title: The Anesthetic Effect of Anterior Middle Superior Alveolar Technique (AMSA).
abstract: Anesthesia of the soft and hard tissues of the maxilla may require up to 5 injections. Thus, the aim of this study was to evaluate the anesthetic efficacy of the anterior middle superior alveolar (AMSA) and supraperiosteal injection techniques during subgingival scaling and root planing (SRP). Thirty individuals with periodontitis were scheduled for SRP on the buccal aspect of teeth in the anterior maxilla. Before SRP, on a randomly chosen side of the maxilla, the supraperiosteal injection was performed in 1 session, while the AMSA injection was conducted in the contralateral side of the same patient in another session. Immediately after each SRP session, patients rated their pain perception during the procedure with a visual analog scale. No statistically significant differences in mean pain ratings during SRP were found after both anesthetic techniques (P > .05). This preliminary study demonstrated that the AMSA and supraperiosteal injection techniques provided similar anesthetic comfort during SRP. The AMSA injection could be an alternative to anesthetize the buccal aspect of maxilla, without the undesirable effects on facial structures such as the upper lip, nostrils, and lower eyelids. However, further randomized clinical trials with larger samples are necessary to confirm such results.
authors.affiliation: School of Dentistry, Division of Periodontics, University of São Paulo, São Paulo, Brazil.
authors.forename: Lívia
authors.initials: L
authors.lastname: de Souza Tolentino
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Barbisan Souza
authors.affiliation: Private practice, Maringá, Maringá, Brazil.
authors.forename: Ana Alice
authors.initials: AA
authors.lastname: Girardi
authors.affiliation: School of Dentistry, Division of Periodontics, University of São Paulo, São Paulo, Brazil.
authors.forename: Giuseppe Alexandre
authors.initials: GA
authors.lastname: Romito
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Brazil.
authors.forename: Maurício Guimarães
authors.initials: MG
authors.lastname: Araújo
mesh_terms: D000328:Adult; D000539:Alveolar Process / Q000294:innervation; D000766:Anesthesia, Dental / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D012534:Dental Scaling / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008442:Maxillary Nerve / Q000187:drug effects*; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010159:Palate / Q000294:innervation; D017622:Periodontal Attachment Loss / Q000628:therapy; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000628:therapy; D016745:Root Planing / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine
keywords: AMSA injection; Local anesthesia; Pain; Periodontics; Scaling