Quality of anesthesia for the maxillary primary anterior segment in pediatric patients: Comparison of the P-ASA nerve block using CompuMed delivery system vs traditional supraperiosteal injections

Purpose: The purpose of this study was to compare the quality of 2 injection techniques to anesthetize the maxillary primary anterior segment by applying either the palatal approach anterior superior alveolar nerve block (P-ASA) utilizing a computer-controlled injection device (CompuMed with the Wand handpiece) or traditional multiple supraperiosteal (TMS) injections with a hand-operated syringe. Depth and duration of anesthesia was assessed by the number of disruptive behaviors 20 minutes following injection. Methods: Twenty-one preschoolers aged 3 to 5 years, who required pulp tissue removal with subsequent crown placement and/or extraction of at least 2 teeth in the maxillary incisor segment on opposite sides of the midline, participated in this study. They were randomly assigned to either the P-ASA or the TMS injection group. The procedure was separated into 3 segments: (1) the injection; (2) overall procedure; and (3) painful event. Each segment was scored for disruptive behaviors (body movements, crying, restraint, or dentist interference) using an established scale. Scores were analyzed via analysis of variance for significance. Results: During injection, disruptive behaviors occurred significantly less in the P-ASA group than in the TMS group. No significant differences were found between the 2 groups for the overall procedure and the painful event segments. Conclusion: Whereas anesthetic solution delivery with CompuMed system caused significantly less disruptive behavior during the injection phase, both methods seem to provide a comparable quality of anesthesia for the maxillary primary incisor segment 20 minutes after deposition of the anesthetic solution.