Journal of Dental Anesthesia and Pain Medicine

  • 제19권1호
  • /
  • Pages.45-54
  • /
  • 2019
  • /
  • 2383-9309(pISSN)
  • /
  • 2383-9317(eISSN)
대한치과마취과학회 (The Korean Dental Society of Anesthsiology)
권호 표지
DOI QR코드

DOI QR Code

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

  • Tandon, Shruti (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Lamba, Arundeep Kaur (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Faraz, Farrukh (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Aggarwal, Kamal (Department of Periodontics, Maulana Azad Institute of Dental Sciences) ;
  • Ahad, Abdul (Department of Periodontics, Dr. Ziauddin Ahmad Dental College, Faculty of Medicine, Aligarh Muslim University) ;
  • Yadav, Neha (School of Dental Medicine, University of Colorado)
  • 투고 : 2019.01.09
  • 심사 : 2019.02.09
  • 발행 : 2019.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. Methods: Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. Results: The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. Conclusions: The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

키워드

참고문헌

  1. Friedman MJ. The AMSA injection: A new concept for local anesthesia of maxillary teeth using a computer - controlled injection system. Quintessence Int 1998; 29: 297-303.
  2. Friedman M, Hochman M. A 21st century computerized injection system for local pain control. Compendium 1997; 18: 995-1003.
  3. Acharya AB, Banakar C, Rodrigues SV, Nagpal S, Bhadbhade S, Thakur SL. Anterior middle superior alveolar injection is effective in providing anesthesia extending to the last standing molar in maxillary periodontal surgery. J Periodontol 2010; 81: 1174-9. https://doi.org/10.1902/jop.2010.100109
  4. Malamed SF. Handbook of Local Anesthesia, 6th ed. St. Louis: Mosby; 2013: 169-224.
  5. Lee S, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic efficacy of the anterior middle superior alveolar (AMSA) injection. Anesth Prog 2004; 51: 80-9.
  6. Hochman M, Chiarello D, Bozzi-Hochman C, Lopatkin R, Pergola S. Computerized local anesthetic delivery vs. traditional syringe technique. NY State Dent J 1997; 63: 24-9.
  7. Fukayama H, Yoshikawa F, Kohase H, Umino M, Suzuki N. Efficacy of anterior and middle superior alveolar (AMSA) anesthesia using a new injection system: The Wand. Quintessence Int 2003; 34: 537-41.
  8. Friedman M, Hochman M. Using AMSA and P-ASA nerve blocks for esthetic restorative dentistry. Gen Dent 2001; 5: 506-11.
  9. Perry DA, Loomer PM. Maximizing pain control: The AMSA injection can provide anesthesia with fewer injections and less pain. Dimens Dent Hyg 2003; 1: 28-33.
  10. Loomer PM, Perry DA. Computer controlled delivery versus syringe delivery of local anesthetic injections for therapeutic scaling and root planing. J Am Dent Assoc 2004; 135: 358-65. https://doi.org/10.14219/jada.archive.2004.0188
  11. Holtzclaw D, Toscano N. Alternative anesthetic technique for maxillary periodontal surgery. J Periodontol 2008; 79: 1769-72. https://doi.org/10.1902/jop.2008.070621
  12. Iwanaga J, Tubbs R. Palatal injection does not block the superior alveolar nerve trunks: correcting an error regarding the innervation of the maxillary teeth. Cureus 2018; 10: e2120.
  13. Shirmohammadi A, Faramarzi M, Lafzi A, Kashefimehr A, Malek S. Comparison of pain intensity of anterior middle superior alveolar injection with infiltration anesthetic technique in maxillary periodontal surgery. J Periodontal Implant Sci 2012; 42: 45-9. https://doi.org/10.5051/jpis.2012.42.2.45
  14. Velasco I, Soto R. Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional syringe. Dent Res J 2012; 9: 535-40. https://doi.org/10.4103/1735-3327.104870
  15. Corbett IP, Jaber AA, Whitworth JM, Meechan JG. A comparison of the anterior middle superior alveolar nerve block and infraorbital nerve block for anesthesia of maxillary anterior teeth. J Am Dent Assoc 2010; 141: 1442-8. https://doi.org/10.14219/jada.archive.2010.0106
  16. Tolentino de Souza L, Barbisan Souza A, Girardi AA, et al. The anesthetic effect of anterior middle superior alveolar technique (AMSA). Anesth Prog 2015; 62: 153-8. https://doi.org/10.2344/13-00013.1
  17. Blanton PC, Roda RS. The anatomy of local anesthesia. J Cal Dent Assoc 1995; 23: 55-69.
  18. Cetkovic D, Antic S, Antonijevic D, Brkovic BMB, Djukic K, Vujaskovic G, Djuric M. Nutrient canals and porosity of the bony palate: A basis for the biological plausibility of the anterior middle superior alveolar nerve block. J Am Dent Assoc 2018; 149: 859-68. https://doi.org/10.1016/j.adaj.2018.05.015
  19. Loetscher CA, Walton RE. Patterns of innervation of the maxillary first molar: a dissection study. Oral Surg 1988; 65: 86-90. https://doi.org/10.1016/0030-4220(88)90198-3
  20. McDaniel WL. Variations in nerve distributions of the maxillary teeth. J Dent Res 1956; 35: 916-21. https://doi.org/10.1177/00220345560350061301
  21. Wijk AJ, Hoogstraten J. Anxiety and pain during dental injections. J Dent 2009; 37: 700-4. https://doi.org/10.1016/j.jdent.2009.05.023
  22. Defrin R, Eli I, Pud D. Interactions among sex, ethnicity, religion, and gender role expectations of pain. Gender Med 2011; 8: 172-83. https://doi.org/10.1016/j.genm.2011.04.001
  23. Wahl MJ, Schmitt MM, Overton DA, Gordon MK. Injection pain of bupivacaine with epinephrine vs. prilocaine plain. J Am Dent Assoc 2002; 133: 1652-6. https://doi.org/10.14219/jada.archive.2002.0115

피인용 문헌

  1. Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique vol.20, pp.6, 2019, https://doi.org/10.17245/jdapm.2020.20.6.387