Effect of Three Different Injection Sites on the Success of Anterior Middle Superior Alveolar Nerve Block with 3% Mepivacaine: A Randomized Controlled Trial.

Abstract

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. 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). 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. Changing the injection site did not result in statistically significant improvements (p > 0.05). Changing the injection site anteropos-teriorly did not influence the success rate of the AMSA nerve block injection.