Comparison of pain intensity of anterior middle superior alveolar injection with infiltration anesthetic technique in maxillary periodontal surgery

Shirmohammadi, Adileh; Faramarzi, Masoumeh; Lafzi, Ardeshir; Kashefimehr, Atabak; Malek, Sepideh

doi:10.5051/jpis.2012.42.2.45

Cited by 7 publications

(8 citation statements)

References 5 publications

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“…We confirmed the findings of Acharya et al [3] for the palatal aspect, but not for the buccal aspect, as injection was effective in 83.95% of PHT and 90.12% of PST sites around the molars. Shirmohammadi et al also used a conventional syringe for the injections and concluded that AMSA technique could be recommended for the anesthesia of palatal tissues in periodontal surgery [13].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

Tandon

Lamba

Faraz

et al. 2019

J Dent Anesth Pain Med

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Background Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. Methods Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. Results The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. Conclusions The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

Tandon

Lamba

Faraz

et al. 2019

J Dent Anesth Pain Med

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“…Another split-mouth clinical trial reported no significant difference in pain during AMSA injections and local infiltrations for open-flap debridement. However, the postoperative pain was significantly less in the quadrant operated under anesthesia performed using the AMSA injection [19]. Another advantage of using AMSA injections for periodontal procedures is adequate hemostasis on the palate for harvesting soft-tissue grafts [1317], scaling and root planing (SRP) [16], open-flap debridement, and osseous surgery [17]; in contrast, conventional nerve blocks provide limited hemostasis only in the immediate areas surrounding the injection sites.…”

Section: Local Anesthesia For Periodontal Procedures In the Maxilla: mentioning

confidence: 99%

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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“…As already mentioned, certain local anesthetic (usually Lidocaine, Mepivacaine, or Articaine) during the AMSA anesthesia is injected into the lateral palate, that is, close to the 1st and 2nd premolars [1][2][3][4][6][7][8][9][10]13].…”

Section: Journal Of Orthodontics and Endodontics Issn 2469-2980mentioning

confidence: 99%

“…One of the procedures in dentistry is the AMSA (Anterior Middle Superior Alveolar) anesthesia, a relatively new local anesthetic technique, which has been introduced to achieve the pulpal anesthesia of the maxillary anterior teeth, and the surrounding tissues, by a single injection of certain anesthetic agent [1][2][3][4][5][6][7][8][9]. The local anesthetic, applied into the lateral palatal region at the level between the 1st and 2nd premolar, must diffuse all the way from the injection site to the anterior and middle part of the superior dental plexus, located just above the maxillary teeth roots, and to inhibit there the nociceptive neurotransmission along its dental (pulpal), and gingival and osseous twigs [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

The Maxillary Neurovascular Canals as the Basis for the Local Anesthesia Efficacy

ÄetkoviÄ¹,

MarinkoviÄ²,

HodÅ3⁄4iÄ³

et al. 2018

J Orthod Endod

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It is not known the way in which a local anesthetic, following the Anterior Middle Superior Alveolar (AMSA) anesthesia, reaches the superior dental plexus. Consequently, the aim of the study was to examine the possible route of diffusion of a local anesthetic from the anterior lateral palatal injection to the superior dental plexus. The palatal and alveolar regions of 48 dry maxillae were examined and 6 autopsy specimens of the same region were prepared for histological and immunohistochemical analysis. The study revealed palatal and alveolar process openings in all the specimens. They average 6.3 in number close to the central incisor, 5.2 to the lateral incisor, 3.7 to the canine, 3.8 to the 1st premolar, and 3.9 to the 2nd premolar. The microscopic structure of the epithelium, lamina propria, submucous layer, arteries and nerves, periosteum, and cortical and spongious bone was described in detail. The neurovascular pores and canals had a diameter of their opening of 90.28-1,230.62 µm (mean, 893.62 µm). The initial part of the canals varied in diameter between 523.42 µm and 903.04 µm (mean, 622.93 µm). The canals penetrated the cortical bone and usually terminated in the spongious bone towards the alveolar process. They contained a larger artery or several smaller arteries, some veins, a few tiny nerves, collagen fibers type I, and small collections of the fatty cells. The neurovascular canals and the pores most likely represent a route for diffusion of an anesthetic from the lateral palatal region to the superior dental plexus.

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Comparison of pain intensity of anterior middle superior alveolar injection with infiltration anesthetic technique in maxillary periodontal surgery

Cited by 7 publications

References 5 publications

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

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

The Maxillary Neurovascular Canals as the Basis for the Local Anesthesia Efficacy

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