Anatomy of Maxilla

Maxilla

It is the second largest bone of the face

It forms the upper jaw with the fellow of the

opposite side

It also contributes to the formation of

1.

Floor of the orbit

2.

Roof of the mouth

3.

Lateral wall of the nose

4.

Pterigopalatine and infratemporal fossae

5.

Pterigomaxillary and infraorbital fissures

Anatomy of the maxilla

The anatomy of the maxilla has two main parts:
1.

2.

Body(pyramidal shape)

Anterior surface

Posterior surface

Orbital surface

Nasal surface

Processes

Zygomatic

Frontal

Alveolar

Palatine

Anterior Surface:

Incisive Fossa:

Depressor septi nasi

Orbicularis oris

Canine fossa:

Levator anguli oris

Infraorbital foramen
(above canine fossa)

Infraorbital nerves and vessels

Above sharp border between

anterior and orbital surface:

Levator labi superioris

Nasal notch: Dilator Naris

Ant Nasal Spine

Posterior Surface

It is directed backwards and laterally

It forms anterior wall of the infratemporal fossa

Anterior and posterior surfaces are seperated by ridge which leads

to the socket of 1st molar tooth

Near the centre of posterior surface 2 to 3 openings of dental

canal for posterior superior alveolar vessels and nerves

At the lower end there is a raised maxillary tubrosity which is

rough in the upper part of its medial end for tubercle of the
palatine bone which has the attachment of superficial fibres of the
medial pterigoid muscles

Above this smooth surface which forms the boundry of the

pterigopalatine fossa is grooved for the maxillary nerve, this
groove is continuous with the infra orbital groove

Orbital surface
Smooth and triangular

Medial border

Notch: lacrimal notch

Behind this it articulates with the

Lacrimal
Orbital plate of ethmoid
Orbital process of palatine

Posterior border: Smooth, rounded and it forms greater part of

infraorbital fissure in middle infraorbital groove

Anterior border: forms orbital margin ,infraorbital groove and canal;

a little lateral to this is lacrimal canalis which passes in the anterior
wall of the maxillary sinus and reaches in the nasal cavity and
opens in the side of the nasal septum in front of incisive canal

A little lateral to the lacrimal groove there is attachment of inferior

oblique muscle of eveball

Nasal Surface

In its upper posterior part there is a large maxillary hiatus which

leads into the maxillary sinus
In articulated skull this hiatus is completed by ethmoid and lacrimal
bones

Behind this there is a rough impression for the perpendicular plate

of palatine bone

More anteriorly concal crest for articulation with inferior nasal

concha

The upper jaw inside view

1
2
3
4
5

frontal process;
lacrimal groove;
cleft maxillary sinus;
infratemporal surface;
palatine process;

Maxillary Sinus

Large pyramidal cavity with its apex directed laterally towards the
zygomatic process

Base is towards the lateral wall of the nose

In articulated skull it is reduced by

Above
Process of ethmoid
Desending part of lacrimal bone

Below: inferior nasal concha

Behind: perpendicular plate of palatine

It opens into the middle meatus of the nose.

Occasionally there are projections in the maxillary sinus from roof

to anterior wall

Processes

Zygomatic: it is rough and pyramidal

Front:it is contineous with the anterior surface of body

Behind(concave):in continuity of the posterior surface

Above: articulates with zygomatic bone

Below(arched border) which anterior and posterior

surface of the body

Frontal Process:

Lateral Surface:
Vertical ridge (Lacrimal crest)
Groove for the lacrimal sac

Medial surface: It is rough and uneven and articulates with the ethmoid
and also closes the anterior ethmoidal sinus below ethmoidal crest
Upper end: Articulates with the frontal bone
Anterior border with the nasal bone
Posterior border with the lacrimal bone

Alveolar processes: It has thick arched border

behind and contains sockets to receive roots of
teeth which vary in size and depth

Canine deepest

Molar widest and subdivided into 3 minor sockets by

septae

Palatine Process: Thick strong horizontal

Inferior surface is concave and presents numerous foramina for

passage of nutrient vessels and contains depressions for lodgement of
glands

Groove for grater palatine Vessels and nerves

Incisive fossa leads into the incisive canal

Sometimes anterior and posterior incisive foramen for long

sphenopalatine nerve which communicates with the greater palatine
nerve

Upper surface: forms the floor of the nasal cavity

Lateral Border fuses with rest of the bone

Posterior border fuses with the horizontal plate of the palatine

Maxillary Artery

Veinous drainage

Nerve Supply

Lymphatics

Mandible

Largest and strongest bone of the face

Curved horizontal body; convex forwards

It has two rami which project upward from posterior

end of the body

The body is horse shoe shaped

External Surface

Faint ridge: symphisis menti

Mental protuberance in the triangular area below

sympisis menti

Mental tubercle on each side of mental

protruberance

Mental foramen between premolar teeth

Oblique line

Internal Surface

Myelohyoid line

Sub mandibular fossa

Sub lingual fossa

Genial tubercle

Myelohyoid groove

Borders

Upper boder:

Sockets for the mandibular teeth are present

Lower border(Base) presents a digastric fossa

Ramus

Lateral Surface

Medial Surface
Mandibular foramen canal
Lingula- mylohyoid groove

Inferior border is continuous with the angle of mandible

Upper Border: Mandibular Notch

Arterial Supply of Maxilla

and Mandible

Nerve supply of Mandible

Veinous drainage of
Mandible

Processes:

Condylar

Coronoid

Mandibular canal

Age changes in mandible

Applied Anatomy
Muscle injuries: Its cause and effects

Incisivus labii Superioris:

During the exposure of the bone of

premaxilla between the canines ,a
mucoperiosteal flap reflection may
detach the muscle and if the
muscle gets damaged the the
drooping of the septum and ala of
the nose may occur

Mylohyoid muscle

Surgical manupulation of the floor of the mouth may result in

edematous swelling of the sublingual space (above the mylohyoid
muscle )and submandibular space(below the mylohyoid muscle)

Cellulitis of this sublingual space in quiet common however excessive

bilateral cellulitis of the sublingual spaces may push the tongue
backwards and compress the pharynx and may result in airway
obstruction

Genoiglossus muscle

During the elevationof the

lingual mucosa before making
an impression for a
subperiosteal implant a portion
of the muscle may be reflected
from te genial tubercle, however
if the muscle is completly
detached from the tubercle it
may lead to retrusion of the
tongue and airway obstruction

Medial pterigoid

The medial pterigoid muscle

binds the pterigomandibular
space medially ,during surgical
procedures involving the area of
pterigomandibular space
infection may occour and may be
dangerous due to its closed
proximity to the pharyngeal
space

Surgical exposure of the tissue

posterior to the maxillary
tubrosity may also involve the
medial pterigoid muscle as a part
of the muscle originates from
the maxillary tubrosity

Lateral pterigoid muscle

The lateral pterigoid muscle fibres are placed in an angulated manner

and because of this there may be pain in patients with a full arched
subperiosteal implant or prosthetic splint

Mentalis muscle:

Complete reflection of the

mentalis muscle for the purpose
of extension of a subperiosteal
implant may result in a
condition known as witchs chin

There is failure of the mentalis

muscle reattachment following
the implantation. An external
bandage is applied for four days
to help in the reattachment of
the muscle

Buccinator muscle:

Myositis of the detached buccinator muscle in patients with

subperiosteal implants may cause swelling and pain at the site of origin
of the muscle

Nerve injuries

Inferior alveolar nerve:

The nerve may be

damaged easily when
making an incision or
reflection of the mucosa in
its area therefore position
of the inferior dental canal
in vertical and
buccolingual dimension is
of great importance during
site preprations for
implants

Lingual nerve

The position of the nerve is

lateral to the retromolar pad
the incision should remain
lateral to the pad and the
mucosal reflection should be
done with a periosteal elevator
in constant contact with the
bone to prevent injury to the
nerve

Nerve to mylohyoid:

The nerve lies in closed relation to the ramus of mandible hence it is

prone to get damaged during surgical intervention

Long buccal nerve:

When the ramus is accessed

for the purpose of a block
graft excision great care
must be take to protect this
nerve from injury

Injury to vessels

Maxillary vessels:

During the surgical orthognathic

procedures the major nutrient
artery of the maxilla are
sometimes damaged, but the
blood supply is maintained by
anastamosis present in the soft
palate

Thank You