Needle selection is based on two factors that are: the type of injection as well as the degree of penetration. Yet, hundreds of studies have revealed that patients can't distinguish between needles with different gauges (25- or 27-gauge, and 30-gauge) even when they are not applied topically. It's really about the method. Anatomy of the needleThe dental anesthetic needle is comprised of three main parts that are the shank, bevel and hub. Typically, the "hub" is the syringe adaptor/hub combination. Needle length_Needle-length There are three kinds of dental needles: ultra-short, long, and short. For intraoral injections using the traditional syringe, the most frequently used lengths of syringes needles are "long" and "short". The length of the needle may differ from manufacturer to manufacturer, but typically, from hub to tip the long needle measures around 32 millimeters (1.5 inches) and the short is 20 mm (1.0 millimeter). The needle that is long is needed for mandibular blocks because the depth of penetration can range between 20-25 millimeters for the average adult (20-25 millimeters for the inferior alveolar, and 25 mm for the Gow-Gates mandibular block technique). It is extremely important to stay clear of insertion into the hub, which is the weakest part of the needle. The needle is prone to break at the hub. If the medical syringes breaks, and there are not less than 5 millimeters of it, it will likely be lost in the tissues and be very difficult to recover. For the anterior superior (ASA)/infraorbital approaches injection the needle should be longer than recommended. A shorter needle is generally preferred for the posterior superior alveolar injection (PSA) to prevent overinsertion for supraperiosteal infusions, as well as tissues infiltrations. Needle gauge The gauge of the needle is the diameter of the lumen, the hollow tunnel that is inside the needle. The most commonly used gauges in dentistry are 25, 27, and 30, (the 30-gauge needle is not to be employed). The smaller the number, and the thinner the gauge, more efficient. As previously mentioned, patients are unable to distinguish between 25-, 27--, and 30-gauge needles. With the larger gauge (25 or 27) needles, because they are more rigid, they offer resistance to needle breakage and less deflection as it travels through the tissues deeper, which then results in greater accuracy for reaching the desired target. More importantly the aspiration process is more secure since the larger lumen facilitates ease of aspiration. For all injections, the 25-gauge needle is recommended. But, it is highly advised for injections with a high probability of positive aspiration, and/or require large penetration depths. The needle with a 27-gauge gauge is only suitable to other injections where the it is safe to penetrate the depth and the risks of positive aspiration are not significant. While the needle of 30 gauge should not be used to administer supraperiosteal and block injections, it could be useful for targeted injections. Needle bevel The bevel is the flat surface of a needle, which creates the tip. It also allows for non-traumatic entry into tissues. Manufacturers often describe bevels as being medium, short or long. Experts have discussed that the angle of the bevel with respect to the long axis the needle can affect the degree of deflection. Septodont developed a needle with a unique bevel designed by a scalpel. This design allows for easier needle penetration, less tissue displacement and requires lesser force from the clinician. They have also developed an injection needle that has a bigger inside bore and the intention is to lessen the pain experienced during injections.
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