Carpule anesthesia in dentistry - what it is and how it works

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The fact that modern methods of dental treatment are carried out almost painlessly is an undoubted achievement in dentistry and the use of effective drugs as an anesthetic.

Many patients, especially older people, are sincerely surprised by the options for freezing the working area, the bizarre shapes of syringes and disposable ampoules.

This article will discuss one of the innovative methods of performing pain relief procedures - carpule anesthesia.

General overview

The name of the technique is due to the design of the syringe, the contents of which sharply reduce the sensitivity threshold of the nerve tissues of the tooth.

The capsule in which the drug is placed is called carpula. Despite the specific packaging of the drug, the manipulation technology itself is standard.

A carpule injection is a reusable syringe. This device is made of a medical metal alloy, and consists of a frame, a piston part and a needle. In this case, the piston cannot be completely removed from the housing, on the side of which there is a gap to accommodate the capsule.

It is a special ampoule containing an anesthetic composition. The capsule is hermetically sealed, has a rubber plug at one end, and a metal valve at the other.

The device works on the following principle - after the cartridge with the necessary product is placed in the gap of the syringe, a needle is screwed into it and an injection is made.

In this case, the plug should be on the side opposite to the needle. When you press the piston, the medicine is injected into the organ cavity and reaches the target.

Selection of carpule needles

The carpule needle consists of a metal nozzle and a plastic coupling, with the help of which the spear is attached to the body. The product must guarantee effortless, painless injection of the medicinal substance.

It has 2 sides, with the help of which manipulations become harmless. The elongated side of the tip is used to penetrate dental tissues; it ends with a chamfer. The short side is a device for opening impenetrable carpules.

The criteria for selecting a device should be based on the following characteristics:

• Dentists recommend choosing a product that has a red mark indicating the direction of movement of the syringe. This can increase the level of medical manipulations and reduce the time a person spends in the dental chair.
• The metal for the manufacture of products is selected according to the parameters of thickness, reliability, and increased elasticity. This will help avoid infection and eliminate discomfort during the procedure, providing opportunities to reach the most inaccessible places in the oral cavity.
• Needles are selected according to length. There are products on sale with lengths from 10 to 25.5 mm (short) and 28.9-41.5 mm (long).
• Dentists also select needles based on diameter.

Foreign-made needles are more expensive; they are certified to European and American standards. The most expensive products include products from the company Septoject Evolution (a package of 100 pieces can cost 1000-1400 rubles), made from high quality metal.

Products made in Korea and Pakistan are much cheaper (300-500 rubles), which are also of good quality (brands NI-PRO, BIODENT, Sun Pharmaceuticals, Cornerstone Corporation). The cheapest needles will cost you Russian-made needles (AERS), which are not inferior in quality to their foreign counterparts.

All manufacturing companies produce products according to standard parameters of diameter and length: 12, 16, 21, 25, 30, 35, 38 mm.

Advantages

According to practicing dentists, this type of anesthesia has the following advantages over analog painkillers:

• adherence to the dosage as accurately as possible. One carpool unit holds 1.7 ml contents;
• 100% sterility - each injection is performed with a disposable needle, and the contents of the capsule are pumped in strict accordance with antiseptic requirements.
  Compliance with sterility standards is especially important for those patients whose immune system is weakened by serious diseases, such as diabetes;
• good tolerance - the needle that comes with the device is so thin that inserting it into soft tissues causes virtually no pain. In addition, it simplifies the administration of the drug where the mucosa is close to the periosteal zone;
• comfortable working conditions for the dentist - the syringe is conveniently located in the doctor’s hand and, unlike standard syringes, is easily directed in different directions due to its design features.
  The needle is so flexible and durable that it can be bent without fear of it breaking and injuring the patient;
• impossibility of administering the wrong drug - the packaging contains a marking with the name and dosage of the composition located inside the capsule.

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Price

The cost of carpule syringes depends on the material of manufacture, ease of use, method of aspiration, and whether additional clamp tips are included in the package. Models of products from various manufacturers with prices are summarized in a table.

Experts note the ease of use of carpule syringes. In dentistry, the device has gained popularity due to its safety and comfort of use, eliminating the possibility of infection. There are injectors on the market of varying prices, with characteristics that can satisfy any need.

Flaws

As for the negative aspects of carpule anesthesia, practically none have been identified.

A number of patients note the high cost of the drug, which makes it limited to the category of citizens with low material income.

However, this is a controversial drawback, since the complexity of manufacturing the product and high efficiency are associated with additional manufacturing costs. A quality product cannot be cheap.

Another disadvantage is the inability to modify the composition. A vasoconstrictor cannot be added to it, but in some clinical cases this is necessary.

Injector contents

The use of the drug requires the dentist to know the composition of the anesthetic. This information is contained on the packaging; there is a detailed breakdown of the percentage of all its components.

Injector includes:

• An anesthetic is a substance that reduces the pain sensitivity threshold in the injection area to a minimum. These compounds are classified under the category of amides and their derivatives. These are mainly Lidocaine, Prilocaine, Articaine;
• vasoconstrictor – activates vasoconstrictive processes, which prolongs the relief of nerve endings and increases the effect of the drug.
  In addition, the substance prevents premature leaching of the drug from the working area.

  It has a serious limitation for use - the drug is prescribed with extreme caution to people with pathologies of the cardiovascular system, diabetes mellitus at any stage of the disease, and elderly patients. Vasoconstrictors include adrenaline, mesaton;

• antioxidants are mainly sodium sulfites or bisulfites.
  Their main function is to protect the vasoconstrictor from destructive processes that occur under the negative influence of an oxygen environment. They can provoke individual intolerance, including acute allergic reactions, since they contain sulfur fragments. Contraindicated for diseases affecting the lungs and bronchi;
• preservatives – ensure the safety of the composition until it is opened;
• EDTA – metal binder;
• parabens are fragments that ensure absolute sterility of the capsule contents. This is especially important when transporting to regions with hot climates.

Thanks to this balanced composition, the anesthetic is reliably protected from the penetration of pathogenic microorganisms.

The main requirement related to the specific composition of the anesthetic is to make sure before using the medicine that the patient is not allergic to its derivatives.

Neglect of this rule is fraught with anaphylactic shock, which can cause irreparable harm to human health.

The video provides a description of an innovative single-use carpule syringe.

Syringe selection

When selecting a suitable syringe, the following important rules must be observed:

• When purchasing, you should take into account that most likely you will have to install needles from different manufacturers into the tool, so it is necessary that a spare clamp attachment is included with the device.
• The syringe must have the characteristics of convenience and aesthetic appeal (so as not to frighten patients).
• The body of the device must have increased strength, which allows the drug to be administered for pain relief under greater pressure.
• The dentist should use the syringe easily (with one hand).
• The device must be suitable for performing an aspiration test, which can prevent inadvertent injection of the substance into the blood vessels.
• When using the instrument on children, experts recommend purchasing auxiliary bright attachments for the device that disguise it, turning the therapy process into a game.

A reusable carpule syringe in dentistry manufactured by Anthogyr (France) is made of tool metal (steel) and often includes a spare clamp attachment. The product is characterized by ease of use and quality parameters.

Carpule syringes of the Asa Dental brand (Italy) are made of chrome-plated steel and are distinguished by a variety of models:

• number of rings;
• aspiration method;
• ergonomics and appearance;
• carpool fastening method.

Pakistani-made syringes (MEDENTA brand) are lower in cost compared to similar instruments produced in the European Union. The products are made from a particularly light alloy with a corrosion-resistant coating.

The design of the device provides for a large visibility window, which allows you to control the progress of aspiration. The model range includes a variety of products in appearance; there are various variations of replaceable tips.

Storage rules and periods

Any medicine needs proper storage. Capsules must be kept in a dark place. The optimal storage temperature is 23-25 ​​degrees.

Failure to comply with basic conditions will shorten the shelf life of the composition, and improper transportation may compromise the structural integrity of the package.

Such drugs should not be used under any circumstances. Injectors should be stored in places inaccessible to children and pets.

Signs of loss of drug properties

You can understand that the medicinal effect of the drug has been neutralized and it has lost its main characteristics by a number of signs:

• the integrity of the packaging is compromised - most often this is due to careless transportation;
• An uncharacteristic sediment has appeared in the liquid or the shade of the composition has changed - this happens when the temperature regime is violated, causing overheating. The vasoconstrictor disintegrates and the agent changes its structural content;
• the appearance of gas bubbles larger than 0.2 cm. This is a consequence of freezing;
• the appearance of rust fragments on the outside of the ampoule.

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Where to buy quality syringes?

The carpule syringe is a popular tool in dentistry. You can purchase quality products from time-tested sellers. If a company has been on the market for 3 years or more, then this indicates an already established reputation that can be verified.

You can buy medical instruments in the following places:

• in stores selling medical equipment;
• on the Internet on relevant trading platforms;
• in large pharmacy chains.

Popular means

The most popular option for carpule anesthesia is the products of French manufacturers, which are effective and affordable:

• Ultracaine is the most popular concentration for dental pain relief. The effect occurs after a couple of minutes and lasts for at least an hour;
• Ubistezin - the duration of pain relief does not exceed half an hour, this time is sufficient in most clinical cases. Indications for use: children, pregnant women;
• Scandonest – has a high concentration of adrenaline. Side effect is a long-term vasoconstrictor result. Prevents bleeding;
• Septanest - has a mild effect. The sensitivity threshold remains extremely low for 15-20 minutes. Indicated for people prone to allergies, with severe pathologies and serious chronic diseases, when the use of stronger drugs is not recommended.

Reasons for the lack of pain relief

In some cases, the effect of the product may be minimal or absent altogether, that is, tissue sensitivity remains almost at the same level.

There are reasons for this. If we exclude damage to the packaging and a violation of the properties of the composition, the lack of pain relief is explained by the following factors:

• fear of the upcoming procedure - fear blocks other reflexes, and anesthesia does not occur;
• production of adrenaline - it is intensely produced in moments of panic and enters the nerve cells, neutralizing the effect of the drug.

To exclude such manifestations, experts recommend that patients prone to panic fear of the dentist take a sedative half an hour before the procedure.

Chronic alcohol dependence, as well as the body’s addiction to the drug, can have an inhibitory effect.

Requirements for drugs

Modern anesthesia solutions have certain requirements:

• Minimal risk of toxic and allergenic effects on the patient’s body;
• No risk of nerve and tissue damage;
• The most minimal manifestation of side effects and consequences;
• Rapid elimination from the body;
• Rapid manifestation of the analgesic effect;
• Complete anesthesia of all tissues at the injection site;
• Should not cause vasodilation;
• Duration of action for the entire period of treatment;
• Rapid cessation of action at the end of treatment;
• Providing all analgesic properties during storage.

Compliance with all these requirements allows you to achieve the desired result of pain relief and not cause negative consequences in the patient’s body.

Reviews

Carpule anesthesia is used almost everywhere in domestic clinics.

Its main purpose is to eliminate the fear of treatment and make it as comfortable as possible.

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