{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:27:18Z","timestamp":1776918438807,"version":"3.51.2"},"reference-count":9,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2008,9,1]],"date-time":"2008-09-01T00:00:00Z","timestamp":1220227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2008,9]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Maxillary periodontal surgery typically requires multiple injections and may inadvertently affect facial structures such as the upper lip, lateral aspect of the nose, and lower eyelid. To minimize these sequelae and reduce the number of total injections, a relatively new injection technique has been proposed for maxillary procedures. The anterior middle superior alveolar (AMSA) injection is reported to effectively anesthetize maxillary teeth and associated gingival tissues extending from the buccal root of the first molar mesially to the central incisor with a single injection while avoiding undesirable side effects. The purpose of this article is to provide background information on the AMSA injection and demonstrate its use in a variety of maxillary periodontal surgeries.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Anesthesia was provided for five separate maxillary periodontal surgeries with unilateral or bilateral AMSA injections. Injections were administered via conventional syringe with a 27\u2010gauge needle. Confirmation of anesthesia was subjectively tested with buccal mucosal sticks and palatal transgingival probing.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The AMSA injection provided promising results for a variety of maxillary periodontal surgical procedures. Benefits of the AMSA injection included outstanding palatal hemostatic control, avoidance of undesirable collateral anesthesia, and a reduced number of cumulative injections. Drawbacks of the AMSA injection included occasionally inadequate buccal hemostatic control and short\u2010lived anesthesia of the maxillary central incisors.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The AMSA injection is a novel anesthetic technique that may prove useful for certain maxillary periodontal surgeries.<\/jats:p>","DOI":"10.1902\/jop.2008.070621","type":"journal-article","created":{"date-parts":[[2008,9,4]],"date-time":"2008-09-04T20:03:05Z","timestamp":1220558585000},"page":"1769-1772","source":"Crossref","is-referenced-by-count":12,"title":["Alternative Anesthetic Technique for Maxillary Periodontal Surgery"],"prefix":"10.1002","volume":"79","author":[{"given":"Dan","family":"Holtzclaw","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Toscano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,9]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"213","volume-title":"Handbook of Local Anesthesia","author":"Malamed SF","year":"2004"},{"key":"e_1_2_6_3_1","first-page":"34","article-title":"The AMSA block: Local anesthesia without collateral numbness","volume":"93","author":"Gomolka KA","year":"2000","journal-title":"CDS Rev"},{"key":"e_1_2_6_4_1","first-page":"506","article-title":"Using AMSA and P\u2010ASA nerve blocks for esthetic restorative dentistry","volume":"49","author":"Friedman MJ","year":"2001","journal-title":"Gen Dent"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.14219\/jada.archive.2004.0188"},{"key":"e_1_2_6_6_1","first-page":"80","article-title":"Anesthetic efficacy of the anterior middle superior alveolar (AMSA) injection","volume":"51","author":"Lee S","year":"2004","journal-title":"Anesth Prog"},{"key":"e_1_2_6_7_1","first-page":"995","article-title":"A 21st century computerized injection system for local pain control","volume":"18","author":"Friedman MJ","year":"1997","journal-title":"Compend Contin Educ Dent"},{"key":"e_1_2_6_8_1","first-page":"28","article-title":"Maximizing pain control: The AMSA injection can provide anesthesia with fewer injections and less pain","volume":"1","author":"Perry DA","year":"2003","journal-title":"Dimens Dent Hyg"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2004.02.064"},{"key":"e_1_2_6_10_1","first-page":"537","article-title":"Efficacy of anterior and middle superior alveolar (AMSA) anesthesia using a new injection system: The Wand","volume":"34","author":"Fukayama H","year":"2003","journal-title":"Quintessence Int"}],"container-title":["Journal of Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/pdf\/10.1902\/jop.2008.070621","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:51:07Z","timestamp":1760874667000},"score":1,"resource":{"primary":{"URL":"https:\/\/aap.onlinelibrary.wiley.com\/doi\/10.1902\/jop.2008.070621"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,9]]},"references-count":9,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2008,9]]}},"alternative-id":["10.1902\/jop.2008.070621"],"URL":"https:\/\/doi.org\/10.1902\/jop.2008.070621","archive":["Portico"],"relation":{},"ISSN":["0022-3492","1943-3670"],"issn-type":[{"value":"0022-3492","type":"print"},{"value":"1943-3670","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,9]]}}}