Let’s talk about the appropriate application technique for dental material.
As a young dentist, one of my main objectives was to improve the multiple daily routine tasks I had and thus create a more efficient workflow in my dental practice. Having had a considerable number of patients, among them many children, I recognized how important it is to work quickly and safely. That’s what I always kept in mind when I started to develop our products some years later.
In the USA we at Ultradent Products, Inc. are generally known as „The Syringe People“, which from my perspective is quite a compliment, although it may sound slightly disrespectful. In fact, whenever it is suitable we use syringes as a dosage form for our materials. The reason why is simple and self-explaining: the direct application out of a syringe is easy, quick, and precise – and in most cases the ideal way of working. We deliberately choose the size of 1.2 ml for our syringes. This size enables the user to hold it with the fingers just behind the tip with the stamp in the palm of the hand. This way, the pressure can be perfectly controlled.
Hold a small syringe with the fingers behind the tip and the stamp in the palm of the Hand.
Let‘s have a detailed look at the advantages of this dosage form:
- Fast. Materials applied by a syringe can be applied directly into the mouth, respectively to the required position, without any detours. The use of alternative application forms, like brushes or pellets, requires the coordination and the back and forth of several working steps between mouth, brushes, pellets, and other tools like mixing wells, mixing pads, etc. Syringes effectively optimize the workflow and save your precious time, which you might better dedicate to your patients or to other essential treatment steps.
- Precise. A very precise form of application is optimal for the use of all materials. For some it is even mandatory. Etching gels, for example, which should only influence specific areas. Also caries indicators, which should only be applied to the cavity in order make the caries visible. Cannulas and brushes are specifically adapted to the requirements of the individual syringe materials. All are the best tools for this treatment step.
- Economical. Using materials out of a bottle will always lead to waste, due to an overdose in the mixing well. The beauty of syringes is that only the required effective amount of material is applied. The residual quantity in the syringe is negligible.
- Safe to use. Mixing and using materials in open mixing wells or mixing pads may cause additional issues since many materials (e.g. primer), contain volatile components. The process of mixing, ingestion, and application usually takes longer time. Therefore, the composition of the material may have already changed, due to evaporation of solvents, before it is applied. Common consequences are failed adhesive techniques. As a matter of fact, these are rarely recognized. However, the way from the syringe to the treated area is extremely short and hence, there is no time for the material to evaporate prematurely, dehydrate, or react with the air in the room.
Each syringe has a different color, so that the right syringe can be grabbed easily. After a short time, the color code is familiar and a quick look for identification is enough.
The variety of tips (small choice) seems to be irritating. Do we really need all of them? Yes - due to different materials and consistencies.
Nevertheless, people frequently ask me questions about the use of syringes and tips. Quite a few are irritated by the diversity of tips. However, this results from the variety of materials—liquids require narrow cannulas or brushes. Gel-based or more viscous materials need another lumen or the Inspiral™ Brush Tip, which optimizes the viscosity. Resins, which require curing, are protected from light by black or orange-red tips. Ultimately, the application into a root canal or sulcus necessitates different cannula lengths. Have a look at your tool box at home—it certainly also contains a variety of nails and screws of various kinds but all of them are designed for a special purpose. From our point of view, it is essential to directly pair the tip that exactly matches the requirements of the specific product. „One size fits all“ tools are often just a bad compromise.
Example InspiralTM Brush Tip: For gel-based materials, increased flowability through spiral guidance, brush tip for brushing in of the material, e.g. in fissures. Porcelain Etch is delivered from Inspiral Brush Tip to prepared porcelain after placement of EtchArrestTM barrier.
Example Black MicroTM FX Tip: For gels, good wetting of surfaces and distribution of the gel, e.g. during root canal preparations or on labial surfaces during teeth whitening Treatments.
Example NaviTipTM Tips: For liquids (30g) and pastes (29g), reaches deep into the root canal to short of the apex and allows application of irrigating preparations, Ca(OH)2 (UltraCalTM XS) and root canal sealer (EndoREZTM). Always gauge the length with the rubber stopper so to be at least 2-3 mm short of the apex or working length.
Example Metal Dento-InfusorTM Tip: For liquids and light gels, allows solid brushing of hemostatics into the sulcus.
Example Capillary Tips: Only for suction from the root canal. Thanks to the soft tip, it can also be used in the sulcus. (Do not use the capillary tips for delivering materials into a root canal as said material may be expressed past the apex. Use a NaviTipTM Tip for this purpose).
However, we should not forget some environmental related aspects. During my trips I noticed that the awareness around environmental friendliness is much more distinct in Europe than in my home country. Our goal is to reduce the number of syringes consumed. Therefore, commonly used materials (such as Ultra-Etch™ etchant) are available in the IndiSpense syringe size. From this 30 ml syringe the small 1.2 ml syringes can be refilled repeatedly. That’s an economic way to decrease the number of used syringes.
Due to hygienic reasons, the tips must be disposable. Our tips and syringes consist of materials which do not release any harmful substances into the environment during combustion or depositing.
Our Luer Lock tips with Lok-Tite™ double threads create a friction-grip that locks the tip into place for increased safety. They also have wings for easy attachment and removal.
Ultradent Products Inc. syringes and tips aren’t only used for our products. Especially in endodontics, a variety of rinsing solutions and gels are used. Equipped with many cannulas, the 1.2 ml or the 5 ml syringes are often used in this area. They are suitable for application, blowing out, or suction of the canal.
As previously mentioned, the conventional ways of mixing and application by mixing wells and pads contains several risks. For example, premature evaporation of solvents, contamination, and incorrect mixing-ratios. Today the syringe application is more relevant than ever – it allows the economic and controlled application of high-quality materials, which would hardly be possible otherwise.
About Dr. Fischer
Dr. Dan Fischer is the founder and CEO of Ultradent Products, Inc., a leading dental manufacturer of high-tech dental materials, devices, and instruments with a 40-year history of innovation and quality. Its products are used worldwide by dentists, orthodontists, group practices, dental labs, government agencies, and universities. Ultradent Products’ vision is to improve oral health globally. For more information visit ultradent.com/eu.