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Anatomy and clinical applications of the maxillary nerve in dentistry: a literature review Krishnaraj Somayaji S Mohandas Rao KG Dental Update 2024 39:10, 707-709.
Authors
KrishnarajSomayaji S
MDS
Assistant Professor, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal India
Few reports in the literature have addressed the course of the maxillary nerve, its regional branches and their significance in anaesthetic procedures. It was observed that the maxillary nerve varies in its branching pattern and the knowledge of the course and distribution of these branches may be useful for dental surgeons and anaesthetists while working in this region. Keeping these points in view, this review is aimed at presenting information about the course, distribution, possible variations, clinical significance and the anaesthetic applications of the maxillary nerve and its branches in dental procedures.
Clinical Relevance: Knowledge of the anatomy of the maxillary nerve is of relevance to the regional anaesthetic technique of this nerve.
Article
The maxillary nerve (V2), intermediate in size between the ophthalmic and mandibular divisions of trigeminal nerve, is wholly sensory in function. It supplies the maxillary teeth, upper gingiva and adjoining part of the cheek, nose, palate, pharynx, dura mater, skin of temple, face, lower eyelid, side of nose, anterior part of cheek, upper lip, oral mucosa, labial glands, mucosa of the maxillary sinus and mobile part of the nasal septum. In early foetal life, it supplies primarily the structures derived from maxillary process but later extends into the adjoining frontonasal process. The maxillary nerve communicates with the facial nerve to carry the proprioceptive sensations. The sensory input from mechanoreceptors in the facial skin, oral mucosa and periodontal membranes to a large extent replaces the intramuscular proprioception which is usual in skeletal muscles.1
The maxillary nerve contains about 50,000 myelinated fibres which are the peripheral processes of the pseudo-unipolar cells of the trigeminal ganglion in the trigeminal cave near the apex of the petrous part of the temporal bone. The central processes of the cells of the ganglion contribute to the sensory root of the trigeminal nerve. Some proprioceptive fibres of the nerve pass through the ganglion without interruption to reach the trigeminal mesencephalic nucleus. Electrophysiological studies indicate that most of the proprioceptive axons have their cell bodies in the trigeminal ganglion.2 Fibres of the sensory root enter the pons to terminate on the principal sensory nucleus. Before reaching this nucleus, about 50% of the fibres divide into ascending and descending branches; others ascend or descend without division. Ninety percent of the descending fibres are less than 4 µm in diameter and they contribute to form the spinal tract of trigeminal nerve which terminates in the spinal nucleus.
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