the block, also use nitrous.
> Have to do the blocks on adults (use lidocaine for the block) but buccal
> infiltration with Septo.(too afraid of prolonged anesth with a Septo block.)
> Otherwise if the tooth isn't a third molar, can use the buccal
> infiltration, but have to wait a good 10min for good anesthesia.

We use Septocaine N (1/200 000) for mandibular blocks and we haven't had
problems. It is the only anesth I use on 'adults'. I use Lido with epi
or even  Citanest Plain on the kids (higher quantity of product usable
over the course of the Tx). If I miss a block with 1.7cc Septo N on a 6
year old, I'm basically knackered for the treatment on him/her for that
day. If I miss it with Lido, I can give another two.
> Wired together a 20 something young man who had a dentoalveolar fx, entire
> anterolateral alveolus fractured from #6-9, teeth all in place.

Barroom Blitz?

Lemmee see: for me that's 2-1, 1-1, 1-2 and 1-3. !!!!  1-3  ?!?!!? Broke
the whole maxilla up to the apex of the UR canine?!?!?!?. That musta
been a chair leg or a baseball bat what hit 'im sqare whilst a buddy was
holdin' 'im down... Or W_B hit 'im... He kinda gets upset over missed
appointments....
>. Gave one
> carpule of Septo, patient stated that even his palate was numb! No other
> anesthesia/sedation used, went great.

Could it be that you actually went through to the palatal side inside
the broken osseous crack? If you're injecting slowly and advancing
slowly, that could be possible.

_I_ would have taken a 27 guage long, bent it to 45deg, and headed for
the greater palatal foramen (I'd aim just distal to the UR 2nd Molar, or
your #2, in the ditch between horizontal and vertical palate). If I
could get a good second division block, he would've been fine for the
procedure. We do this in perio when we can.
> IMHO it seems to work better with a little longer waiting time.

That's probably part of the problem 'chez-nous'. We only have two
treatment rooms; mine and the hygienist's room, so we can't just let 'em
freeze up for 1/2 hour whilst we do something else. So we tend to do
allot of intraosseous where and when we can, if the block is taking
time. I use X-Tip in the posterior hard to get at places(HATE it), and
the original Stabident everywhere else(LOVE it). We use articaine there,
as well. You're not supposed to inject a 4% sol'n that contains
vasoconstrictor with intraosseous, I know. In my experience,if you
in...ject..... slow....ly and never more that about 1/3 carpule, it goes
OK, and I've never had any problems like osteonecrosis or circulatory
complications. We never do this if there is bone loss or severe cardio
problems.

I would be interested in any comments to the above that you would have,
and also what size and make of needles you use for blocks and
infiltrations.
Thanks
SP
Signature

Finally: take out the TRASHH

Dr. V OMFS, DMD - 02 May 2005 12:34 GMT
Fracture patient fell on his face in a parking lot, stone cold sober, good
kid just clumsy.
Anesthetic was just under the unattached mucosa, infiltrated, without
advancing into the bone at all.

Vern
StovePipe - 03 May 2005 05:23 GMT
> Fracture patient fell on his face in a parking lot, stone cold sober, good
> kid just clumsy.
> Anesthetic was just under the unattached mucosa, infiltrated, without
> advancing into the bone at all.
>
> Vern

Wow.... He should be wearin' a helmet permanently.
SP
Signature

Finally: take out the TRASHH

Dr Steve - 02 May 2005 18:45 GMT
-- > I would be interested in any comments to the above that you would have,
> and also what size and make of needles you use for blocks and
> infiltrations.

25 ga for everything
W_B - 02 May 2005 19:02 GMT
>-- > I would be interested in any comments to the above that you would have,
>> and also what size and make of needles you use for blocks and
>> infiltrations.
>
>25 ga for everything

Same here, except for the occasional 30 ga on kiddies
and upper anteriors.
(just because we have so many left over)
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Steven Fawks - 02 May 2005 19:17 GMT
I've been using 25 ga. Astra's.  Is anything sharper?

Fawks

>>-- > I would be interested in any comments to the above that you would have,
>>
>>>and also what size and make of needles you use for blocks and
>>>infiltrations.

>>25 ga for everything

> Same here, except for the occasional 30 ga on kiddies
> and upper anteriors.
>  (just because we have so many left over)
> --
>
> W_B
Dr Steve - 02 May 2005 19:23 GMT
The more obtuse the angle of the bevel (greater sharpness), the thinner the
point and the sooner it gets dull.  Really sharp needles need to be changed
every time you tap the end on bone.

Not saying we should use dull needles, just pointing out that in the search
for ever sharper needles, we end up having to change them more often.

For the lay-person reading this, we use the same needle on the same patient
1-6 times depending on how many teeth we are working on.  We do not use the
same needle on another patient.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>
> I've been using 25 ga. Astra's.  Is anything sharper?
[quoted text clipped - 15 lines]
>>
>> W_B
Steven Fawks - 02 May 2005 19:58 GMT
One bone hit or three tissue sticks and I get a new needle.
(I use quite a few needles)

Fawks

> The more obtuse the angle of the bevel (greater sharpness), the thinner the
> point and the sooner it gets dull.  Really sharp needles need to be changed
[quoted text clipped - 6 lines]
> 1-6 times depending on how many teeth we are working on.  We do not use the
> same needle on another patient.
Dr Steve - 02 May 2005 20:01 GMT
agreed

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>
> One bone hit or three tissue sticks and I get a new needle.
[quoted text clipped - 13 lines]
>> patient 1-6 times depending on how many teeth we are working on.  We do
>> not use the same needle on another patient.
StovePipe - 03 May 2005 05:50 GMT
> agreed

Thanks for all your input
SP

I don't get why the 25 guage needles, though. Big (unnecessary) hole...
Thanks again
SP
Signature

Finally: take out the TRASHH

Dr Steve - 03 May 2005 12:26 GMT
Larger lumen is easier to aspirate.  Studies continually show that the
patient cannot tell the difference between a 25 ga and a 30 ga needle.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

>
>> agreed
[quoted text clipped - 5 lines]
> Thanks again
> SP
Steven Fawks - 03 May 2005 14:04 GMT
Exactly.  It is the sharpness of the point, not the diameter of
the needle.

Two more reasons:  25's do not deflect much at all.  Your number
of single injection blocks will increase noticeably.

And....broken needle cases in dentistry *never* have involved a
25 ga. (at least in the last 30 years).

Fawks

> Larger lumen is easier to aspirate.  Studies continually show that the
> patient cannot tell the difference between a 25 ga and a 30 ga needle.
Stormin Mormon - 04 May 2005 14:42 GMT
Any online links to studies? That would be interesting. I presume it's true,
but would like to read it.

Signature

Christopher A. Young
Learn more about Jesus
    www.lds.org
    www.mormons.com

Larger lumen is easier to aspirate.  Studies continually show that the
patient cannot tell the difference between a 25 ga and a 30 ga needle.
Dr Steve - 04 May 2005 15:04 GMT
You do the search, I don't have time.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

> Any online links to studies? That would be interesting. I presume it's
> true,
> but would like to read it.
>
> Larger lumen is easier to aspirate.  Studies continually show that the
> patient cannot tell the difference between a 25 ga and a 30 ga needle.
NOYB - 04 May 2005 16:18 GMT
> You do the search, I don't have time.

     Pharmacotherapy. 2002 Sep;22(9):1105-9. Related Articles, Links

Comparison of two needle sizes for subcutaneous administration of
enoxaparin: effects on size of hematomas and pain on injection.

Robb DM, Kanji Z.

Pharmacy Department, Lions Gate Hospital, North Vancouver, British Columbia,
Canada.

STUDY OBJECTIVE: To determine whether use of a smaller needle size for
subcutaneous injection of enoxaparin would reduce the size of injection-site
hematomas and/or decrease the pain of injection. DESIGN: Prospective,
randomized trial. SETTING: Community hospital in North Vancouver, British
Columbia, Canada. PATIENTS: One hundred twenty-four patients with unstable
angina or non-Q-wave myocardial infarction who were administered enoxaparin
for anticoagulation. INTERVENTION: Each patient was randomly assigned to one
of two groups. One group received enoxaparin injections with a 30-gauge,
5/16-inch insulin syringe, and the other group was injected with a 26-gauge,
3/8-inch tuberculin syringe. MEASUREMENTS AND MAIN RESULTS: Participating
nurses used standard measuring tape to determine the largest diameter of
each hematoma. Pain was assessed with a 10-unit numeric scale. The two
groups did not differ significantly with regard to either the mean size of
the largest hematoma/patient (4.2 cm in the insulin-syringe group vs 3.8 cm
in the tuberculin-syringe group, p=0.68) or the mean pain score (0.3 in the
insulin-syringe group vs 0.5 in the tuberculin-syringe group, p=0.10).
CONCLUSIONS: Use of a 30-gauge, 5/16-inch insulin syringe instead of a
26-gauge, 3/8-inch tuberculin syringe does not significantly reduce either
hematoma size or pain of injection. A larger study is required to determine
whether needle size affects the frequency of hematoma formation.
W_B - 03 May 2005 16:08 GMT
>> agreed
>
[quoted text clipped - 4 lines]
>Thanks again
>SP

Less needle deflection, less missed blocks, no perceptible difference to the patient.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Stormin Mormon - 04 May 2005 14:42 GMT
Ah, the good old days. Boil em up (if you felt like it) and resharpen the
needle with a whetstone. Needles last for a year or so of moderate volume
practice back then?

Signature

Christopher A. Young
Learn more about Jesus
    www.lds.org
    www.mormons.com

One bone hit or three tissue sticks and I get a new needle.
(I use quite a few needles)

Fawks

Dr Steve wrote:

> The more obtuse the angle of the bevel (greater sharpness), the thinner the
> point and the sooner it gets dull.  Really sharp needles need to be changed
[quoted text clipped - 6 lines]
> 1-6 times depending on how many teeth we are working on.  We do not use the
> same needle on another patient.
Dr Steve - 04 May 2005 15:04 GMT
> Ah, the good old days. Boil em up (if you felt like it) and resharpen the
> needle with a whetstone. Needles last for a year or so of moderate volume
> practice back then?

And there were no small lumen needles either.
Mark & Steven Bornfeld - 04 May 2005 15:06 GMT
> Ah, the good old days. Boil em up (if you felt like it) and resharpen the
> needle with a whetstone. Needles last for a year or so of moderate volume
> practice back then?

    We'd have to consult the historical record.  Just how old do ya think
we are, anywho?

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

StovePipe - 04 May 2005 17:29 GMT
> > Ah, the good old days. Boil em up (if you felt like it) and resharpen the
> > needle with a whetstone. Needles last for a year or so of moderate volume
[quoted text clipped - 4 lines]
>
> Steve

Did what SN describes here actually really happen? Boiling NEEDLES? I
know they re-used the glass syringes, but surely not the needles?
Thanks
SP
Signature

Finally: take out the TRASHH

Mark & Steven Bornfeld - 04 May 2005 20:48 GMT
>>>Ah, the good old days. Boil em up (if you felt like it) and resharpen the
>>>needle with a whetstone. Needles last for a year or so of moderate volume
[quoted text clipped - 9 lines]
> Thanks
> SP

    They certainly did.  I like to listen to the discussion of 25 vs 27 vs
30 ga. needles.  Some of these harpoons might have been maybe 19 or 21.
 When I bought my practice the old guy still had a couple of the
syringes around.  I shudda saved them for yucks.
    By the time I entered dental school in '73, all they had were
single-use needles.

Steve

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Dr. Steve - 04 May 2005 21:57 GMT
>> > Ah, the good old days. Boil em up (if you felt like it) and resharpen the
>> > needle with a whetstone. Needles last for a year or so of moderate volume
[quoted text clipped - 9 lines]
>Thanks
>SP
Yes, this is what was done commonly.
..
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
W_B - 04 May 2005 17:40 GMT
>> Ah, the good old days. Boil em up (if you felt like it) and resharpen the
>> needle with a whetstone. Needles last for a year or so of moderate volume
[quoted text clipped - 4 lines]
>
>Steve

Joel would know.
--

W_B
Take out the G'RBAGE
wubbabubbazG@RBAGEyahoo.com
Steven Fawks - 04 May 2005 22:04 GMT
My father-in-law graduated from dental school in 1939.  He died in 1971
before I started dating his daughter, but I still ended up with a few
items after I got out of school.  I got some very nice glass syringes
with needles of such manufacture that they do not seem to be disposable.

There were several "sterilizers" that were actually just different
means of cleaning or disinfection.  Even in the 70's it was common
to use glutaraldehyde solutions in glass trays to 'sterilize' many
dental instruments, though disposable needles were a given by that time.

Now, I throw it away or run it through the autoclave no matter what it is.

Fawks

>>>Ah, the good old days. Boil em up (if you felt like it) and resharpen the
>>>needle with a whetstone. Needles last for a year or so of moderate volume
[quoted text clipped - 9 lines]
>
> W_B
Mark & Steven Bornfeld - 04 May 2005 22:17 GMT
> My father-in-law graduated from dental school in 1939.  He died in 1971
> before I started dating his daughter, but I still ended up with a few
[quoted text clipped - 9 lines]
>
> Fawks

    It's actually worse than that.  In the 70's, I'm not sure
glutaraldehydes were widely used in dentistry.  In dental school we used
Zephirin chloride, which was probably not much better than Listerine.

Steve

>>>> Ah, the good old days. Boil em up (if you felt like it) and
>>>> resharpen the
[quoted text clipped - 8 lines]
>>
>> Joel would know.

Signature

Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Stormin Mormon - 04 May 2005 14:34 GMT
I've asked my various dentists. One  uses 27, puts in 3% mepivicaine.
Another puts in some "light anaesthesia" with a 30, I think it was 1%
prilocaine. And then pumps in 4% marcaine. One oral surgeon who worked on me
used 1% lido.

What's the advantages of 25? Good delivery flow, and doesn't terrify the
patient too badly?

Signature

Christopher A. Young
Learn more about Jesus
    www.lds.org
    www.mormons.com

25 ga for everything
Dr Steve - 04 May 2005 15:02 GMT
There is NO advantage to using the smaller needles.

Signature

~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................

> I've asked my various dentists. One  uses 27, puts in 3% mepivicaine.
> Another puts in some "light anaesthesia" with a 30, I think it was 1%
[quoted text clipped - 4 lines]
> What's the advantages of 25? Good delivery flow, and doesn't terrify the
> patient too badly?

NO THANK YOU.  Want to learn more about Hinduism?

>     www.lds.org
>     www.mormons.com
>
> 25 ga for everything
Steven Fawks - 04 May 2005 22:08 GMT
Marcaine is 0.5%.  Articaine and Citanest come in 4%.  Lido is usually
2%.

25's don't deflect on insertion, aspirate better, and don't BREAK!

Fawks

> I've asked my various dentists. One  uses 27, puts in 3% mepivicaine.
> Another puts in some "light anaesthesia" with a 30, I think it was 1%
[quoted text clipped - 3 lines]
> What's the advantages of 25? Good delivery flow, and doesn't terrify the
> patient too badly?
Dr. V OMFS, DMD - 03 May 2005 00:22 GMT
27 Gauge for just about everything.
Anesthetic probably infiltrated through the buccal fracture line to
anesthetize the palate.

I use the 2nd division blocks for midface fractures and rhinoplasties,
really great anesthesia and helps decrease blood loss.

No experience with intra-osseous technique. I do respect those who treat
wide awake patients with local only, doing the full gambit of restorative
dentistry.

Was a general dentist a long time before OMFS training, truly an art form
few if any other providers (non dentist) understand. To keep a terrified
patient comfortable and pain free adult or child is really a challenge.

I get a lot of satisfaction in a good anesthesia/sedation technique. Most
patients wake up wanting to know when the surgery is going to happen! Makes
it all worth while, at least to me.
StovePipe - 03 May 2005 05:50 GMT
> I get a lot of satisfaction in a good anesthesia/sedation technique. Most
> patients wake up wanting to know when the surgery is going to happen! Makes
> it all worth while, at least to me.

Thanks for your input.
SP
Signature

Finally: take out the TRASHH

StovePipe - 30 Apr 2005 19:18 GMT
> > Zorcor (made in USA by Kodak) will be replacing my Septocaine (made in
> > France by Septodont).
>
> Forgot to mention...
> Both are 4% articaine with 1:100,000 epi.

You can also get Septcaine N which is 1:200 000 epi. This is what I use.
SP
Signature

Finally: take out the TRASHH

 
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