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to be more comfortable than a rapid injection (15 seconds). The Computer-Controlled Local Anesthetic Device (CCLAD) system (Milestone Scientific, NJ), formerly referred to as the Wand, has the advantage of administering a slow injection. The CCLAD system delivers 1.4 mL of anesthetic solution over a time period of 4 minutes and 45 seconds (referred to as ControlFlo). There is also a faster rate (referred to as RapidFlo). The majority of the literature on CCLAD systems has dealt with the pain of injection with the CCLAD compared with standard injections

Wand-STA Single Tooth Anesthesia CCLADS (Milestone Scientific Inc, Livingston, NJ) was launched in dentistry in 2006 by the manufacturers of the Wand-Compudent system. It utilizes dynamic pressure-sensing technology and can provide more precise and accurate delivery of local anesthetic solution to a single tooth via the intraligamental route. Various studies in the literature report adequate anesthesia with intraligamentary injection for primary tooth cavity preparation and pulpectomy as well as permanent tooth extraction. 6 – 9 Limited studies have been

esterases. 9 Only 1 study has used articaine with epinephrine for primary intraseptal anesthesia in mandibular first premolars. 3 The highest dose in the study was only 0.8 mL, divided in equal doses (0.4 mL) between the mesial and distal aspects of the premolar. Further studies are indicated to determine if articaine is superior to lidocaine when using a larger volume of local anesthetic. Traditionally, intraseptal injections have been administered with a conventional syringe. 2 , 4 – 6 The computer-controlled local anesthesia delivery (C-CLAD; CompuDent, STA

lack more than limited clinical substantiation. 6 The use of a computer-controlled local anesthetic delivery device (CCLAD) is an exception because it has been demonstrated to provide less painful injections, and for that reason, CCLADs were not used in this study. 34 – 36 In addition to a number of studies verifying a statistically significant reduction in pain experienced when CCLADs are used, the manufacturer of one of the most common CCLAD devices describes an anesthetic pathway technique that it claims produces its own topical anesthetic effect, which likely

IANB, but this was not confirmed clinically. The anesthetic was delivered using a Computer Controlled Local Anesthetic Delivery system (CCLAD; Milestone Scientific, Deerfield, IL) unit. Because a buccal infiltration of articaine was added to the mandibular teeth, no long buccal nerve block was used initially. For maxillary teeth, all patients received 2.45 mL of 2% lidocaine with 1:100,000 epinephrine via buccal infiltration and 0.35 mL via palatal infiltration using the CCLAD system. The total dose was 56 mg of lidocaine and 28 μg of epinephrine. The principal