MAXILLARY NERVE

1. Definition
2. Course
3. Branches and Distribution
4. Anesthesia
definition

The maxillary nerve(v2), or second )middle) division of the

trigeminal nerve(v) ,It is a pure sensory nerve , enters the
pterygopalatine fossa where it gives rise to nerves that serve the
orbit, the hard and soft palate, maxillary molars and supporting
tissues, portions of the nasal cavity, anterior maxillary teeth and
supporting tissues, and nasopharynx.
COURSE

it arises from the Convex anterior border of the trigeminal ganglion .

It Leave the middle Cranial fossa through the foramen rotundum

It enter the pterygopalatine fosse where pterygopalatine ganglion is

suspended from it by two roots .
Leave pterygopalatine fossa passing through pterygo-maxillary
fissure and crosses infratemporal fossa .

Enter the orbit through the inferior orbital fissure, it Called infra
orbital Nerve .

It appear on the face through the infraorbital foramen.

BRANCHES

a) In middle Cranial fossa.

b) In Pterygo Palatine fossa.

c) In orbit (infraorbital Canal).

d) In Face.
a) In middle Cranial fossa.
It is called meningeal branch supply dura mater of the fossa

b) In Pterygo Palatine fossa.

1. ganglionic branches (2 branch) -pre
and post ganglionic branches which Supply (suspended) pterygo palatine
ganglion.

zygomatic-temporal to temporal fossa

2. Zygomatic nerve
Zygomatic-facial to the face.
3. posterior superior alveolar nerve
• Enter the posterior surface of maxilla to supply

1. Upper molar teeth

2. Mucosa of upper gum

3. Maxillary sinus.
c) In the infraorbital canal

Here it is called the infraorbital nerve.

It gives:

• Middle superior alveolar nerve -

Supplies the upper premolar teeth, mucosa of maxillary sinus and upper gum

• Anterior superior alveolar nerve

 Runs a sinuous course in the anterior wall of the maxillary air sinus.

 Supplies the upper incisors and canine teeth and the upper gum.

 It also gives nasal branches to the anteroinferior part of the lateral wall of the nose.
d) In the face:
-It gives 3 terminal branches:

• Labial branches
- To the skin and mucosa of the upper lip.

• Nasal branches

- To the side of the nose

• Palpebral branches

-To the lower eyelid.

• Superior dental plexus is formed by:

 posterior Superior alveolar nerve .

 middle Superior alveolar nerve.
 anterior Superior alveolar nerve.
 maxillary buccal infiltration
Maxillary infiltration
maxillary palatal infiltration
 BUCCAL INFILTRATION TECHNIQUE

The point of needle insertion The point

of intersection of 2 imaginary lines
• 1st line is a vertical line parallel to the
long axis of the tooth
• 2nd line is a horizontal line along the
mucobuccal fold
Direction of needle insertion

• 45° with the buccal cortical plate of bone

 STEPS FOR BUCCAL INFILTRATION

 The lip/cheek is retracted using dental mirror or your finger to make almost a right angle with the
labial/buccal aspect of the jaw

 The point of insertion is determined as mentioned

 The needle is inserted with its bevel toward the bone and making an angle of 45° with the buccal
aspect

 The needle is pushed through the soft tissue until the bone is reached (within 2mm)
 PALATAL INFILTRATION TECHNIQUE
• The point of needle insertion
• Midway between the gingival margin of the tooth and the
median palatine raphe

• Along the long axis of the tooth

• The needle is 90 degree with the palatal aspect

 NERVE SUPPLY OF MAXILLARY TEETH

Pulp, Investing structures & Labial (buccal) mucoperiosteum

Anterior teeth (1,2,3) Anterior superior alveolar nerve

Premolars (4,5) & MB Middle superior alveolar nerve

root of 1st molar(6)

Molars except MB root Posterior superior alveolar nerve

of 1st molar(6)
 Palatal mucoperiosteum

Anterior teeth (1,2,3) Nasopalatine nerve

Greater (Anterior) palatine nerve

Premolars (4,5) & Molars (6.7.8(
Thank you
• Hazem Mohamed Metwally Draz

• Sayed Said Metwally Draz

• Eman Salah

• Amira Atia