Using AMSA and P-ASA nerve blocks for esthetic restorative dentistry.

Esthetic restorative dentistry procedures represent an increasing segment of the services provided by the general practitioner. One important assessment criterion for a successful anterior esthetic restoration is how well it harmonizes with the lips to create a pleasing smile line. Unfortunately, traditional local anesthetic techniques interfere with this assessment by distorting the lips and face during anesthesia. The anterior, middle superior alveolar block and the palatal approach anterior superior alveolar block injections represent two recently defined techniques to anesthetize maxillary teeth effectively without numbness of the face, lips, or muscles of expression. Although safety and efficacy studies are only beginning to emerge, these injections appear to be useful additions to local anesthetic techniques, especially when anterior esthetic restorative procedures are being performed.