FAQ

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

Surgical Devices

  • Piezomed (6)
    • 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.
    • 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 sterilizer or sterilization process.
    • Can Piezomed instruments also be used on third-party devices?
      No
      a. Different thread
      b. Third-party devices are not engineered for 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 only have a marginal influence on the live span.
      a. Instruments need to be replaced
      - If there is a loss of cutting power while working
      - In case of visible damage on the cutting portion or the shank of the instrument.
      b. Saws must be replaced if
      - Teeth are broken off
      - Teeth are worn and cutting power drops
      - In case of visible damage on the cutting portion or the shank of the instrument.
      c. Diamond-coated instruments must be replaced
      - As soon as the diamond coating is worn
      - In case of visible damage on the cutting portion or the shank of the instrument.
      - For USA only - Diamond-coated instruments are considered single-use by the FDA.
    • 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

Accessories

  • W&H Osstell ISQ module (1)
    • 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.
  • Piezomed Instruments (4)
    • Can Piezomed instruments also be used on third-party devices?
      No
      a. Different thread
      b. Third-party devices are not engineered for 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 only have a marginal influence on the live span.
      a. Instruments need to be replaced
      - If there is a loss of cutting power while working
      - In case of visible damage on the cutting portion or the shank of the instrument.
      b. Saws must be replaced if
      - Teeth are broken off
      - Teeth are worn and cutting power drops
      - In case of visible damage on the cutting portion or the shank of the instrument.
      c. Diamond-coated instruments must be replaced
      - As soon as the diamond coating is worn
      - In case of visible damage on the cutting portion or the shank of the instrument.
      - For USA only - Diamond-coated instruments are considered single-use by the FDA.
    • 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

Electric Motor

Sterilizers

  • Lisa (27)
    • Lisa 17/22
      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 a service engineer.
    • Lisa 17/22
      Warning about saving to the USB (HTML and SCL files)
      POSSIBLE CAUSE
      The USB mass storage is not connected or not properly connected to the sterilizer.
      SOLUTION
      Check presence and connection of the USB pen drive. If the problem persist, contact a service engineer.
    • Lisa 17/22
      Warning about programmed maintenance.
      POSSIBLE CAUSE
      A component needs replacing for the programmed maintenance of the sterilizer.
      SOLUTION
      Order the requested component (door seal, dust filter, bacteriological filter…). See “Maintenance” chapter.
    • Lisa 17/22
      The cycle report printer does not work.
      POSSIBLE CAUSE
      Printer not properly connected or not powered
      SOLUTION
      Check the data and the power connection to the printer.
    • Lisa 17/22
      When the sterilizer is connected to an automated water supply system: there is no clean water in the tank, but the automatic water filling does not fill the water.
      POSSIBLE CAUSE
      Water fill system not connected
      SOLUTION
      Connect the water fill system to the sterilizer (see ANNEX 7 for water quality requirements).

      POSSIBLE CAUSE
      When the water fill system attempted to fill the tank, water was temporarily unavailable
      SOLUTION
      Since 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
      Call service.
    • Lisa 17/22
      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 electric circuit.

      POSSIBLE CAUSE
      The power cord is not connected properly
      SOLUTION
      Check and connect the power cord properly
    • Lisa 17/22
      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.
      SOLUTIONS
      Contact a service engineer.
    • Lisa 17/22
      The cycle commences but there is no rise in pressure/temperature
      POSSIBLE CAUSE
      The thermal overload switch is open
      SOLUTION
      Reset the thermal overload switch (see RESETTING THE THERMAL OVERLOAD).

      POSSIBLE CAUSE
      Electric – electronic fault

      SOLUTION
      Contact a service engineer.
    • Lisa 17/22
      At the end of the cycle, there is residual water in the chamber
      POSSIBLE CAUSE
      Sterilizer not properly levelled
      SOLUTION
      Properly level the surface that the sterilizer is placed on.

      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 MAINTENANCE)

      POSSIBLE CAUSE
      Load incorrectly placed
      SOLUTION
      Follow the recommendations as listed in ANNEX 2.
    • Lisa 17/22
      Corrosion or spots on instruments
      POSSIBLE CAUSE
      Tap water on instruments when placed in the sterilizer
      SOLUTION
      Ensure that instruments are 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 APPENDIX 7).

      POSSIBLE CAUSE
      Organic or chemical residues on the instruments
      SOLUTION
      Clean, rinse and dry instruments before placing them in the sterilizer (see APPENDIX 2).

      POSSIBLE CAUSE
      Chamber, trays, tray rack dirty
      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 (aluminum, carbon or stainless steel, etc.); place them on different trays or cassettes or pouch them (refer to APPENDIX 2).

      POSSIBLE CAUSE
      Scale deposits on the chamber
      SOLUTION
      Clean the chamber and use good quality water (refer to APPENDIX 7).
    • Lisa 17/22
      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.
    • Lisa 17/22
      No cycles are stored in the cycle history menu
      POSSIBLE CAUSE
      An electronic board was replaced when serviced.
      SOLUTION
      None. The memory of the old board cannot be restored. You are advised to Save the history regularly onto the USB pen drive.
    • Lisa 17/22
      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; seal sticking out
      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 that the door does not push against the load or the chamber furniture.
    • Lisa 17/22
      The sterilizer enters into “Sleep mode” immediately after opening the chamber door.
      POSSIBLE CAUSE
      The chamber door has not been opened after the previous cycle had finished and the “Sleep mode delay” has expired
      SOLUTION
      Press the SLEEP MODE button to exit.
    • Lisa 17/22
      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 in vacuum due to an internal malfunction
      SOLUTION
      Switch the sterilizer OFF: this releases any internal pressure allowing the chamber door to be opened. Call technical service if the problem persists.

      POSSIBLE CAUSE
      The bacteriological filter is blocked
      SOLUTION
      Remove the bacteriological filter to release the pressure. Replace the filter. Note that bacteriological filters need to be replaced every 400 cycles.
    • Do I need to carry out periodic testing on my Lisa/Lina?
      Yes, testing is an integral part of ensuring that a small sterilizer consistently performs to operating parameters set during the machines commissioning. Failure to carry out routine periodic tests and maintenance tasks could compromise safety and have legal and insurance-related implications for the registered Manager.
    • What is validation?
      Validation is a documented procedure for collecting, recording and interpreting data required for proving that a procedure constantly complies with the specified specifications. W&H sterilizers feature a process evaluation system, which continually monitors the stipulated specifications (temperature, pressure and time).
    • What periodic tests do I need to carry out on my Lisa/Lina?
      Country/regional specific laws and guidelines referring to periodical testing or routine monitoring are individual and must be considered. Our recommendation for periodical testing is mentioned in the delivered IFU and depends on the integrated features in your sterilizer.
    • Do I need to document the results of all periodic testing?
      W&H recommends to record all periodic tests, repairs and modifications on the sterilizer in the logbook including date and signature of the person who carried out the test or other activity.
    • How long should I keep periodic test records?
      Keep the results according your country/regional specific laws and guidelines and the definitions in your QM. Those records can be of assistance in case of service as well.
    • Does my Lisa/Lina 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.
    • Whom should I get to validate and maintain my Lisa/Lina sterilizer?
      All validation and maintenance work should be performed by a qualified individual.
    • How do I change consumable components on my Lisa/Lina?
      Information and videos relating to consumable components and how to replace them can be found on the Consumables & Accessories and Video Tutorial section of this web site.
    • How do I clean the water tanks and what products should I use?
      Information and videos relating to the cleaning of the water tanks and cleaning products can be found on the Video Tutorial section of this web site.
    • Which water quality should I use for my Lisa/Lina 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 jeopardised. 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.
    • 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 packing them in suitable sterile barrier systems from even before sterilization. The recommended storage periods can be found in your national/regional laws and directives. 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.

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.

Straight & Contra-angle Handpieces

Straight & Contra-angle Handpieces

Accessories

Turbines

Couplings

Air Scaler

Reprocessing Devices

Saw Handpieces

Straight & Contra-angle Handpieces

Straight & Contra-angle Handpieces

Straight & Contra-angle Handpieces

Laboratory Devices

Prosthodontic Screwdriver

Piezo Scaler

Air Motor

  • 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.
  • Does the air motor need to be greased?
    Yes, the air motor must be lubricated as described in the "Hygiene and care" section of the instructions for use. Please make sure that the controll ring is positioned either to forward or reverse direction.