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VibraJect- The Analgesic Syringe Clip Fact Sheet What is the Competition to VibraJect? The CompuDent with the Wand hand piece (formerly The Wand) and the Comfort Control Syringe (CCS) from Dentsply are the competitors to VibraJect. A third competitor, the IntraFlow dental anesthesia system from IntraVantage Inc. , was introduced at the Chicago Mid-Winter Meeting, 2002, as was the VibraJect. How Do Competitive Systems Compare With VibraJect? CompuDent and CCS are similar systems to each other. They are electronic devices that employ microprocessors that control the volume and pressure of local anesthetic. CCS costs $891 and the CompuDent with Wand hand piece costs $1,395. Both systems require the purchase of additional disposable items which cost about $1.10 for the Wand and 52 cents for the CCS per usage. Both products rely on giving the injection slowly to reduce the pain. This increases chair time. The CompuDent requires a floor foot pedal in addition to the several already used in the dental operatory. The CCS is bulky and somewhat awkward to use. IntraFlow is a totally different concept that injects anesthetic directly into the bone. It uses a pneumatic hand piece that is compatible with standard clinic equipment. A disposable transfuser in the hand piece holds an anesthetic cartridge and a 24 gauge rotating needle/drill. After a topical anesthetic is applied, the hand piece delivers the anesthetic in a combined process of bone perforation, infusion and withdrawal. The cost of this system is unknown. VibraJect advantages: No electricity, no foot pedals, no hand piece or special needles, no disposable items to increase costs, no special technique that could double the chair time for an injection, no topical anesthetic and has an economical kit price of $269. It attaches to conventional or disposable syringes including intraligamental syringes. Do Dentists Need This Technology? Statistics tell us that only 50 percent of the US population visit a dentist on a regular basis. The other 50% need dental care but are fearful of the dental experience. These statistics were published in 1985 by the NIDCR ( National Institute of Dental and Craniofacial Research). One major association people have with pain in the dental office is the fear of injections. Dentists have given injections for years and have developed distracting techniques like shaking the cheek while dispensing the anesthetic. Many will tell you that their injections don’t hurt but the reality is that their injections are probably not painless. Theuse of an instrument like VibraJect allows the dentist to consistently give more comfortable injections. There are injections that no matter how inventive the dentist is that hurt. Palatal, intraligamental, PDL, and blocks are examples of such injections. VibraJect is particularly effective with these injections. Do These Products Work Equally Well for All Patients? The answer is no. Pain research has shown a correlation between patient fear and pain. There is a segment of patients that do not fear injections or have a higher pain tolerance level. These patients may not feel a difference between an injection with or without an anesthetic injection system. However, it is impossible for the dentist to determine the pain tolerance capability of a patient until an injection is given. Anesthetic injection systems cause no negative result to this segment of patients but it gives a more comfortable experience to those patients that experience injection pain. A study completed by Queen’s University of Belfast, UnitedKingdom has quantified the pain reduction results of using the VibraJect. Subjects receiving the conventional injection methods had a mean pain score of 4.6 (± 0.414) The VibraJect group had a mean pain score of 1.71 (±0.235)(P<0.05). Children are a specific patient group that are developing their comfort level or fear to dentistry. If pain could be removed from this patient group, the comfort level would be developed for a lifetime. An anesthetic injection system can aid in the reduction/removal of pain and fear. How Does VibraJect Work? VibraJect removes or reduces pain from injections based on the Gate Control Theory of Pain Management. In a normal injection, the pain receptors indicate that “tissue damage” is occurring. In contrast, pressure or vibration on areas of the mouth are interpreted simply as “pressure” or “vibration”. When these signals are combined, as inthe case with an injection using the VibraJect, the “tactile “ pathway has an inhibitory action on the “pain” pathway at the dorsal horn ofthe spinal cord (or wherever these nerve fibers actually connect). Thus, the patient doesn’t feel the pain, because the “pain signal” is essentially masked by the “vibration” signal. The VibraJect attachment effectively raises the pain threshold of the nerve tissue involved during dental injections. This modulation of the pain threshold can be explained for the following reasons. First, of the variety of nerve cells in the human body, two types are most likely associated with the pain reduction phenomenon created by the VibraJect attachment. These cells include free nerve endings and mechanoreceptors or tactile nerves in the oral tissues. The free nerve endings (receptors) are small nerve fibers without insulation. These receptors respond relatively slowly to stimulation and their signal intensity is also relatively low. These receptors are associated with sensing temperature and pain. Tactile nerve cells (mechanoreceptors), such as Pacinian corpuscles, are larger as well as insulated. These cells respond quickly to stimulation and have a relatively high signal intensity. These receptors are associated with pressure and vibration; i.e., “tactile” sensations. The basic process of sensory nerve functions involves the following steps. First, the receptor (nerve cell) receives a stimulus. Next, the receptor transforms the stimulus to a nerve impulse. Finally, this impulse is passed on to the nerve fiber, and on to a series of synapes that end up in the spinal cord, which communicates with the brain where sensation is interpreted. Sensory circuits are made up of the small and large nerve fibers that connect at synapse junctions at the dorsal horn of the spinal cord. The types of sensations are interpreted as pain, temperature change, pressure, etc. based on a complex filtering process involving nerve signal differentials, among other interpretive functions. How To Use The VibraJect? The VibraJect attachment is a combination of a battery powered motor and clip bracket that attaches to any conventional syringe. The clip bracket is autoclavable and it is intended to remain on the syringe. The motor can be cleaned with alcohol or disinfecting solution. The attachment is clipped onto the syringe and can be positioned anywhere on the barrel to provide maximum visibility. The motor is turned on by twisting a control knob on the top of the motor. A topical anesthetic is not necessary when using the VibraJect attachment. Use a standard injection technique for any injection including shaking the cheek if desired. The six batteries included in the Kit provide for approximately 200 injections. Replacement batteries can be purchased in packages of 6 or 10 batteries through Fcop Corporation (888-267-2737) or a local drug store or mass merchandiser. The batteries are 1.5V batteries and two are required. Installation of the Batteries: Unscrew the control knob in a counter clockwise motion to remove. The batteries are located in the top of the control knob. Batteries are placed into the control knob with the wider, flat side facing to the top of the control knob. Screw in the control knob, clock wise, until motor starts to operate and turn back two full turns to stop to avoid drainage of the batteries during non-usage. Autoclavability: The clip brackets are autoclavable and are intended to remain on the syringe. Additional clip brackets are available through ITL Dental ( ask for code VJCB). The motor is not to be autoclaved. Clean the motor with an alcohol wipe or disinfecting solution. VibraJect Published Evaluations CRA Associates Volume 26, Issue 12 December, 2002 Dental Economics December, 2002 Kisco Perspective Newsletter Volume #4 Reality Now February, 2003 No: 149 IF YOU HAVE ANY QUESTIONS, PLEASE CALL Fcop Corp  (888)267 2737