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

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.