Efficacy of the anterior and middle superior alveolar nerve block in achieving pulpal anesthesia of maxillary teeth

Abstract

Introduction. The anterior and middle superior alveolar (AMSA) nerve block is an alternative technique of local anesthesia in the maxilla, unpredictably efficient for pulpal anesthesia. The aim of this study was to determine the anesthetic efficacy of the AMSA injection for pulpal anesthesia, using computer-controlled injection system or conventional syringe, and two local anesthetic solutions with or without adrenaline. Methods. The authors administered two AMSA injections during two separate appointments, utilizing the computer-controlled system and conventional syringe to 40 subjects, divided into two groups of 20 subjects each depending on the local anesthetic used. A pulp tester was used to test the achieved anesthesia of the central and lateral incisors, canine, first and second premolars, and the first molar in 10-minute cycles over a period of 60 minutes. Duration of anesthesia for all the mentioned teeth was also determined for both the anesthetic solutions and ways of application. Results. The AMSA injection with both types of equipment was successful, showing slow onset, satisfying intensity, and declining duration of pulpal anesthesia at the last two measurements. Local anesthetic with vasoconstrictor exhibited a significantly longer pulpal anesthesia. Conclusion. The AMSA nerve block could be recommended for achieving pulpal anesthesia of maxillary teeth from the region of the first incisor to the second premolar.