Comparison of the Pain Perception of Conventional and Computer-controlled Anesthesia Techniques for Extraction of Maxillary First Premolar

Introduction: Anterior middle superior alveolar (AMSA) block is a nerve block technique in conjunction with computer-controlled local anesthetic delivery (CCLAD) system. Anterior middle superior alveolar produces local anesthesia (LA) to the maxillary teeth from second premolar to the central incisor including the hard palate and corresponding soft-tissue of both buccal and palatal side, with single palatal injection. Aim: To evaluate efficacy of AMSA block for extraction of maxillary first premolar. Study design: In randomized single blind, split mouth clinical trial, the 14 patients received the conventional buccal-palatal (B-p) anesthesia on one side and CCLAD anesthesia AMSA for other side. the treatment consisted of bilateral extraction of maxillary first premolars for orthodontics. Pain perception ratings were obtained by using 10 point visual analog scale (VAS). Results: A total of 100% cases had painless injection with CCLAD, whereas 28.57% patients had painless injection experience with conventional LA. In all cases, there was no pain during extraction on both sides. With CCLAD, buccal retraction was painful in four cases whereas palatal retraction was painful in one case. Conclusion: Anterior middle superior alveolar block injected with CCLAD is better as LA technique for extraction of maxillary first premolar as compared to B-P approach.