P-ASA block injection: a new palatal technique to anesthetize maxillary anterior teeth.

UNLABELLED: This technique article presents a new local anesthetic injection that is reported to produce anesthesia of the six maxillary anterior teeth, the anterior third of the palate, and the facial gingiva from a single-site injection. The injection is referred to as the palatal approach anterior superior alveolar (P-ASA) nerve block. The 0.9 to 1.4 mL dosage recommendation for this block injection is significantly less than for a traditional supraperiosteal approach. The primary advantage of this injection is that it allows the dentist to anesthetize the teeth and gingiva without collateral anesthesia to the lips, face, or muscles of facial expression. Therefore, the smile line is not distorted during the operative phase of an appointment, and the patient is more comfortable postoperatively. CLINICAL SIGNIFICANCE: The P-ASA is a new block injection technique that provides anesthesia of the maxillary anterior teeth from a single injection without numbness of the face, lips, and muscles of facial expression. This injection technique prevents distortion of the smile line and enhances restorative procedures that use the lip line as an esthetic reference element.