FAQ

Frequently asked questions on W&H products and helpful descriptions on the topic of hygiene and care.

Air polisher

Accessories

Sterilizers

  • Lara (27)
    • Warning about consumable replacement.
      POSSIBLE CAUSE
      A consumable needs to be replaced.
      SOLUTION
      Order the requested consumable (door seal, dust filter, bacteriological filter) and replace it. See the chapter “Maintenance” in the Instructions for Use.
    • Does my sterilizer need any periodic qualification/validation?
      Validation generally comprises a range of tests defined in internationally recognised standards. These tests begin for every device with the factory tests at W&H. In addition, corresponding documentation is included with your device. Prior to commissioning the device at your premises, the technician performs further checks to ensure the device functions correctly. Then, depending on the national/regional laws and directives, the device must be subjected to a so-called renewed performance qualification at regular intervals. For further information, please contact your dealer.
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • The cycle starts but there is no rise in pressure/temperature
      POSSIBLE CAUSE
      The safety thermostat is open.
      SOLUTION
      Reset the safety thermostat (see chapter “Reset the safety thermostat” in the Instructions for Use).

      POSSIBLE CAUSE
      Electric/electronic fault
      SOLUTION
      Contact an authorized W&H service partner.
    • At the end of the cycle, there is residual water in the chamber.
      POSSIBLE CAUSE
      Sterilizer not properly levelled.
      SOLUTION
      Place the sterilizator on a flat, level surface.

      POSSIBLE CAUSE
      Overloaded chamber.
      SOLUTION
      Comply with the maximum load weight limits for each type of load. Always use the chamber rack for trays and cassettes.

      POSSIBLE CAUSE
      Chamber filter clogged.
      SOLUTION
      Remove and clean the chamber filter.

      POSSIBLE CAUSE
      Chamber filter cap mispositioned.
      SOLUTION
      Mount the chamber filter cap properly (see chapter “Monthly or 50-cycle maintenance - Cleaning the chamber filter” in the Instructions for Use).

      POSSIBLE CAUSE
      Load incorrectly placed.
      SOLUTION
      Follow the recommendations as listed in chapter “Load maintenance and preparation” in the Instructions for Use.
    • Stains or spots on instruments.
      POSSIBLE CAUSE
      Instruments rinsed with tap water and not dried before sterilization.
      SOLUTION
      Ensure that instruments are rinsed with distilled or demineralized water and completely dry before they are placed in the sterilizer.

      POSSIBLE CAUSE
      Use of water of poor quality or water containing chemical substances.
      SOLUTION
      Drain both water tanks. Use good quality water (see chapter “Water quality” in the Instructions for Use).

      POSSIBLE CAUSE
      Organic or chemical residues on the instruments
      SOLUTION
      Clean, rinse and dry instruments before placing them in the sterilizer (see chapter “Load maintenance and preparation” in the Instructions for Use.

      POSSIBLE CAUSE
      Dirt in chamber, trays, tray rack.
      SOLUTION
      Clean the chamber and wash the chamber furniture.

      POSSIBLE CAUSE
      Contact between instruments of different materials.
      SOLUTION
      Ensure that instruments of different materials do not touch each other (aluminium, carbon or stainless steel, etc.); place them on different trays or cassettes or pouch them (see chapter “Load maintenance and preparation” in the Instructions for Use).

      POSSIBLE CAUSE
      Scale deposits on the chamber.
      SOLUTION
      Clean the chamber and use good quality water (see chapter “Water quality” in the Instructions for Use).
    • Instruments are turning brown or black.
      POSSIBLE CAUSE
      Incorrect temperature selected.
      SOLUTION
      Select a sterilization cycle featuring a lower sterilization temperature. Follow the instructions of the instrument manufacturer.
    • No cycles are stored in the cycle history menu.
      POSSIBLE CAUSE
      An electronic board was replaced when serviced.
      SOLUTION
      The memory of the old board can not be restored. Consult the cycle history in the USB pen drive.
    • When starting a cycle, the chamber door locks but re-opens immediately. The “Open the door” message appears.
      POSSIBLE CAUSE
      Door seal not properly placed.
      SOLUTION
      Ensure that the door seal is correctly inserted around the whole circumference.

      POSSIBLE CAUSE
      Door jammed by external objects or by the load itself.
      SOLUTION
      Remove any objects interfering with the chamber door. Check for interference between the door and the chamber furniture and/or the load.
    • The sterilizer enters into “Standby mode” immediately after being switched on.
      POSSIBLE CAUSE
      The unit was turned off while in standby mode.
      SOLUTION
      Press the standby mode button to exit.
    • At the end of the cycle the display reads “Open the door” but it is not possible to open the door.
      POSSIBLE CAUSE
      The chamber is still under pressure due to an internal malfunction.
      SOLUTION
      Unplug the sterilizer and wait at least three hours: this releases any internal pressure allowing the chamber door to be opened. Then retry. Call service if the problem persists.

      POSSIBLE CAUSE
      The bacteriological filter is blocked.
      SOLUTION
      Remove the bacteriological filter to release the pressure. Replace the filter (see the chapter “400-cycle maintenance – Replacing the bacteriological filter” in the Instructions for Use). Note that bacteriological filters need to be replaced every 400 cycles.
    • The sterilization (PROCESS) phase of a sterilization cycle was longer than expected.
      POSSIBLE CAUSE
      The chamber temperature dropped below the minimum threshold and the software performed a successful recovery.
      SOLUTION
      Wait for cycle completion. If the problem occurs frequently, contact an authorized W&H service partner.
    • Warning about saving to the USB (HTML and SCL files)
      POSSIBLE CAUSE
      The USB mass storage is disconnected or full.
      SOLUTION
      Check presence and condition of the USB pen drive. If the problem persist, contact an authorized W&H service partner.
    • Warning about programmed maintenance.
      POSSIBLE CAUSE
      The maintenance program needs to be carried out.
      SOLUTION
      Contact an authorized W&H service partner.
    • The cycle report printer does not work.
      POSSIBLE CAUSE
      Printer not properly connected or not powered.
      SOLUTION
      Check the data and power connection to the printer.
    • The sterilizer is connected to an automated water supply system, there is no clean water in the tank and the automatic water filling does not fill the water.
      POSSIBLE CAUSE
      Water filling system not connected.
      SOLUTION
      Connect the water filling system to the sterilizer. (see ANNEX 7 For water quality requirements see chapter “Water quality” in the Instructions For Use).

      POSSIBLE CAUSE
      When the water filling system attempted to fill the tank, water was temporarily unavailable.
      SOLUTION
      Since the water tank filling is attempted only once in-between cycle execution, this event inhibits water feeding. Switch the sterilizer OFF and then ON again.
      Check the external water supply system.
      Check for water leaks from the sterilizer.

      POSSIBLE CAUSE
      Faulty MIN water level sensor in the clean water tank.
      SOLUTION
      Contact an authorized W&H service partner.
    • The sterilizer remains switched OFF.
      POSSIBLE CAUSE
      The main switch or network circuit breaker is OFF.
      SOLUTION
      Activate the main switch or network circuit breaker (ON).

      POSSIBLE CAUSE
      No voltage at the socket.
      SOLUTION
      Check the building electrical supply.

      POSSIBLE CAUSE
      The power cord is not connected properly.
      SOLUTION
      Check and connect the power cord properly.
    • Water is leaking at the front of the sterilizer.
      POSSIBLE CAUSE
      Leaks through the chamber door seal.
      SOLUTION
      Clean or replace the door seal. Clean the door surface facing the chamber.

      POSSIBLE CAUSE
      Internal leak.
      SOLUTION
      Contact an authorized W&H service partner.
    • Whom should I contact to validate and maintain my sterilizer?
      Validation shall be carried out by an official authority. Maintenance tasks shall be carried out by a qualified and authorised technician.
    • How do I change consumable components on my sterilizer?
      Consumable replacement instructions are provided in the Instructions for Use, chapter “Maintenance”. In addition, a video description is available: • in the sterilizer, in the maintenance section of the menu (only for Lisa); • in the Consumables & Accessories and Video Tutorial section of this web site.
    • How do I clean the water tanks and what products should I use?
      Water tank cleaning instructions are provided in the Instructions for Use, chapter “Maintenance”. Information and videos relating to the cleaning of the water tanks and cleaning products can also be found on the Video Tutorial section of this web site.
    • Which water quality should I use for my sterilizer?
      The water quality for sterilizers is internationally specified by standards and directives. The reasons for this are that your sterilizer can be seriously damaged by it or the sterilization can be jeopardized. Consequently, only water with conductivity of less than 15 µS/cm should be used for your W&H sterilizer. The Multidem system is especially suited to preparing suitable water (see chapter “Water quality” in the Instructions for Use).
    • Should I pouch/wrap my instruments and how long can I store them after sterilization?
      To ensure that your instruments are stored in a sterile state from their successful sterilization until they are used, W&H recommends wrapping them in suitable sterile barrier systems before sterilization. The recommended storage period can be found in the recommendations of the wrapping material manufacturer. For further information, please contact your dealer.
    • Do I need to carry out periodic testing on my Lisa/Lina/Lara?
      Lisa/Lina/Lara features test cycles (B&D/Helix test, Vacuum test). Compulsory and frequency of testing are regulated by local/national guidelines.
    • What is validation?
      Validation is a testing procedure carried out by an official authority, proving the effectiveness of your sterilizer. Compulsories and frequency of validation are regulated by local/national guidelines.
    • Do I need to document the results of all periodic tests?
      W&H recommends recording all periodic tests, repairs and modifications on the sterilizer in a logbook including date and signature of the person who carried out the test or other activity. Compulsories of recording is regulated by local/national guidelines.
    • How long should I archive the documentation of regular tests?
      Keep the results according to your country/regional specific laws and guidelines. Those records can be of assistance in case of service as well.
  • Lisa (27)
    • Warning about consumable replacement.
      POSSIBLE CAUSE
      A consumable needs to be replaced.
      SOLUTION
      Order the requested consumable (door seal, dust filter, bacteriological filter) and replace it. See the chapter “Maintenance” in the Instructions for Use.
    • Does my sterilizer need any periodic qualification/validation?
      Validation generally comprises a range of tests defined in internationally recognised standards. These tests begin for every device with the factory tests at W&H. In addition, corresponding documentation is included with your device. Prior to commissioning the device at your premises, the technician performs further checks to ensure the device functions correctly. Then, depending on the national/regional laws and directives, the device must be subjected to a so-called renewed performance qualification at regular intervals. For further information, please contact your dealer.
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • The cycle starts but there is no rise in pressure/temperature
      POSSIBLE CAUSE
      The safety thermostat is open.
      SOLUTION
      Reset the safety thermostat (see chapter “Reset the safety thermostat” in the Instructions for Use).

      POSSIBLE CAUSE
      Electric/electronic fault
      SOLUTION
      Contact an authorized W&H service partner.
    • At the end of the cycle, there is residual water in the chamber.
      POSSIBLE CAUSE
      Sterilizer not properly levelled.
      SOLUTION
      Place the sterilizator on a flat, level surface.

      POSSIBLE CAUSE
      Overloaded chamber.
      SOLUTION
      Comply with the maximum load weight limits for each type of load. Always use the chamber rack for trays and cassettes.

      POSSIBLE CAUSE
      Chamber filter clogged.
      SOLUTION
      Remove and clean the chamber filter.

      POSSIBLE CAUSE
      Chamber filter cap mispositioned.
      SOLUTION
      Mount the chamber filter cap properly (see chapter “Monthly or 50-cycle maintenance - Cleaning the chamber filter” in the Instructions for Use).

      POSSIBLE CAUSE
      Load incorrectly placed.
      SOLUTION
      Follow the recommendations as listed in chapter “Load maintenance and preparation” in the Instructions for Use.
    • Stains or spots on instruments.
      POSSIBLE CAUSE
      Instruments rinsed with tap water and not dried before sterilization.
      SOLUTION
      Ensure that instruments are rinsed with distilled or demineralized water and completely dry before they are placed in the sterilizer.

      POSSIBLE CAUSE
      Use of water of poor quality or water containing chemical substances.
      SOLUTION
      Drain both water tanks. Use good quality water (see chapter “Water quality” in the Instructions for Use).

      POSSIBLE CAUSE
      Organic or chemical residues on the instruments
      SOLUTION
      Clean, rinse and dry instruments before placing them in the sterilizer (see chapter “Load maintenance and preparation” in the Instructions for Use.

      POSSIBLE CAUSE
      Dirt in chamber, trays, tray rack.
      SOLUTION
      Clean the chamber and wash the chamber furniture.

      POSSIBLE CAUSE
      Contact between instruments of different materials.
      SOLUTION
      Ensure that instruments of different materials do not touch each other (aluminium, carbon or stainless steel, etc.); place them on different trays or cassettes or pouch them (see chapter “Load maintenance and preparation” in the Instructions for Use).

      POSSIBLE CAUSE
      Scale deposits on the chamber.
      SOLUTION
      Clean the chamber and use good quality water (see chapter “Water quality” in the Instructions for Use).
    • Instruments are turning brown or black.
      POSSIBLE CAUSE
      Incorrect temperature selected.
      SOLUTION
      Select a sterilization cycle featuring a lower sterilization temperature. Follow the instructions of the instrument manufacturer.
    • No cycles are stored in the cycle history menu.
      POSSIBLE CAUSE
      An electronic board was replaced when serviced.
      SOLUTION
      The memory of the old board can not be restored. Consult the cycle history in the USB pen drive.
    • When starting a cycle, the chamber door locks but re-opens immediately. The “Open the door” message appears.
      POSSIBLE CAUSE
      Door seal not properly placed.
      SOLUTION
      Ensure that the door seal is correctly inserted around the whole circumference.

      POSSIBLE CAUSE
      Door jammed by external objects or by the load itself.
      SOLUTION
      Remove any objects interfering with the chamber door. Check for interference between the door and the chamber furniture and/or the load.
    • The sterilizer enters into “Standby mode” immediately after being switched on.
      POSSIBLE CAUSE
      The unit was turned off while in standby mode.
      SOLUTION
      Press the standby mode button to exit.
    • At the end of the cycle the display reads “Open the door” but it is not possible to open the door.
      POSSIBLE CAUSE
      The chamber is still under pressure due to an internal malfunction.
      SOLUTION
      Unplug the sterilizer and wait at least three hours: this releases any internal pressure allowing the chamber door to be opened. Then retry. Call service if the problem persists.

      POSSIBLE CAUSE
      The bacteriological filter is blocked.
      SOLUTION
      Remove the bacteriological filter to release the pressure. Replace the filter (see the chapter “400-cycle maintenance – Replacing the bacteriological filter” in the Instructions for Use). Note that bacteriological filters need to be replaced every 400 cycles.
    • The sterilization (PROCESS) phase of a sterilization cycle was longer than expected.
      POSSIBLE CAUSE
      The chamber temperature dropped below the minimum threshold and the software performed a successful recovery.
      SOLUTION
      Wait for cycle completion. If the problem occurs frequently, contact an authorized W&H service partner.
    • Warning about saving to the USB (HTML and SCL files)
      POSSIBLE CAUSE
      The USB mass storage is disconnected or full.
      SOLUTION
      Check presence and condition of the USB pen drive. If the problem persist, contact an authorized W&H service partner.
    • Warning about programmed maintenance.
      POSSIBLE CAUSE
      The maintenance program needs to be carried out.
      SOLUTION
      Contact an authorized W&H service partner.
    • The cycle report printer does not work.
      POSSIBLE CAUSE
      Printer not properly connected or not powered.
      SOLUTION
      Check the data and power connection to the printer.
    • The sterilizer is connected to an automated water supply system, there is no clean water in the tank and the automatic water filling does not fill the water.
      POSSIBLE CAUSE
      Water filling system not connected.
      SOLUTION
      Connect the water filling system to the sterilizer. (see ANNEX 7 For water quality requirements see chapter “Water quality” in the Instructions For Use).

      POSSIBLE CAUSE
      When the water filling system attempted to fill the tank, water was temporarily unavailable.
      SOLUTION
      Since the water tank filling is attempted only once in-between cycle execution, this event inhibits water feeding. Switch the sterilizer OFF and then ON again.
      Check the external water supply system.
      Check for water leaks from the sterilizer.

      POSSIBLE CAUSE
      Faulty MIN water level sensor in the clean water tank.
      SOLUTION
      Contact an authorized W&H service partner.
    • The sterilizer remains switched OFF.
      POSSIBLE CAUSE
      The main switch or network circuit breaker is OFF.
      SOLUTION
      Activate the main switch or network circuit breaker (ON).

      POSSIBLE CAUSE
      No voltage at the socket.
      SOLUTION
      Check the building electrical supply.

      POSSIBLE CAUSE
      The power cord is not connected properly.
      SOLUTION
      Check and connect the power cord properly.
    • Water is leaking at the front of the sterilizer.
      POSSIBLE CAUSE
      Leaks through the chamber door seal.
      SOLUTION
      Clean or replace the door seal. Clean the door surface facing the chamber.

      POSSIBLE CAUSE
      Internal leak.
      SOLUTION
      Contact an authorized W&H service partner.
    • Whom should I contact to validate and maintain my sterilizer?
      Validation shall be carried out by an official authority. Maintenance tasks shall be carried out by a qualified and authorised technician.
    • How do I change consumable components on my sterilizer?
      Consumable replacement instructions are provided in the Instructions for Use, chapter “Maintenance”. In addition, a video description is available: • in the sterilizer, in the maintenance section of the menu (only for Lisa); • in the Consumables & Accessories and Video Tutorial section of this web site.
    • How do I clean the water tanks and what products should I use?
      Water tank cleaning instructions are provided in the Instructions for Use, chapter “Maintenance”. Information and videos relating to the cleaning of the water tanks and cleaning products can also be found on the Video Tutorial section of this web site.
    • Which water quality should I use for my sterilizer?
      The water quality for sterilizers is internationally specified by standards and directives. The reasons for this are that your sterilizer can be seriously damaged by it or the sterilization can be jeopardized. Consequently, only water with conductivity of less than 15 µS/cm should be used for your W&H sterilizer. The Multidem system is especially suited to preparing suitable water (see chapter “Water quality” in the Instructions for Use).
    • Should I pouch/wrap my instruments and how long can I store them after sterilization?
      To ensure that your instruments are stored in a sterile state from their successful sterilization until they are used, W&H recommends wrapping them in suitable sterile barrier systems before sterilization. The recommended storage period can be found in the recommendations of the wrapping material manufacturer. For further information, please contact your dealer.
    • Do I need to carry out periodic testing on my Lisa/Lina/Lara?
      Lisa/Lina/Lara features test cycles (B&D/Helix test, Vacuum test). Compulsory and frequency of testing are regulated by local/national guidelines.
    • What is validation?
      Validation is a testing procedure carried out by an official authority, proving the effectiveness of your sterilizer. Compulsories and frequency of validation are regulated by local/national guidelines.
    • Do I need to document the results of all periodic tests?
      W&H recommends recording all periodic tests, repairs and modifications on the sterilizer in a logbook including date and signature of the person who carried out the test or other activity. Compulsories of recording is regulated by local/national guidelines.
    • How long should I archive the documentation of regular tests?
      Keep the results according to your country/regional specific laws and guidelines. Those records can be of assistance in case of service as well.
  • Lina (24)
    • Does my sterilizer need any periodic qualification/validation?
      Validation generally comprises a range of tests defined in internationally recognised standards. These tests begin for every device with the factory tests at W&H. In addition, corresponding documentation is included with your device. Prior to commissioning the device at your premises, the technician performs further checks to ensure the device functions correctly. Then, depending on the national/regional laws and directives, the device must be subjected to a so-called renewed performance qualification at regular intervals. For further information, please contact your dealer.
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • The cycle starts but there is no rise in pressure/temperature
      POSSIBLE CAUSE
      The safety thermostat is open.
      SOLUTION
      Reset the safety thermostat (see chapter “Reset the safety thermostat” in the Instructions for Use).

      POSSIBLE CAUSE
      Electric/electronic fault
      SOLUTION
      Contact an authorized W&H service partner.
    • At the end of the cycle, there is residual water in the chamber.
      POSSIBLE CAUSE
      Sterilizer not properly levelled.
      SOLUTION
      Place the sterilizator on a flat, level surface.

      POSSIBLE CAUSE
      Overloaded chamber.
      SOLUTION
      Comply with the maximum load weight limits for each type of load. Always use the chamber rack for trays and cassettes.

      POSSIBLE CAUSE
      Chamber filter clogged.
      SOLUTION
      Remove and clean the chamber filter.

      POSSIBLE CAUSE
      Chamber filter cap mispositioned.
      SOLUTION
      Mount the chamber filter cap properly (see chapter “Monthly or 50-cycle maintenance - Cleaning the chamber filter” in the Instructions for Use).

      POSSIBLE CAUSE
      Load incorrectly placed.
      SOLUTION
      Follow the recommendations as listed in chapter “Load maintenance and preparation” in the Instructions for Use.
    • Stains or spots on instruments.
      POSSIBLE CAUSE
      Instruments rinsed with tap water and not dried before sterilization.
      SOLUTION
      Ensure that instruments are rinsed with distilled or demineralized water and completely dry before they are placed in the sterilizer.

      POSSIBLE CAUSE
      Use of water of poor quality or water containing chemical substances.
      SOLUTION
      Drain both water tanks. Use good quality water (see chapter “Water quality” in the Instructions for Use).

      POSSIBLE CAUSE
      Organic or chemical residues on the instruments
      SOLUTION
      Clean, rinse and dry instruments before placing them in the sterilizer (see chapter “Load maintenance and preparation” in the Instructions for Use.

      POSSIBLE CAUSE
      Dirt in chamber, trays, tray rack.
      SOLUTION
      Clean the chamber and wash the chamber furniture.

      POSSIBLE CAUSE
      Contact between instruments of different materials.
      SOLUTION
      Ensure that instruments of different materials do not touch each other (aluminium, carbon or stainless steel, etc.); place them on different trays or cassettes or pouch them (see chapter “Load maintenance and preparation” in the Instructions for Use).

      POSSIBLE CAUSE
      Scale deposits on the chamber.
      SOLUTION
      Clean the chamber and use good quality water (see chapter “Water quality” in the Instructions for Use).
    • Instruments are turning brown or black.
      POSSIBLE CAUSE
      Incorrect temperature selected.
      SOLUTION
      Select a sterilization cycle featuring a lower sterilization temperature. Follow the instructions of the instrument manufacturer.
    • When starting a cycle, the chamber door locks but re-opens immediately. The “Open the door” message appears.
      POSSIBLE CAUSE
      Door seal not properly placed.
      SOLUTION
      Ensure that the door seal is correctly inserted around the whole circumference.

      POSSIBLE CAUSE
      Door jammed by external objects or by the load itself.
      SOLUTION
      Remove any objects interfering with the chamber door. Check for interference between the door and the chamber furniture and/or the load.
    • The sterilizer enters into “Standby mode” immediately after being switched on.
      POSSIBLE CAUSE
      The unit was turned off while in standby mode.
      SOLUTION
      Press the standby mode button to exit.
    • At the end of the cycle the display reads “Open the door” but it is not possible to open the door.
      POSSIBLE CAUSE
      The chamber is still under pressure due to an internal malfunction.
      SOLUTION
      Unplug the sterilizer and wait at least three hours: this releases any internal pressure allowing the chamber door to be opened. Then retry. Call service if the problem persists.

      POSSIBLE CAUSE
      The bacteriological filter is blocked.
      SOLUTION
      Remove the bacteriological filter to release the pressure. Replace the filter (see the chapter “400-cycle maintenance – Replacing the bacteriological filter” in the Instructions for Use). Note that bacteriological filters need to be replaced every 400 cycles.
    • The sterilization (PROCESS) phase of a sterilization cycle was longer than expected.
      POSSIBLE CAUSE
      The chamber temperature dropped below the minimum threshold and the software performed a successful recovery.
      SOLUTION
      Wait for cycle completion. If the problem occurs frequently, contact an authorized W&H service partner.
    • The cycle report printer does not work.
      POSSIBLE CAUSE
      Printer not properly connected or not powered.
      SOLUTION
      Check the data and power connection to the printer.
    • The sterilizer is connected to an automated water supply system, there is no clean water in the tank and the automatic water filling does not fill the water.
      POSSIBLE CAUSE
      Water filling system not connected.
      SOLUTION
      Connect the water filling system to the sterilizer. (see ANNEX 7 For water quality requirements see chapter “Water quality” in the Instructions For Use).

      POSSIBLE CAUSE
      When the water filling system attempted to fill the tank, water was temporarily unavailable.
      SOLUTION
      Since the water tank filling is attempted only once in-between cycle execution, this event inhibits water feeding. Switch the sterilizer OFF and then ON again.
      Check the external water supply system.
      Check for water leaks from the sterilizer.

      POSSIBLE CAUSE
      Faulty MIN water level sensor in the clean water tank.
      SOLUTION
      Contact an authorized W&H service partner.
    • LINA PRO13-003
      What is the maximum noise level of the sterilizer?
      The silent running noise at a maximum level of 66.5 dB(A) guarantees a quiet working environment.
    • The sterilizer remains switched OFF.
      POSSIBLE CAUSE
      The main switch or network circuit breaker is OFF.
      SOLUTION
      Activate the main switch or network circuit breaker (ON).

      POSSIBLE CAUSE
      No voltage at the socket.
      SOLUTION
      Check the building electrical supply.

      POSSIBLE CAUSE
      The power cord is not connected properly.
      SOLUTION
      Check and connect the power cord properly.
    • Water is leaking at the front of the sterilizer.
      POSSIBLE CAUSE
      Leaks through the chamber door seal.
      SOLUTION
      Clean or replace the door seal. Clean the door surface facing the chamber.

      POSSIBLE CAUSE
      Internal leak.
      SOLUTION
      Contact an authorized W&H service partner.
    • Whom should I contact to validate and maintain my sterilizer?
      Validation shall be carried out by an official authority. Maintenance tasks shall be carried out by a qualified and authorised technician.
    • How do I change consumable components on my sterilizer?
      Consumable replacement instructions are provided in the Instructions for Use, chapter “Maintenance”. In addition, a video description is available: • in the sterilizer, in the maintenance section of the menu (only for Lisa); • in the Consumables & Accessories and Video Tutorial section of this web site.
    • How do I clean the water tanks and what products should I use?
      Water tank cleaning instructions are provided in the Instructions for Use, chapter “Maintenance”. Information and videos relating to the cleaning of the water tanks and cleaning products can also be found on the Video Tutorial section of this web site.
    • Which water quality should I use for my sterilizer?
      The water quality for sterilizers is internationally specified by standards and directives. The reasons for this are that your sterilizer can be seriously damaged by it or the sterilization can be jeopardized. Consequently, only water with conductivity of less than 15 µS/cm should be used for your W&H sterilizer. The Multidem system is especially suited to preparing suitable water (see chapter “Water quality” in the Instructions for Use).
    • Should I pouch/wrap my instruments and how long can I store them after sterilization?
      To ensure that your instruments are stored in a sterile state from their successful sterilization until they are used, W&H recommends wrapping them in suitable sterile barrier systems before sterilization. The recommended storage period can be found in the recommendations of the wrapping material manufacturer. For further information, please contact your dealer.
    • Do I need to carry out periodic testing on my Lisa/Lina/Lara?
      Lisa/Lina/Lara features test cycles (B&D/Helix test, Vacuum test). Compulsory and frequency of testing are regulated by local/national guidelines.
    • What is validation?
      Validation is a testing procedure carried out by an official authority, proving the effectiveness of your sterilizer. Compulsories and frequency of validation are regulated by local/national guidelines.
    • Do I need to document the results of all periodic tests?
      W&H recommends recording all periodic tests, repairs and modifications on the sterilizer in a logbook including date and signature of the person who carried out the test or other activity. Compulsories of recording is regulated by local/national guidelines.
    • How long should I archive the documentation of regular tests?
      Keep the results according to your country/regional specific laws and guidelines. Those records can be of assistance in case of service as well.

Straight & Contra-angle Handpieces

Laboratory Devices

Cordless Devices

Straight & Contra-angle Handpieces

Accessories

Reprocessing Devices

  • Assistina TWIN (9)
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • Which processing steps are carried out in the Assistina TWIN?
      • Cleaning the spray channels with W&H Activefluid
      • Lubricating the rotating parts with W&H Service Oil
      • Throughout the maintenance process, potentially contaminated aerosols are extracted from the process chamber and the exhaust air is cleaned using a HEPA filter.
    • What instrument adaptors are available for the Assistina TWIN?
      All adaptors that are suitable for the Assistina 3x2/3x3 can also be used in the Assistina TWIN. There is only one exception: the RM/ISO adaptor for the Assistina 3x2/3x3 is not compatible with the Assistina TWIN. The HPI adaptor can be used for the Assistina TWIN instead.
    • Why does the Assistina TWIN have a HEPA filter?
      During the maintenance process in the Assistina TWIN, the rotating parts are lubricated with oil and the spray channels rinsed with cleaning solution. These liquids are introduced to the handpieces using compressed air, which produces aerosols that may contain potentially contaminated body fluids (e.g. blood and saliva). In order to ensure that the apparatus poses no risk to the user, the patient or third parties, the law stipulates that aerosols must be prevented from leaking out of the apparatus. We make sure of this by using active suction and the HEPA filter. This HEPA filter must of course be changed regularly, which is why the lifespan of the filter is matched exactly to the capacity of the two cartridges. The HEPA filter therefore reaches the end of its service life once one set of cartridges has been used.
    • What does HEPA mean, and what is filtered out of the air?
      HEPA is short for 'High Efficiency Particular Air', and the filter is classified as HEPA class E11. This means that the filter retains all particles larger than 1 µm, which includes, among other things, a wide range of bacteria and viruses, suspended particles such as dust and respirable aerosols.
    • How does the user know when the TWIN Care Set needs to be replaced?
      The intelligent process monitoring system documents the number of maintenance cycles that have been performed, thereby automatically calculating the number of instruments that can be serviced with the remaining quantity of fluid. The user receives an alert 300 cycles before the cartridge needs replacing (the oil and cleaner LEDs on the top of the unit turn yellow in colour).
    • How often does the TWIN Care Set need to be replaced?
      The consumption volumes for each instrument are 0.07 ml of oil and 0.07 ml of cleaning solution. This gives a maximum capacity of 2857 cycles. In reality, the value is around 2800 to 2850 cycles, as initial filling is also required and the fill quantity of the cartridges is subject to certain tolerances that are regulated by the applicable standards.
    • How do you replace the TWIN Care Set?
      The two cartridges and the filter can be changed easily without any tools. As with the Assistina 3x2/3x3, the fluid is supplied via tapping needles in the bottom of the cartridge spaces that penetrate the cartridge membrane, thereby drawing the fluid out of the cartridge. The two cartridges have different shapes to ensure that the two fluid types cannot be mixed up. In addition, it is only possible to install the HEPA filter incorrectly by using force, which is not necessary.
    • Why is there no rotational lubrication option in the Assistina TWIN?
      The oil is atomized in the Assistina TWIN before it is enters the instrument. This ensures full coverage of the gear parts, eliminating the need for technically complex and time-consuming rotational lubrication. However, there is no negative impact on the maintenance quality: the results of a maintenance operation correspond to those achieved with the Assistina 301 Plus.

Water Treatment Devices

  • Multidem (2)
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • Which water quality should I use for my sterilizer?
      The water quality for sterilizers is internationally specified by standards and directives. The reasons for this are that your sterilizer can be seriously damaged by it or the sterilization can be jeopardized. Consequently, only water with conductivity of less than 15 µS/cm should be used for your W&H sterilizer. The Multidem system is especially suited to preparing suitable water (see chapter “Water quality” in the Instructions for Use).
  • Osmo (2)
    • Should I call the service station before sending equipment for repair?
      If you are not sure what the cause of the problem is, it is better to call the service station and talk to a technician. Together with the technician it can be determined what needs to be sent in and sometimes it is possible to even solve the problem right away.
    • Which water quality should I use for my sterilizer?
      The water quality for sterilizers is internationally specified by standards and directives. The reasons for this are that your sterilizer can be seriously damaged by it or the sterilization can be jeopardized. Consequently, only water with conductivity of less than 15 µS/cm should be used for your W&H sterilizer. The Multidem system is especially suited to preparing suitable water (see chapter “Water quality” in the Instructions for Use).

Straight & Contra-angle Handpieces

Saw Handpieces

Prosthodontic Screwdriver

Surgical Devices

  • Piezomed (8)
    • How does it work to wirelessly control the Implantmed and the Piezomed?
      W&H introduces a new concept in oral surgery and implantology. Via dongles (receiver), which can be connected to the unit by the doctor, the wireless foot control S-NW communicates with the surgical units of W&H.wireless foot control
    • How long is the useful service life of the instrument detection?
      The instrument detection is located in the LED socket and is automatically replaced at the same time as the LED socket.
    • Is it necessary for the torque driver to engage audibly when tightening the instrument?
      Yes, it must engage audibly once, as otherwise the required torque is not achieved.
    • How long is the useful service life of the LED?
      The user must replace the LED socket as soon as the protective coating on the LED discolours and the luminous power is impaired as a result. The length of time this takes can differ depending on the type of steriliser or sterilization process.
    • Can Piezomed instruments also be used on third-party devices?
      No
      a. Different thread
      b. Third-party device cannot find the correct resonance point – instrument fails to oscillate
    • How long do the instruments last and when should they be replaced?
      The useful service life of the instruments is determined by the length of time they are used reprocessing and sterilization cycles have only marginal influence.
      a. Instruments need to be replaced
      - If there is a loss of power while working
      - Where there is visible damage on the working part or the shank of the instrument.
      b. Saws must be replaced if
      - Teeth are broken off
      - Teeth are worn
      c. Diamond-coated instruments must be replaced
      - As soon as the diamond coating is worn
    • How are the instruments prepared for cleaning?
      a. Preparation in the ultrasonic bath:
      - Place the instruments in the instrument tray and lower into the ultrasonic bath.
      - Use cleaning agents and disinfectants suitable for hand instruments (probes, mirrors, forceps, etc.).
      DO NOT USE a bur bath, as this is very aggressive.
      - After cleaning in the ultrasonic bath, rinse adequately with water to remove any remnants of the cleaning agent and disinfectant from the coolant channels.
      - Blow dry with compressed air after rinsing
      - Replace dried instruments in the instrument tray and package for sterilization

      b. Mechanical preparation in the cleaning unit and disinfector
      - Use the cleaning adapter for cleaning units and disinfectors (see Instructions for Use – Accessories)
      - After preparation in the cleaning unit and disinfector, check that the coolant channels are dry and, if necessary, dry again with compressed air.
    • Can third-party instruments be used on the Piezomed?
      No
      a. Different thread
      b. The Piezomed instrument detection cannot detect third-party instruments

Air Scaler

Straight & Contra-angle Handpieces

  • Proxeo TWIST (2)
    • Can I use any Prophy cup that is available on the market for the WP-66 W?
      In order to benefit from the advantages of the LatchShort system and to support the longevity of the contra-angle handpiece (WP-66 W), we recommend using W&H Prophy cups. However, it is possible for Prophy cups from standard latch systems (with a shaft of 2.35 mm) to be used.
    • Why should I use a prophylaxis contra-angle handpiece (WP-66 W)?
      Generally, prophylaxis contra-angle handpieces feature a seal on the head that prevents the ingress of saliva and paste. This extends the lifespan of the contra-angle handpiece.

      The most effective removal of discolouration that at the same time protects the enamel and dentine as much as possible, depends on the polishing speed, i.e. revolutions per minute, among other things. With a speed ratio of 4:1 (four revolutions of the motor mean one revolution of the cup), the revolution speed of the Prophy cup is reduced. This means during application, there is no risk of paste splattering.

Ozone Devices

Piezo Scaler

Air Motor

Couplings

Electric Motor

Straight & Contra-angle Handpieces

Turbines

Cordless Devices

Accessories

  • W&H Osstell ISQ module (7)
    • What does ISQ stand for?
      The abbreviation ISQ stands for Implant Stability Quotient. It is a value between 1 and 100 and gives the surgeon an insight of the implant stability after placing the implant. With the ISQ value the surgeon can monitor the osseointegration.
    • How does the measurement of the ISQ work?
      > To measure the ISQ of an implant, you first screw a so called SmartPeg into the placed implant. The SmartPeg, with its magnet on top, works like a small tuning fork. The magnet on the SmartPeg is ‘hit’ with magnetic pulses, from the probe, which makes the SmartPeg vibrate. Due to the stiffness in the interface between the implant surface and the bone the SmartPeg will vibrate accordingly. The more dense the bone is the higher stability and the higher ISQ value.
      isq scale
    • Where can I buy the SmartPegs?
      Please contact your local W&H partner
      The sale of SmartPegs will be defined per country
      The surgeon will receive 5 free SmartPegs. A voucher will be provided with the delivery of the product.
    • Is the ISQ scientifically proven?
      The Osstell ISQ technology is proven by over 700 scientific studies. These studies have shown, that torque and ISQ correlate.
    • What’s the difference between torque and ISQ?
      Torque is a one time, static measurement at the time of placement of the implant and cannot be repeated later on in a non-invasive way. Osstell ISQ measures the lateral stability of the implant and the measurements can be repeated in a non-invasive, dynamic way to monitor the development of osseointegration.
    • Is every new Implantmed compatible with the W&H Osstell ISQ module?
      Yes. All control units SI-1023, SI-1015 and SI-1010 can be upgraded with the W&H Osstell ISQ module
    • Can the surgeon upgrade the unit by themself or does the unit need technical service?
      The surgeon or dental nurse can easily attach the module to the right side of the Implantmed with the help of the provided quick manual. The module is plug-n-play via a USB connection.Implantmed with ISQ model comparison
  • Piezomed Instruments (5)
    • Is it necessary for the torque driver to engage audibly when tightening the instrument?
      Yes, it must engage audibly once, as otherwise the required torque is not achieved.
    • Can Piezomed instruments also be used on third-party devices?
      No
      a. Different thread
      b. Third-party device cannot find the correct resonance point – instrument fails to oscillate
    • How long do the instruments last and when should they be replaced?
      The useful service life of the instruments is determined by the length of time they are used reprocessing and sterilization cycles have only marginal influence.
      a. Instruments need to be replaced
      - If there is a loss of power while working
      - Where there is visible damage on the working part or the shank of the instrument.
      b. Saws must be replaced if
      - Teeth are broken off
      - Teeth are worn
      c. Diamond-coated instruments must be replaced
      - As soon as the diamond coating is worn
    • How are the instruments prepared for cleaning?
      a. Preparation in the ultrasonic bath:
      - Place the instruments in the instrument tray and lower into the ultrasonic bath.
      - Use cleaning agents and disinfectants suitable for hand instruments (probes, mirrors, forceps, etc.).
      DO NOT USE a bur bath, as this is very aggressive.
      - After cleaning in the ultrasonic bath, rinse adequately with water to remove any remnants of the cleaning agent and disinfectant from the coolant channels.
      - Blow dry with compressed air after rinsing
      - Replace dried instruments in the instrument tray and package for sterilization

      b. Mechanical preparation in the cleaning unit and disinfector
      - Use the cleaning adapter for cleaning units and disinfectors (see Instructions for Use – Accessories)
      - After preparation in the cleaning unit and disinfector, check that the coolant channels are dry and, if necessary, dry again with compressed air.
    • Can third-party instruments be used on the Piezomed?
      No
      a. Different thread
      b. The Piezomed instrument detection cannot detect third-party instruments

Implant stability measurement

  • Osstell Beacon (2)
    • What does ISQ stand for?
      The abbreviation ISQ stands for Implant Stability Quotient. It is a value between 1 and 100 and gives the surgeon an insight of the implant stability after placing the implant. With the ISQ value the surgeon can monitor the osseointegration.
    • Where can I buy the SmartPegs?
      Please contact your local W&H partner
      The sale of SmartPegs will be defined per country
      The surgeon will receive 5 free SmartPegs. A voucher will be provided with the delivery of the product.

Intraosseous Injection

  • Anesto (27)
    • What do we need for intraosseous anaesthesia?
      Intraosseous anaesthesia relies on the spongiosa being in good working order, so the anaesthetic can diffuse to the place where it is required.
    • Can the Anesto system be sterilized?
      Yes, it not only can but must be prepared in a thermo washer disinfector and then sterilized in accordance with recognized standards.
    • Is palatal application also possible or sensible?
      We always inject from the vestibular side. A palatal application is subject to your own discretion and the responsibility of the person performing the treatment, but we do not recommend it. For patients who are sensitive to pain, a palatal/lingual surface anaesthetic can be used in addition (gels are particularly effective here), meaning palatal/lingual penetration can be avoided. The palate is shaped like a Gothic arch, particularly in the case of patients with narrow faces. If there is not sufficient palate height, certain areas cannot be treated using Anesto. In these cases, a topical anaesthetic is required.
    • We know that when a tooth is extracted an injection should be used to numb various nerve structures. In the case, for example, of mandibular anaesthesia, it is expected that correct placement of the conduction anaesthesia should numb the N. mandibularis and the N. lingualis. How does that work with Anesto?
      Intraosseous anaesthesia primarily affects only the target area of the N. alveolaris. To affect the nourishment area of the N. lingualis, I recommend the use of a surface anaesthetic. This is actually a separate treatment procedure, but nerve damage, as can occur with direct nerve puncture or application close to the nerve at N. mandibularis or N. lingualis, will not occur in future when taking this approach.
    • Anaesthetic leaks out of the handpiece
      If the needle is blocked (this can also occur if the needle is twisted) and pressure is put on the lever, anaesthetic can leak from the needle injection site into the cartridge and then onto the handpiece. Corrective action is to: check the flow through the needle and change the needle if necessary.
    • Anaesthetic emerges from the deep tissue along the needle.
      If the mucous membrane is very thin, the hole in the mucosa can become stretched and consequently there may be a reflux of anaesthetic if excessive injection pressure builds up during the infiltration phase. The situation in the spongy bone is different, but reflux is also possible if excessive injection pressure builds up. Please take your time. The absorption speed in the tissue is just a few drops per minute. Please remember that the anaesthetic is a drug and is slightly alkaline. The chemical aspect alone and in large concentrations can cause local tissue damage if the quantity is too large in too short a period. However, this is not particular to Anesto. The feel for careful application is required in all anaesthesia procedures. If the needle is not centred, it will wobble and the puncture hole will become larger. Then reflux is a certainty.
    • What effect does needle speed have?
      If the needle is inserted too slowly, the drill holes can expand in the highly cancellous area. If there is too little rotation, the spongiosa are compressed. A high speed makes a jagged »rupture« in the spongiosa, thus creating little or no compression or clogging. In order to prevent this, it is important to precisely follow the information provided in the treatment protocol and in the handbook. Guide the stationary injection needle in accordance with the selected access techniques in the direction of the periosteum/bone until contact is made with the bone. Only use a discreet amount of penetration pressure and immediately depress the footoperated switch completely in order to achieve the speed set immediately (15,000-25,000 rpm). The needle will work through the bone on its own. No soft start, Sotherwise there is increased risk of the needle becoming clogged and the gums being torn by the rotating contact surfaces. Note: the drill hole in the cortical bone centres the needle. Our drill procedures should last for max. 3 seconds. The drill regions should be neither expanded nor jagged.
    • Should the injection pressure be memorized and what injection speed should be used?
      The injection pressure should be built up by slowly pumping the lever over a period of several minutes. This means the anaesthetic flows out better and there are no effects to vital systems, e.g. raised pulse. If too much is injected into an area, it will inevitably flow back. Slowly inject the anaesthetic into the spongiosa by repeatedly and carefully pressing the dosage lever. At least 10 seconds per injection are recommended. Therefore a total of 2-3 minutes should be scheduled for this treatment stage. Because the absorption speed is around 1 drop/second, the first injections should be administered very slowly. Too much injection pressure and too great a concentration of injection medium carry the risk of tissue rupture and necrosis.
    • How does adrenaline affect blood flow in the spongiosa?
      Adrenaline in a concentration of 1:100,000 has optimal vasoconstrictor characteristics. The spongiosa themselves have a good blood supply, not least through the presence of bone marrow structures.
    • Anaesthetic cannot be injected because the needle is blocked. What needs to be done? What can the person performing the treatment do to avoid the needle becoming clogged?
      Using a non-rotating approach to perforating the bone or working at low revs can lead to the cannula becoming clogged with blood and pieces of bone. You should, therefore, avoid turning the device on too slowly and pressing down too hard in the first seconds of application. On the other hand, this problem can also be caused by a mechanical change to the needle point. When using Anesto, we have observed warping from 0 to 360°, which means a considerable restriction in the lumen at the needle point. If greater pressure is required on the dosage lever or if this lever cannot be pressed down, then the intraosseous injection needle is blocked and injection is not possible. Remove the intraosseous injection needle from the needle clamping device, replace it with a new one and repeat the process. The argument against the use of the initial drill hole is just that you have to locate it again. In the time you spend searching or the old perforation has expanded, you can create a new access point.
    • Can I also use standard needles? What is different about the intraosseous injection needles?
      A standard cannula cannot meet the requirements for perforating bone. The needle specially developed for this system has a special cutting guide and a defined length-diameter ratio so it can withstand the rotational forces. Use in a clinical setting shows that the cannulas show deformations of up to 360°.
    • Do we need a new cannula for each patient?
      The injection cannulas are single-use products, firstly due to the risk of infection and secondly because re-use in a second drilling process is not possible due to the needle changes that occur.
    • Do you have to use a new cannula for a new injection site?
      Due to the risk of reflux of bacteria, blood components, etc. when the cannula is withdrawn, a new unused cartridge must always be used. The needle becomes deformed and could close up or fracture if it is used a second time. On our recommendation, the manufacturer of Anesto has included several protective caps and connectors in the kit. In cases where several types of injection must be given to the patient, this can be done quickly without any problem using a second pre-prepared system.
    • Broken needle
      This situation is not without risk, especially if the needle has already been pushed deep through the cortical bone. All cases I know of occurred before penetrating the cortical bone and, therefore, removal was simple using tweezers. EIf the needle suddenly disappears into the mucous membranes, references are needed so you can orientate yourself in three dimensions. CPGM biteblocks which you have prepared yourself with a metal sphere as reference (defined diameter) and recorded in two planes on an x-ray enable orientation and a targeted approach to the removal procedure.
    • Aspiration option using the Anesto handpiece.
      If you following the application guidelines, you will successfully inject into the spongiosa. It is unlikely that you will hit a larger blood vessel (e.g. N. alveolaris inferior). Please study the clinical handbook once again, as the injection sites are described here.
    • Risk of damaging a vessel.
      If you select the right injection site, the nerve and vascular bundle is rarely affected; it is more common to affect the nutritive vessels which are narrow in diameter and therefore unproblematic. The spongiosa have a good blood supply and respond immediately to the anaesthetic. Therefore there should be no intensive secondary bleeding.
    • Risk of damaging a tooth root.
      Before selecting the injection site, please consider the shape of the tooth, the angle of the tooth and then the tooth x-ray to avoid damaging the periodontal tissue or the tooth root. In extreme cases, you may meet great resistance. You must immediately carry out another accurate check of the injection site.
    • Rupture of the mucosa.
      Rupture of the mucosa depends on the characteristics of the mucous membranes. Thin mucous membranes will be easier to distend or lightly rupture than thick mucosa. In addition, you should be mindful of the effects of needle rotation. The needle torque goes against the slackness of the adjacent mucous membrane area. Therefore you need to start the motor with a speed of at least 15,000 rpm up to a maximum of 25,000 rpm. Always make sure that no soft start occurs; the mucous membranes and the cortical bone must be penetrated with full torque right from the start, otherwise there is increased risk of the needle becoming clogged and the gums being torn by the rotating contact surfaces. Carefully press the intraosseous injection needle through the attached mucosa and place it upright on the bone.
    • If you are dealing with a small amount of anaesthetic, do you have to change the cartridge with this system?
      We have already addressed the risk of infection under the question about »changing cannulas«. Setting aside the fact that anaesthetic has a worldwide price of between 18 and 50 eurocents, there is the risk that blood and bacteria can run back into the needle when you withdraw it. Studies have shown that a vacuum appears at the rubber penetration (rubber fastener) for a fraction of a second at the moment of removal, which can effectively suck some of the material from the needle into the cartridge (Source: Walter Gräf in »Aktuelle Aspekte der Lokalanästhesie« September 1984, published by Firma Hoechst, author Prof. Dr.Dr. Walter Hoffmann-Axthelm, Freiburg im Breisgau, page 147).
    • Can surface bacteria spread into the tissue?
      A pre-operative prophylaxis is a procedure worth considering not only from a business point of view, but also because this stage leads to better pre-operative hygiene conditions, in addition to the standard pre-operative use of Chlorhexamed 0.1% or 0.2%, which alone reduces bacteria by a factor of 5,000. Creating fully sterile conditions in the oral cavity pre-operatively is wishful thinking and has nothing to do with reality. There are two known ways of managing the risk of an intraoral intervention responsibly. The first is to reduce the bacterial count through a pre-intervention prophylactic and intraoral rinsing for 2-3 minutes using a 0.1% or 0.2% Chlorhexamed rinse. The second is to use a single shot dose of antibiotics for the whole body. This recommendation is primarily aimed at oral surgical interventions. Normal preserving, prosthetic and also endodontic interventions do not require this level of risk management.Intraligamentary, infiltration and conduction anaesthesia also do not require any non-standard safeguards. If you consult the literature on this subject, the risk of infection after an intraoral injection when immune status is normal can be reckoned to be quite low. The only exception is in patients who require endocarditis prophylaxis as prescribed by an internist. (Kneist E. »Plaquekontrolle mit Chlorhexidin ZWR« – Das Deutsche Zahnärzteblatt 2011; 120 (4) page 156 – 167)
    • Does penetration through the cortical bone hurt and is the anaesthetic application painful?
      No, penetration, i.e. drilling through the cortical bone, is not painful. If the anaesthetic is applied carefully with the pumping mechanism, this process is also completely pain-free. Giving too large a dose of anaesthetic can lead to a reflux of anaesthetic, because the tissue simply cannot absorb this.
    • Can you implement intraosseous anaesthesia in every area of bone or are there problem areas?
      We should not forget that sensory suppression only applies to nerve structures or receptor areas – that is, just the periosteum area where there is the greatest density of receptors, along the desmodontal structures and in the areas around the nerves. The cortical bone, for example, is not innervated and so pain cannot be registered here. Therefore there is no need to suppress pain here. The injection should be made at the height of the transitional zones in the region of the middle lower root third. This is where the root structures start becoming narrower but there is still a large enough gap to the serious anatomical structures, such as the N. alveolaris inferior and the sinus maxillaris. The area between the lower premolars can be considered as a relative contraindication, because vessels can be punctured here and painful haematomas caused.
    • We know from the recognized anaesthesia procedures that anaesthesia can fail. What is the success rate with Anesto?
      In the period from February 2010 to January 2011, we surveyed a total of 532 patients after first clarifying with them that they would be happy for us to anaesthetize them using Anesto. After the treatment, we asked them to tell us how they felt the desensitisation had worked. Patients were selected at random and participation in our study took place on a voluntary basis. There was no pre-selection based on injection areas, gender, age distribution or diagnosis. 478 patients were evaluated and we reported a success rate of 97%.
    • Post-operative side effects (a feeling of numbness in the tongue or lip, paresthesia, secondary bleeding)
      No adverse effects have yet been reported. It is important to observe the contraindications so the number of adverse effects reported remains small. Follow the instructions for use, leave yourself time and do not experiment.
    • Does thermal necrosis occur with intraosseous anaesthesia? General risk of necrosis?
      If the speed is too high (> 25,000 rpm) or too much pressure is used, tissue necrosis can occur as a result of heat generation. However, this can be kept to a minimum by working intermittently. Because the absorption speed is around 1 drop/second, the injection should be administered very slowly. Injection pressure that is too great and an injection medium concentration that is too high carry the risk of rupture and necrosis to the tissue.
    • Incomplete anaesthesia
      Classic anaesthesia failure can, of course, also be observed with IOA when the inflammation and associated shifts in pH-values are substantial enough.
    • How do you charge for Anesto?
      It is important to explain to the patient that this form of anaesthesia has a high probability of success in every respect. Neither the new German dental fee schedule (GOZ) nor BEMA have a specific position on charging. In the German dental fee scale (GOÄ), something quite different is meant by bone puncture and intraosseous infusion. However, the new GOZ offers enough room for manoeuvre thanks to paragraph 2 and sub-paragraphs, so an agreement can be made in the range of EUR 25-40. Combining the charges with »The Wand« on the invoice is another possible recommendation. Anaesthetics and cannula tips are invoiced as consumables.