Oral Anatomy

1. Dr. Hadi Munib
Oral and Maxillofacial Surgery Resident

2. Outline
 Cranial Nerves
 Trigeminal Nerve
 Maxillary branch
 Mandibular branch
 Anatomical Sites in Maxilla
 Anatomical Sites in Mandible
 References

5. Trigeminal Nerve
 V1: Ophthalmic Division
 V2: Maxillary Division
 V3: Mandibular Division

6. Ophthalmic Division
 Supplies the skin of the forehead, the upper eyelid, the conjunctiva, and the
side of the nose down to and including the tip.
1. The lacrimal nerve supplies the skin and conjunctiva of the lateral part of
the upper eyelid.
2. The supraorbital nerve supplies the central part of the upper eyelid
3. The supratrochlear nerve; supplies the skin and conjunctiva on the medial
part of the upper eyelid and the skin over the lower part of the forehead.
4. The infratrochlear nerve supplies medial part of the upper eyelid and the
part of the side of the nose.
5. The external nasal nerve supplies the skin on the side of the nose down as
far as the tip.

8. Maxillary Division
 Foramen Rotundum
 Inter-cranial
 Pterygopalatine
 Infraorbital
 Facial

9. Maxillary Division
 Within the pterygopalatine fossa:
 Zygomatic nerve
 Pterygopalatine nerves
 Posterior superior alveolar nerve
 Zygomatic nerve:
 Zygomaticofacial nerve- skin to cheek prominence
 Zygomaticotemporal nerve- skin to lateral forehead

10. Maxillary Division
 Pterygopalatine nerves:
 Serves as communication for the pterygopalatine ganglion and the maxillary
nerve
 Carries postganglionic secreto-motor fibers through the zygomatic branch to
the lacrimal gland
 Orbital branches- supplies periosteum of the orbits
 Nasal branches- supplies mucous membranes of superior and middle conchae,
lining of posterior ethmoid sinuses, and posterior nasal septum.

11. Maxillary Division
 Nasopalatine nerve- travels across the roof of nasal cavity giving branches off
to the anterior nasal septum and floor of nose, provides palatal gingival
innervation to the premaxilla
 Palatine branches- greater (anterior) and lesser (middle or posterior) palatine
nerves
 Greater palatine: travels through the pterygopalatine canal and enters the
palate via the greater palatine foramen. Innervates palatal tissue from
premolars to soft palate. Lies 1cm medial from 2nd molar region
 Lesser palatine: emerges from lesser palatine foramen and innervates the
mucous membranes of the soft palate and parts of the tonsillar region

12. Maxillary Division
 Posterior Superior Alveolar Nerve: branches from V2 prior to entrance
into infraorbital groove.
 Innervates posterior maxillary alveolus, periodontal ligament, buccal
gingiva, and pulpal tissue (only for 1st, 2nd, and 3rd molars)
 MB Root of upper 1st molar?

13. Maxillary Division
 Infra-Orbital:
 Middle Superior Alveolar Nerve: Pulpal supply for First and Second
Premolars, Buccal Gingiva and PDL
 Anterior Superior Alveolar Nerve: Pulpal Supply for Central, Lateral
Incisors and Canine, labial Gingiva and the PDL
 Facial branches: Emerge from the infraorbital foramen
 Inferior palpebral- lower eyelid
 External nasal- lateral skin of nose
 Superior labial branch- upper lip skin and mucosa

16. Mandibular Division
 Foramen Ovale
 Mixed
 Branches of Undivided nerve
 Branches of Anterior Division
 Branches of Posterior Division

17. Mandibular Division
 Branches of the undivided nerve:
 Nervus spinosus- innervates mastoids and dura
 Medial pterygoid- innervates medial pterygoid muscle
 Tensor veli palatini
 Tensor tympani

18. Mandibular Division
 Anterior Division
 Buccal nerve (long buccal):
 Travels anteriorly and lateral to the lateral pterygoid muscle
 Deep temporal (temporalis muscle), masseter, and lateral pterygoid muscle.
 Antero-lateral direction.
 At level of the mandibular 3rd molar, branches exit through the buccinator
and provide innervation to the skin of the cheek.
 Retromolar Triangle; sensory innervation to the buccal gingiva of the
mandibular molars and buccal vestibule.

19. Mandibular Division
 Posterior Division: Inferior and Medial to Lateral Pterygoid
 Auricotemporal: Upper part of parotid and posterior part of zygoma
 Communicates with facial nerve to provide sensory innervation to the skin
over the zygomatic, buccal, and mandibular areas.
 Communicates with the otic ganglion for sensory, secretory, and vasomotor
fibers to the parotid
 Anterior auricular- skin over helix and tragus
 External auditory meatus- skin over meatus and tympanic membrane
 Articular- posterior TMJ
 Superficial temporal- skin over temporal region

20. Mandibular Division
 Lingual: Lies between ramus and medial pterygoid within the
pterygomandibular raphe
 Lies inferior and medial to the mandibular 3rd molar alveolus
 Provides sensation to anterior 2/3rds of tongue, lingual gingiva, floor of
mouth mucosa, and gustation (chorda tympani).
 Inferior Alveolar: Provides innervation to the mandibular alveolus, buccal
gingiva from premolar teeth anteriorly, and the pulpal tissue of all
mandibular teeth on side blocked

21. Mandibular Division
 Travels medial to the lateral pterygoid and latero-posterior to the lingual
nerve
 Enters mandible at the lingula.
 Accompanied by the inferior alveolar artery and vein (artery anterior to
nerve)
 Mylohyoid nerve- motor branch of IDN prior to entry into lingula.
 Incisive Nerve
 Mental Nerve

33. References
 Chapter 11: The Head and Neck