Maxillary Nerve

Maxillary nerve is the second division of the trigeminal nerve. It divides into several branches. You will read here about those that are related to dentistry below.

 

Image maxillary nerve

Figure 1: Maxillary nerve and its main branches

 

 

Posterior Superior Alveolar Nerve

Posterior superior alveolar nerve arises in the pterygopalatine fossa from the maxillary division of the Trigeminal nerve. This nerve passes downwards, over the maxillary tuberosity to provide sensory supply to the mucous membrane of the cheek and adjacent gingiva.

It then, passes through a foramen, named as posterior superior alveolar foramen to supply the maxillary sinus and the maxillary molar teeth except mesio-buccal root of the maxillary first molar. This root is supplied by the middle superior alveolar nerve.

Infraorbital Nerve

The maxillary nerve continues as Infraorbital nerve into the floor of the orbit via the inferior orbital fissure and exits the skull at the infraorbital foramen.

Middle Superior Alveolar Nerve

It descends from the infraorbital nerve along the lateral wall of the maxillary sinus. It supplies sensory fibers to the mesio-buccal root of maxillary 1st molar and all roots of premolars.

Anterior superior alveolar nerve

Anterior Superior alveolar nerve descends from the infra-orbital nerve before it exits the infra-orbital foramen. It supplies sensory fibers to anterior maxilla, maxillary sinus, roots of the anterior teeth, twigs to the floor of nasal cavity serving inferior meatus, and adjacent mucus membrane.

The posterior, middle, and anterior superior alveolar nerves intermingle, forming a dental plexus before innervating the upper teeth.

 

Greater Palatine Nerve

Image greater palatine nerve

Figure 2: Greater palatine and incisive nerve

The greater palatine nerve arises the ganglion to enter and descend in the pterygopalatine canal. It finally emerges on the palate through the greater palatine foramen. The greater palatine nerve serves the anterior border of the soft palate, hard palate, gingiva, and mucous membranes of this region as far anteriorly as the incisive teeth, where it communicates with the nasopalatine nerve.

In its descent in the pterygopalatine canal, posteroinferior nasal branches emerge and innervate the inferior concha and the middle and inferior meatuses.

The greater palatine nerve splits while in the canal to form a lesser palatine nerve, which exits on the palate through two or three same-named foramina serving the soft palate, tonsil, and uvula. Many of the afferents to this region are from the facial nerve communicated to the lesser palatine nerve through the pterygopalatine ganglion by way of the greater petrosal nerve and the nerve of the pterygoid canal. You will read about them with the facial nerve.

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