by Dr. Syed Irfan Qadeer(MS) Prof. and Head Department of Anatomy, Sardar Patel Dental College, Lucknow

1. Anatomy of Maxilla and Mandible
By:-
Dr. Syed Irfan Qadeer
Prof. And Head, Department of Anatomy
Sardar Patel Dental College, Lucknow.

2. 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 nose and the orbit
2. Roof of the mouth
3. Lateral wall of the nose
4. Pterigopalatine and infratemporal fossae
5. Pterigomaxillary and infraorbital fissures

3. Anatomy of the maxilla
• The anatomy of the maxilla has two main
parts:
1. Body(pyramidal shape)
– Anterior surface
– Posterior surface
– Orbital surface
– Nasal surface
2. Processes
– Zygomatic
– Frontal
– Alveolar
– Palatine

5. 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

7. 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 themedial pterigoid muscles
• Above this smooth surface which forms the boundry of the
ptrigopalatine fossa is grooved for the maxillary nerve, this
groove is contineous with the infra orbital groove

8. 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 canalis sinuosus 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

9. 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
• Infront of maxillary hiatus there is a lacrimal
groove
• More anteriorly concal crest for articulation with
inferior nasal concha

11. 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
• Uncinate 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 usually by two
openings one of which is closed by mucous membrane in
living state
• Occasionally there are projections in the maxillary sinus
from roof to anterior wall

13. 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

14. • 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

15. • 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
– Incisors and premolars single
– Occasionally incisors are divided into 2 sockes

16. • 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

17. Muscles attached to maxilla

18. Muscles of face

19. Arterial supply

20. Maxillary Artery

21. Veinous drainage

23. Nerve Supply

24. Lymphatics

25. Age changes in Maxilla

26. 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

29. 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

31. Internal Surface
• Myelohyoid line
• Sub mandibular fossa
• Sub lingual fossa
• Genial tubercle
• Myelohyoid groove

32. 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

33. Arterial Supply of Maxilla and
Mandible

35. Nerve supply of Mandible

37. Veinous drainage of Mandible

38. • Processes:
– Condylar
– Coronoid
• Mandibular canal

39. Age changes in mandible

40. 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

41. • 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

42. • 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

43. • 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

44. • 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

45. • Mentalis muscle:
– Complete reflection of the
mentalis muscle for the
purpose of extension of a
subperiosteal implant may
result in a condition known
as witch’s 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

46. • 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

47. 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

48. • 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

49. • Nerve to mylohyoid:
– The nerve lies in closed relation to the ramus of
mandible hence it is prone to get damaged during
surgical intervention

50. • 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

51. 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

52. Thank You
syedirfanqadeer@ymail.com