PSA block for maxillary molar's anesthesia - an obsolete technique?

Abstract

Routine use of posterior superior alveolar (PSA) nerve block or maxillary infiltration for the removal of maxillary molars has been validated. The present study was undertaken to determine the relative contribution of posterior superior alveolar (PSA) block in cases of anesthesia required for maxillary molars. One hundred patients requiring removal of maxillary second and third molars were enrolled. These patients were divided into 2 groups. One group received infiltration for anesthesia and other group received PSA nerve block using lignocaine with vasoconstrictor. All extractions were performed using a consistent technique of intraalveolar extraction. Data relating to the pain during extraction obtained on a visual analog scale and a verbal response scale, requirement of repeated injection for anesthesia, efficacy of these injections in localized infections, and requirement of rescue analgesics 3 hours after extraction. Statistical data confirmed clinical equivalence between infiltration and PSA nerve block. Considering the difficulty in mastering the technique of PSA nerve block, and the possibility of more complications associated with it (compared with infiltration); it may not be necessary for anesthesia of maxillary molars.