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

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Dec;112(6):e39-43. doi: 10.1016/j.tripleo.2011.04.046. Epub 2011 Sep 16.

Abstract

Background: Routine use of posterior superior alveolar (PSA) nerve block or maxillary infiltration for the removal of maxillary molars has been validated.

Objective: The present study was undertaken to determine the relative contribution of posterior superior alveolar (PSA) block in cases of anesthesia required for maxillary molars.

Study design: 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.

Results: Statistical data confirmed clinical equivalence between infiltration and PSA nerve block.

Conclusions: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Analgesics, Non-Narcotic / therapeutic use
  • Anesthesia, Dental / methods*
  • Anesthetics, Local / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Epinephrine / administration & dosage
  • Hematoma / etiology
  • Humans
  • Injections / methods
  • Lidocaine / administration & dosage
  • Maxillary Nerve / drug effects*
  • Molar / innervation*
  • Molar / surgery
  • Molar, Third / innervation
  • Molar, Third / surgery
  • Nerve Block / methods*
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Periapical Diseases / complications
  • Postoperative Complications
  • Postoperative Hemorrhage / etiology
  • Tooth Extraction / methods*
  • Treatment Outcome
  • Trismus / etiology
  • Vasoconstrictor Agents / administration & dosage

Substances

  • Analgesics, Non-Narcotic
  • Anesthetics, Local
  • Anti-Inflammatory Agents, Non-Steroidal
  • Vasoconstrictor Agents
  • Lidocaine
  • Epinephrine