Abstract
Objectives
To evaluate and compare the anesthetic efficacy of anterior middle superior alveolar (AMSA) injection in single-visit endodontic therapy, an in vivo study.
Materials and methods
Teeth in the maxillary anterior segment (N = 60) requiring single-visit endodontic (SVE) therapy were selected. A conventional syringe with 26-guage needle containing 1.5 ml lignocaine with 1:80,000 epinephrine was used for the AMSA injection. The SVE therapy was performed using standard protocol. Profoundness of anesthesia during therapy was evaluated at 15-, 30-, 60-, and 90-min intervals using pain rating score and marked on visual analogue scale. In patients who reported pain/ineffectiveness of anesthesia during the course of endodontic therapy, additional supplemental anesthesia (buccal/labial infiltration) was administered. Depending on effectiveness of anesthesia with the AMSA injection alone or the need for additional supplementary injections, patients were divided as: group I—only AMSA and group II—AMSA with one or two supplemental anesthesia.
Results
The AMSA injection was effective in 91.67% of the patients undergoing the SVE therapy and the duration of anesthesia for the AMSA injection alone was adequate until the completion of the SVE therapy. Supplementary injections were required in 8.33% of cases at 15-min interval to achieve profound anesthesia.
Conclusion
The AMSA injection technique could be used as an alternative to the conventional infiltration technique for anesthetizing teeth in maxillary anterior segment during the SVE therapy.
Clinical relevance
The AMSA injection provides profound pulpal anesthesia of teeth in maxillary anterior segment during endodontic therapy.
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References
Kaufman E, Weinstein P, Milgrom P (1984) Difficulties in achieving local anesthesia. J Am Dent Assoc 108:205–208
Malamed SF (2013) Handbook of local anesthesia, 6th edn. Elsevier Mosby, St. Louis
Roda RS, Blanton PL (1994) The anatomy of local anesthesia. Quintessence Int 25:27–38
Jin GC, Kim KD, Roh BD, Lee CY, Lee SJ (2005) Buccal bone plate thickness of the Asian people. J Endod 31:430–434
Allen A(2005) Considerations for ensuring complete anesthesia during endodontic care. Inside Dent 1(1). http://www.dentalaegis.com/id/2005/10/. Accessed 10 April 2019
Friedman MJ, Hochman MN (1999) P-ASA block injection: a new palatal technique to anesthetize maxillary anterior teeth. J Esthet Dent 11:63–71
Friedman MJ, Hochman MN (1998) The AMSA injection: a new concept for local anesthesia of maxillary teeth using a computer-controlled injection system. Quintessence Int 29:297–303
Holtzclaw D, Toscano N (2008) Alternative anesthetic technique for maxillary periodontal surgery. J Periodontol 79:1769–1772. https://doi.org/10.1902/jop.2008.070621
Acharya AB, Banakar C, Rodriques SV, Nagpal S, Bhaddbhade S, Thakur SL (2010) Anterior middle superior alveolar injection is effective in providing anesthesia extending to the last standing molar in maxillary periodontal surgery. J Periodontol 81:1174–1179. https://doi.org/10.1902/jop.2010.100109
Yenisey M (2009) Comparison of the pain levels of computer-controlled and conventional anesthesia techniques in prosthodontic treatment. J Appl Oral Sci 17:414–420
Faiz A (2009) A clinical assessment on the efficacy of the anterior and middle superior alveolar nerve block technique during extraction of maxillary teeth. Al Rafidain Dent J 9:183–188
Oliet S (1983) Single-visit endodontics: a clinical study. J Endod 9:147–152. https://doi.org/10.1016/S0099-2399(83)80036-3
Trope M, Delano FO, Orstavik D (1999) Endodontic treatment of teeth with apical periodontitis: single vs multivisit treatment. J Endod 25:345–350. https://doi.org/10.1016/S0099-2399(06)81169-6
Figini L, Lodi G, Gorni F, Gagliani M (2008) Single versus multiple visits for endodontic treatment of permanent teeth: a Cochrane systematic review. J Endod 34:1041–1047. https://doi.org/10.1016/j.joen.2008.06.009
Behrend GD, Cutler CW, Gutman JL (1996) An in-vitro study of smear layer removal and microbial leakage along root-canal fillings. Int Endod J 29:99–107
Bender IB (1997) Factors influencing the radiographic appearance of bony lesions. J Endod 23:5–14. https://doi.org/10.1016/S0099-2399(97)80199-9
Mohammadi Z, Farhad A, Tabrizizadeh M (2006) One- visit versus multiple –visit endodontic therapy – a review. Int Dent J 56:289–293
Nusstein JM, Reader A, Drum M (2010) Local anesthesia strategies for the patient with a “hot” tooth. Dent Clin N Am 54:237–247. https://doi.org/10.1016/j.cden.2009.12.003
Couper M, Tourangeau R et al (2006) Evaluating the effectiveness of visual analog scale. Soc Sci Comput Rev 24:227–245. https://doi.org/10.1177/0894439305281503
Bodian CA, Freedman G, Hossain S, Eisenkraft JB, Beilin Y (2001) The visual analog scale for pain: clinical significance in postoperative patients. Anesthesiology 95:1356–1361
Blanton PL, Jeske AH (2003) Dental local anesthetics: alternative delivery methods. J Am Dent Assoc 134:228–234
Nusstein J, Lee S, Reader A (2004) Injection pain and postinjection pain of the anterior middle superior alveolar injection administered with the Wand or conventional syringe. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98:124–131. https://doi.org/10.1016/S1079210404001659
Corbett IP, Jaber AA, Whitworth JM, Meechan JG (2010) A comparison of the anterior middle superior alveolar nerve block and infraorbital nerve block for anesthesia of maxillary anterior teeth. J Am Dent Assoc 141:1442–1448
Goodell GG, Galiagher FJ, Nicoli BK (2000) Comparison of a controlled injection pressure system with the conventional technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:88–94. https://doi.org/10.1067/moe.2000.107365
Gibson RS, Allen K, Hutfless S, Beiraghi S (2000) The Wand vs. traditional injection: a comparison of pain related behaviors. Pediatr Dent 22:458–462
Hargreaves KM, Berman LH Case selection and treatment planning. Cohen’s pathways of the pulp, 11th edn. Elsevier Mosby, St. Louis, pp 79–81
Jacab S(2006) Single visit endodontics Famdent practical dentistry handbook. 6:1–6
Lee S, Reader A, Nusstein J, Beck M, Weaver J (2004) Anesthetic efficacy of the AMSA injection. Anesth Prog 51:80–89
Fukayama H, Yoshikawa F, Kohase H, Umino M, Suzuki N (2003) Efficacy of anterior and middle superior alveolar anesthesia using a new injection system: the Wand. Quintessence Int 34:537–541
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The present study was approved by the Research and Ethical Committee of KLE Academy of Higher Education, Belagavi, India, and was registered in the Clinical Trials Registry, India (CTRI/2017/05/008632).
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Anesthetic procedure was explained to the patient/guardian, and a written informed consent was obtained from all participants included in the study.
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Patil, S.A., Patil, A.C. & Patil, P.A. Anesthetic efficacy of anterior middle superior alveolar injection in single-visit endodontic therapy: an in vivo study. Clin Oral Invest 24, 1701–1707 (2020). https://doi.org/10.1007/s00784-019-03028-2
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DOI: https://doi.org/10.1007/s00784-019-03028-2