Frequently Asked Questions - Dentistry

If more than one shoot is necessary, there should be 2 prefilled ampoules available. The reset of the injector is not lavish. There are nurses, who can do this very quickly. Many dentists invest in 2 or 3 injectors, to safe time. 2 – 3 injectors prepared with prefilled ampoules are optimal for every treatment. 

Is the word „edema“the correct characterisation? A swelling can be seen in very few cases, when the injection site is producing an allergic reaction on the preservatives of the local anaesthetic agent. 

The Injectors trigger has a „press point“. This point has to be found and it’s position has to be trained. If you start pressing the trigger from this point, you will get a proper injection. The injector will not start producing uncontrolled movements, because the trigger will not perform two different movements. 

Infiltration anaesthesia using INJEX is possible on ALL teeth, except wisdom teeth.  Use the injector in the same area you would a traditional needle but at an angle of 90˚.

Injection should be performed into the firm gingiva.
Injecting into the free gingiva may result in intraligamentous injection and damage to the tooth support apparatus due to the applied pressure.
Injecting into the periodontal membrane fold of the mucosa allows rapid penetration of the local anaesthetic into the infra-orbitale foramen. This should be prevented as well. 

The patient should be sitting upright in a relaxed position. The time between positioning and releasing the injector should be kept as brief as possible with children and especially restless patients . 

The patient should be informed about the release noise of the injector to prevent defensive arm movement or startle reflexes 

The prepared injector is positioned above the tooth to be anaesthetized at an angle of 90"‑ while applying medium pressure. It is the same method as with a traditional needle. Once the patient has been informed about the release noise the trigger mechanism should be pressed as quickly as possible. The injector should be left firmly in place of the injection site for 2 seconds after injecting the anaesthetic.

The number of required ampoules should be filled and fitted with the SiliTop prior to use. Resetting the injector with the reset box takes only seconds. Administration is even quicker if several injectors are utilized 

Studies with different needle-free systems have shown that medication chooses the path of least resistance and thus no blood vessels or nerve fibres are injured. The mucous membrane is not damaged if the injector is positioned vertically while applying medium pressure. 

Haematoma at the injection site are still possible even when using a needle-free system.
They might occur with patients taking anticoagulants to treat cardiovascular disease (e.g., Marcumar) or thrombocytic aggregation inhibitors (e.g., ASS100 = time-released aspirin), or patients occasionally taking aspirin for pain relief.
Small bruises can also be due to too little or too much pressure when positioning the injector on the gingiva. 

Swelling is observed in a few cases, which might also be caused by the local anaesthetic itself (preservatives).  

Bleeding usually does not occur. As with needle injections, INJEX might cause some damage to the uppermost capillaries. In rare cases, this might cause a pin-sized drop of blood to emerge at the injection site. This is especially the case if the patient has been taking medication to treat cardiovascular disease (e.g., Marcumar, ASS100 = time-released aspirin) or normal aspirin for pain relief. 

The recommended basic dosage is 0.3 ml per injection. A second injection to prolong the effect can be administered at any time. The local anaesthetic dose is still lower than with a conventional syringe in spite of the second injection. 

Less than 0.3 ml for the initial injection is not sufficient and the degree of anaesthesia is too low, just as with conventional infiltration anaesthesia.  

The local anaesthetic becomes effective more quickly than after a conventional injection. The injected area is anaesthetized after just a few seconds 

Injecting with INJEX provides a therapeutic window larger than with conventional infiltration anaesthesia due to the better distribution within the tissue. 

After anaesthetizing with INJEX, numerous procedures may be performed on the teeth such as fillings, extractions, or polishing. Small gum procedures may also be carried out as part of a periodontal or orthodontic treatment.  Do not use for wisdom teeth.

It is recommended to use a probe to check the anaesthesia depth before commencing treatment. An additional injection may be administered if necessary. 

SiliTop is a cap affixed to the ampoule head before the injection developed especially for dental applications. It prevents pressure sensations that might be caused by the injector impulse when activating the trigger.  

Using INJEX without SiliTop is not recommended because SiliTop ensures the accurate, safe, and gentle positioning of the INJEX injector.  . 

Each ampoule of the INJEX system may be filled with max 0.3 ml of anaesthetic. A dose of 0.3 ml is recommended for dental applications.  

All routine treatments such as (simple) fillings, endodontic measures, preparations, extractions, etc. may be performed, except on wisdom teeth.  Smaller periodontal procedures as well as sub gingival wiring performed by orthodontists are possible as well. Treatment may last up to approx. 20 minutes without administering additional doses.

Especially children but also very sensitive and very anxious adults may exhibit panicked behavior when faced with needle injections. Since this reaction usually results in a sudden and jerky motion, the risk of injury for patient as well physician or dental staff is higher.
The INJEX system eliminates this risk since it does not feature a needle. 

The transporter adapter is a sterile disposable product and can be used only with one cylinder cartridge to prevent contamination as well as diminishing functionality. Dispose of the adapter when the medication cartridge is empty. The local anaesthetic may crystallize within the adapter if the same adapter is used with additional medication cartridges. This can impair the transfer to the INJEX ampoule. 

A modified injection angle results in an enlarged medication injection point. This may lead to increased bleeding and risk of haematoma. 

Medications licensed for subcutaneous use can be administered with the needle-free INJEX.
The main applications for the INJEX system at present are diabetes (subcutaneous administration of insulin), the prevention of thrombosis (by means of Heparin) and local anaesthesia (e.g. prior to venous catheterisation, prior to minor surgical procedures or for dental infiltration anaesthesia). Other applications for INJEX are the treatment of dupuytren´s disease or homeosiniatry. Please note the technical reports for these mentioned applications.

When applied correctly the injection with INJEX is virtually painless. The sensation can be described as a short slight pressure on the skin surface. As pain is felt individually one cannot state a general and obliging assertion. As fluid is pressed under the skin the patient will sense the injection with INJEX more or less, depending on the volume and the individual sensibility. Patients generally assesse the sting from a needle as more unpleasant than the injection with INJEX.
(literature review: DENNE et al., 1992, TEINTZ et al., 1991, RESMAN et al., 1985)
The micro orifice of the ampoule has a diameter of 0.18 mm. Currently, the thinnest needle has a comparatively thick diameter of 0.25 mm. 

No. In order to guarantee sterility and function, the ampoules are intended to be used once only. 

SiliTop is a cap affixed to the ampoule head before the injection developed especially for dental applications. It prevents pressure sensations that might be caused by the injector impulse when activating the trigger.  

SiliTop is a cap affixed to the ampoule head before the injection developed especially for dental applications. It prevents pressure sensations that might be caused by the injector impulse when activating the trigger.

 Adapter, ampoules, and SiliTop are sterile products for single-use only. 

After anaesthetising with INJEX, numerous procedures may be performed on the listed teeth (primary dentition 55-85, upper jaw 15-25, lower jaw 33-43) such as fillings, extractions, or polishing. Small gum procedures may also be carried out as part of a periodontal or orthodontic treatment. 

Infiltration anaesthesia using INJEX is possible wherever the injector can be vertically applied to the firm gingiva surrounding the tooth to be anaesthetized. This applies to the following adult teeth: upper jaw region 15-25 and lower jaw region 33-43. The vertical application of INJEX is possible with virtually all teeth of a child's primary dentition (upper jaw region 55-65 and lower jaw region 75-85). 

The local anaesthetic becomes effective more quickly than after a conventional injection. The injected area is anaesthetized after just a few seconds. 

Injection should be performed into the firm gingiva.
Injecting into the free gingiva may result in intraligamentous injection and damage to the tooth support apparatus due to the applied pressure.
Injecting into the periodontal membrane fold of the mucosa allows rapid penetration of the local anaesthetic into the infra-orbitale foramen. This should be prevented as well.  

Topical anaesthesia is usually not required for adult patients. Patients tolerate positioning the INJEX ampoule very well due to the special SiliTop. Children or very sensitive adults might require some topical anaesthesia first (e.g., lidocaine gel) to reduce the topical pressure sensation when positioning the injector. 

Additional doses (within the scope of the respective limit dosage) may be administered with INJEX as soon as necessary as long as conditions for a proper injection exist. The proven shorter dispersion time facilitates subsequent dosing, saves time, and provides a greater therapeutic effective window. 

No, the utilized materials are not suitable for autoclave treatment. Adapter, ampoules, and SiliTop are sterile products for single-use only. The injector, the reset box, and the transporter are designed for multiple-use and need not be sterilized since they are not in direct contact with the patient.  

Using INJEX to inject into inflamed and/or infected gums should be avoided since it can cause increased bleeding or spread germs. The same guidelines and preventative measures as with conventional injections are to be observed when injecting with INJEX into an inflamed area as part of an emergency treatment. Antibiosis is recommended. 

Using INJEX to inject into inflamed and/or infected gums should be avoided since it can cause increased bleeding or spread germs. The same guidelines and preventative measures as with conventional injections are to be observed when injecting with INJEX into an inflamed area as part of an emergency treatment. Antibiotics are recommended. INJEX should not be used on wisdom teeth.