Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used

Tomić, Slavoljub; Simić, Ivana; Stanojevic, Mihael; Janković, Svetlana; Todorović, Ljubomir

doi:10.2298/sarh1610470t

Cited by 3 publications

(4 citation statements)

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“…The present study aimed to understand the anatomical basis of AMSA anesthetic injection. Although this technique has been reported to be effective in many clinical studies [10][11][12][13], others have questioned its predictability [14,15]. Some authors have questioned the Many studies have compared the thickness and the density of buccal and palatal cortices using CBCT-based analysis, although for a different purpose [20,21].…”

Section: Discussionmentioning

confidence: 99%

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Ahad¹,

Haque

Naaz

et al. 2020

J Dent Anesth Pain Med

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Background: The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique. Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. Results: Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. Conclusions: The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

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Section: Discussionmentioning

confidence: 99%

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Ahad¹,

Haque

Naaz

et al. 2020

J Dent Anesth Pain Med

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“…Tomić et al compared the anesthetic efficacy of AMSA injections by using three different anesthetic solutions: 3% mepivacaine plain, 2% lignocaine with adrenaline (1:80000), and 4% articaine with adrenaline (1:100000). They concluded that predictable efficacy of AMSA injections was achieved for the extraction of the permanent premolars, regardless of the LA used [32]. Both of these studies also reported an insignificant difference in pain on injection with different LA solutions and vasoconstrictors [3032].…”

Section: Factors Affecting the Success Of Amsa Injectionsmentioning

confidence: 99%

“…They concluded that predictable efficacy of AMSA injections was achieved for the extraction of the permanent premolars, regardless of the LA used [32]. Both of these studies also reported an insignificant difference in pain on injection with different LA solutions and vasoconstrictors [3032]. The conflicting results in these two studies regarding the efficacy of different LA solutions for AMSA injections may be attributed to the intended procedure.…”

Section: Factors Affecting the Success Of Amsa Injectionsmentioning

confidence: 99%

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Current status of the anterior middle superior alveolar anesthetic injection for periodontal procedures in the maxilla

Ahad

Haque

Tandon

2019

J Dent Anesth Pain Med

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Periodontal procedures require adequate anesthesia not only to ensure the patient's comfort but also to enhance the operator's performance and minimize chair time. In the maxilla, anesthesia is often achieved using highly traumatic nerve blocks, apart from multiple local infiltrations through the buccal vestibule. In recent years, anterior middle superior alveolar (AMSA) field block has been claimed to be a less traumatic alternative to several of these conventional injections, and it has many other advantages. This critical review of the existing literature aimed to discuss the rationale, mechanism, effectiveness, extent, and duration of AMSA injections for periodontal surgical and non-surgical procedures in the maxilla. It also focused on future prospects, particularly in relation to computer-controlled local anesthetic delivery systems, which aim to achieve the goal of pain-free anesthesia. A literature search of different databases was performed to retrieve relevant articles related to AMSA injections. After analyzing the existing data, it can be concluded that this anesthetic technique may be used as a predictable method of effective palatal anesthesia with adequate duration for different periodontal procedures. It has additional advantages of being less traumatic, requiring lesser amounts of local anesthetics and vasoconstrictors, as well as achieving good hemostasis. However, its effect on the buccal periodontium appears highly unpredictable.

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Nutrient canals and porosity of the bony palate

Ćetković¹,

Antic²,

Antonijevic³

et al. 2018

The Journal of the American Dental Association

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Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used

Abstract: The anterior and middle superior alveolar nerve block may be recommended if maxillary permanent premolars have to be extracted.

Cited by 3 publications

References 0 publications

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Current status of the anterior middle superior alveolar anesthetic injection for periodontal procedures in the maxilla

Nutrient canals and porosity of the bony palate

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