Effects of Articaine Computer-controlled and Conventional Delivery for Anterior and Middle Superior Alveolar Nerve Block
Effects of Articaine Computer-controlled and Conventional Delivery for Anterior and Middle Superior Alveolar Nerve Block
The purpose of this study was to investigate and compare pulpal anesthesia and cardiovascular
 parameters obtained with 0.6 ml of 4% articaine with epinephrine (1:100.000) for anterior and
 middle superior alveolar nerve (AMSA) block performed by standard and computer-controlled
 delivery in healthy volunteers.
Traditionally, pulpal anesthesia is obtained by infiltration or mandibular nerve block.
 However, it is not always possible to achieve complete pulpal anesthesia with previously
 mentioned anesthetic techniques.

 It is well documented that administration of 0,6-0,9 ml of anesthetic solution with palatal
 approach with anterior middle superior injection (AMSA) provided successful pulpal anesthesia
 from central incisor to second premolar. In addition, palatal soft tissues from midpalate to
 free gingiva and from central incisor to first molar are fully anesthetized with AMSA. The
 injection site is located at a point that bisects the maxillary first and second premolars,
 and midway between the crest of the free gingival margin and mid-palatine suture. The needle
 is orientated at a 45-degree angle with the bevel facing the palatal tissue. AMSA presents
 intraosseous anesthetic technique.

 Traditionally, palatal injection administered with conventional syringe was described as very
 painful. On the other hand, computer controlled local anesthetic delivery system (CCLADS) has
 been recommended for AMSA as a system which allows slow administration of anesthetic
 solution, with constant pressure. It was shown that AMSA do not provide undesired buccal and
 upper lip anesthesia.

 The AMSA technique has been recommended for proce¬dures ranging from operative restorations,
 crown preparation to scaling and root planning.

 The aim of this study is to evaluate and compare parameters of pulpal anesthesia and
 cardiovascular function after AMSA injection of 4% articaine with epinephrine (1:100.000),
 delivered by conventional syringe or CCLADS. Study sample will comprise 30 healthy (ASA1)
 volunteers who will receive 0.6 ml 4% articaine with epinephrine (1:100.000) by conventional
 syringe, and after two-week washout period the same amount of local anesthetic by CCLADS.
 Parameters of pulpal and soft tissue anesthesia (onset and duration) for all maxillary teeth
 on the anesthetized side, as well as parameters of cardiovascular function (systolic blood
 pressure, diastolic blood pressure, heart rate) will be monitored and compared.
Inclusion Criteria:

 -  ASA I

 -  full maxillary dental arch

 -  vital maxillary teeth without caries, restorations, periodontal disease or history of
 trauma

 Exclusion Criteria:

 -  allergies to local anesthetic solution ingredients, food and drugs

 -  alcohol and drugs abuse

 -  heavy tobacco smoking