Malamed Amsa.Sta Ii 11.28.09

3,540

Published on

Published in: Business, Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
3,540
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
142
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Malamed Amsa.Sta Ii 11.28.09

  1. 1. Anterior Middle Superior Alveolar * (AMSA) * Friedman MJ, Hochman MN. The AMSA Injection, A New Concept for Local Anesthesia of Maxillary Teeth Using a Computer-controlled Injection System. Quint. Int’l. 1998: 297-303
  2. 2. AMSA Block Injection • Single Site, Palatal Approach • 5 Teeth and Tissue Anesthetized • Duration Approx. 60-90 minutes • Dose Approx. ¾-1 Cartridge (2% Drugs) ½ Cartridge (4% Drugs) – Rx: Articaine 1:200,000 The Textbook of Local Anesthesia (Fifth Edition), Malamed S. DDS
  3. 3. New Approach Palatal Instead of Buccal
  4. 4. AMSA Landmarks • Midway Between Free Gingival Margin and Mid-palatine Suture • Bisects Premolars
  5. 5. Computer-Controlled INJECTION DYNAMICS
  6. 6. Components of an Injection • Puncture • Penetration • Delivery
  7. 7. Puncture •Topical •Pre-Puncture
  8. 8. Pre-Puncture
  9. 9. Puncture
  10. 10. Penetration
  11. 11. Anesthetic Pathway
  12. 12. Penetration • Anesthetic Pathway • Slight Rotation • ControlFlo • Paced Advancement (2/4 Rule)
  13. 13. Delivery
  14. 14. Delivery of Anesthetic • ControlFlo – Penetration – Palatals, Intraligamentary Injections – Tissues of Resistance • RapidFlo – Tissues of Least Resistance – Infiltrations, Inferior Alveolar Blocks, etc.
  15. 15. AMSA Scope of Anesthesia
  16. 16. AMSA Benefits The anterior teeth are anesthetized in both views
  17. 17. STA-Intraligamentary Injection
  18. 18. Periodontal Ligament Injections Traditional Syringe Ligmaject
  19. 19. STA Dynamic Pressure Sensing (DPS) • Informs the Dentist of Correct Injection Site (PDL Space) with Ascending Lights and Sounds. • Informs the Dentist if the Needle has Left the Correct Site. • Informs the Dentist if the Needle has been Blocked. • All Feedback Information in Real Time.
  20. 20. STA Intraligamentary vs. Syringe PDL Limited Feedback Total Feedback
  21. 21. STA-Intraligamentary Injection • Site-specific Injection • Primary Injection • Dosage of: – ½ Cartridge per Root (2% Lidocaine) – ¼ Cartridge per Root (4% Articaine) – Recommended: Articaine 1:200,000 • Delivery Time 2-4 minutes • Duration of Approx. 45-60 minutes • Safe, Comfortable, Successful Injection
  22. 22. STA-Intraligamentary Injection Injection Sites • Maxillary Teeth – Distal-buccal & Mesial-buccal Line Angles • Mandibular Teeth – Distal-lingual & Mesial-lingual Line Angles – Buccal bifurcation on some lower molars • Always Start on Distal then Mesial
  23. 23. Shorten Wand Length • Break Wand Handpiece shorter for easier access • Bend Needle about 10-15o towards the bevel, if necessary
  24. 24. STA-Intraligamentary Injection Technique • Verify the STA mode is ON • Place the needle passively in the gingival sulcus at about a 45o orientation to the vertical • Keep the bevel towards the tooth
  25. 25. STA-Intraligamentary Injection Technique • Maintain the needle’s 45o orientation • As the flow of anesthetic is started and Cruise Control is engaged, slowly and gently move the needle apically
  26. 26. STA-Intraligamentary Injection Technique • Continue to slowly move the needle apically until resistance is felt at the top of the PDL space • Hold the needle in place with minimal pressure • Wait for the STA sound and light indicators to begin
  27. 27. STA-Intraligamentary Injection Technique INCORRECT TECHNIQUE • Wrong Needle Orientation (Too Vertical, not 45o ) • Needle too deep into the PDL space • Excessive Pressure on Needle
  28. 28. Tissue Effects • Circumferential Blanching “suggests” Adequate Anesthesia • Blanching Occurs with Anesthetics Containing Vasoconstrictors
  29. 29. Dr. Marco Ferrari Clinical Study International Dentistry, South Africa 2009 STA-Intraligamentary Injection vs. Syringe & Ligmaject PDL • STA - Faster Onset of Anesthesia • STA – Less Discomfort During the Injection • STA – More Effective Anesthesia • STA – Longer Duration • STA – Less Post-op Discomfort Conclusion: “STA produces more predictable, reliable, and comfortable anesthesia than the dental syringe or Ligmaject”.
  30. 30. STA-Intraligamentary Injection • Simple to Administer • No Tissue Damage or Bone Resorption • Comfortable for Patients • Minimal Collateral Anesthesia • No Intravascular or Trismus Risk • Almost Immediate Onset of Anesthesia • Increased Productivity
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×