title: Effect of Three Different Injection Sites on the Success of Anterior Middle Superior Alveolar Nerve Block with 3% Mepivacaine: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Anterior middle superior alveolar (AMSA) nerve block injection targets the anterior superior alveolar nerve and the middle superior alveolar nerve branches of the infraorbital nerve through nutrient canals. Therefore, the central incisor to the second premolar teeth of one quadrant can be anesthetized. The aim of the present study was to evaluate the efficacy of AMSA nerve block injection with 3% mepivacaine solution at three different injection sites.
  
  
  METHODS
  In a double-blind crossover study, 47 volunteers participated and three AMSA nerve block injections of 3% mepivacaine solution without epinephrine were administered at the anterior, posterior, and the most common injection sites with a 1-week interval between injections. Anesthesia of the central incisor to the second premolar of the injected side was evaluated by using an electric pulp tester. The success of the injection was considered as lack of response to two consecutive 80 readings. The generalized estimating equation analytic tests were administered (α = 0.05).
  
  
  RESULTS
  The success rate of the AMSA nerve block injection ranged from 27.5-47.5% for the most common injection site and 22.5-42.5% for both the anterior and posterior injection sites.
  
  
  CONCLUSIONS
  Changing the injection site did not result in statistically significant improvements (p > 0.05).
  
  
  CONCLUSIONS
  Changing the injection site anteropos-teriorly did not influence the success rate of the AMSA nerve block injection.
authors.affiliation: Department of Endodontics, School of Dentistry, Kashan University of Medical Sciences, Kashan, Islamic Republic of Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Shokraneh
authors.affiliation: Department of Oral and Maxillofacial Radiology, School of Dentistry, Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran, e-mail:nastaranfarhadi@yahoo.com.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Farhadi
authors.affiliation: Department of Endodontics, Torabinejad Dental Research Center, Isfahan University of Medical Sciences, Isfahan, Islamic Republic of Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Saatchi
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Islamic Republic of Iran.
authors.forename: Hooman
authors.initials: H
authors.lastname: Navaei
authors.affiliation: Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Yaghmaei
mesh_terms: D000766:Anesthesia, Dental; D018592:Cross-Over Studies; D003481:Cuspid / Q000294:innervation; D003782:Dental Pulp / Q000294:innervation*; D004311:Double-Blind Method; D064368:Healthy Volunteers; D006801:Humans; D007180:Incisor / Q000294:innervation; D007267:Injections; D008442:Maxillary Nerve; D008619:Mepivacaine / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D016896:Treatment Outcome
chemical_list: D008619:Mepivacaine
keywords: Dental pulp; Local anesthesia; Mepivacaine; Nerve block; Randomized controlled trial.