Anterior middle superior alveolar block anesthetic technique in maxillary scaling and root planning

Abstract

Objective To evaluate the clinical effect of the anterior middle superior alveolar block (AMSA) injection using the computer-controlled local anesthetic delivery system for maxillary scaling and root planing. Methods Forty-five adult patients with periodontal disease were selected for the research. The maxillary region of each patient was divided into left part and right part to receive two different anesthetic techniques randomly. The local anesthesia was performed using 4% articaine with either AMSA or with the conventional infiltration technique. Pain response was recorded and evaluated with a standardized visual analogue scale (VAS) ranging from 0-10. The anesthetic efficacy, duration and side effect of both anesthetic techniques were evaluated with questionnaire and clinical assessment. The dates were analyzed by t-test, Chi-square test, Fisher exact test and Wilcoxon signed-rank test. Results The VAS was 1.86 ± 0.76 in the test group and 3.18 ± 1.05 in the control group, the test group showed significantly lower VAS scores compared to the control group (t = -9.487, P<0.001) . In the evaluation of efficacy and safety, no statistically significant differences were found. The achievement ratio was 82.2% in the test group and 93.3% in the control group (χ2 = 1.6571, P = 0.198) . The complication ratio was 2.2% in the test group and 0 in the control group (P = 0.5) . No patient reported facial anesthesia in the test group while all patients in the control group reported varying degrees of facial anesthesia. The anesthetic duration was ranged from 30 to 90 min in the test group and 61 to 120 min in the 83.3% subjects of the control group. The results showed higher satisfaction (Z = -8.857, P<0.001) and shorter duration (Z = -5.748, P<0.001) in the test group compared to the control group. Conclusion The AMSA injection delivered with the computer-controlled local anesthetic delivery system was found to be more comfortable and acceptable for patients than conventional local infiltration technique, and thus to be a promising anesthetic technique for maxillary scaling and root planing. Key words: Nerve block, superior alveolar nerve; Infiltration anesthesia, local; Dental scaling; Root planning; Computer-controlled local anesthetic delivery system