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Anterior and middle superior alveolar block is efficient for maxillary premolar teeth extractions regardless of the injection system or anesthetic with adrenaline used.

Introduction
The anterior and middle superior alveolar nerve block was claimed to be unpredictably
efficient for clinical application.


Objective
The aim of this report was to establish the efficacy of the anterior and middle superior alveolar
nerve block, applied with a computer-controlled injection system or a conventional syringe, for upper
premolars extraction.


Methods
Sixty healthy adults were divided into two groups regarding the device used as follows: the first
group was injected by a computer-controlled injection system, and the second group by a conventional
syringe. Pain ratings were obtained via a visual analog scale (VAS) and a verbal rating scale (VRS).


Results
Anterior and middle superior alveolar injection enabled a painless extraction in all patients,
regardless of the local anesthetic or injection system used. It was slightly less painful when administered
by a computer-controlled injection system, but insignificantly when evaluated by VRS.


Conclusion
The anterior and middle superior alveolar nerve block may be recommended if maxillary
permanent premolars have to be extracted.