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Neurovascular Supply of Dentition

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Read the article below to know the details of arteries and nerves supplying the maxillary and mandible regions and the pathologic implications when a tooth's supply is cut off.

Medically reviewed by

Dr. Lekshmipriya. B

Published At April 7, 2022
Reviewed AtDecember 16, 2022

How Is the Arterial Supply to the Maxillary and Mandibular Teeth?

The neurovascular supply to the teeth is quite rich and is due to the same sources that immediate the upper and lower jaws.

The arterial supply to the jawbones and the teeth comes from the maxillary artery, a branch of the external carotid artery. The branches of the maxillary artery that feed the teeth directly are the inferior alveolar artery and the superior alveolar arteries. The inferior alveolar artery branches from the maxillary artery medial to the ramus of the mandible. After giving off the mylohyoid branch, it immediately enters the mandibular foramen and continues downward and forward through the mandibular canal, giving off branches to the premolar and molar teeth.

It divides into mental and incisive branches in the vicinity of the mental foramen. The mental branch, in turn, passes through the mental foramen to supply the tissues of the chin and to anastomose with the inferior labial and submental arteries. The incisive branch moves forward into the bone to supply the anterior teeth and bone and to anastomose those of the opposite side. The anastomosis of the mental and incisive branches furnishes a good collateral blood supply for the mandible and teeth.

Other branches that enter the interdental septa usually supply the bone and adjacent periodontal membranes. These accessory branches terminate in the gingiva. Numerous small anastomoses connect the vessels with those supplying the neighboring alveolar mucosa.

  1. The posterior superior alveolar artery branches from the maxillary artery superior to the maxillary tuberosity. It enters the alveolar canals along with the posterior superior alveolar nerves and supplies the maxillary teeth, alveolar bone, and membrane of the sinus.

  2. A middle superior alveolar branch is usually given off by the infraorbital continuation of the maxillary artery somewhere along the infraorbital groove or canal.

  3. Anterior superior alveolar branches arise from the infraorbital artery just before this vessel leaves its foramen. They course down the anterior aspect of the maxilla in bony canals to supply the maxillary anterior teeth and their supporting tissues and join the middle and posterior superior alveolar branches in completing an anastomotic plexus.

The palatal blood supply comes from two sources but chiefly from the descending palatine artery. Its greater palatine branch enters the palate through the greater palatine foramen. It is distributed to the bone, glands, and mucosa of the hard palate and to the bone and mucosa of the alveolar process.

How Is the Nerve Supply to the Maxilla?

The sensory nerve supply to the jaws and teeth is derived from the maxillary and mandibular branches of the fifth cranial, or trigeminal nerve, whose ganglion, the trigeminal, is located at the apex of the petrous portion of the temporal bone. The innervation of the orofacial region includes, in addition to the trigeminal nerve (including V2 and V3), other cranial nerves; the maxillary nerve courses forward through the wall of the cavernous sinus and leaves the skull through the foramen rotundum. It crosses the pterygopalatine fossa, where it gives branches to the pterygopalatine ganglion, a parasympathetic ganglion. This ganglion gives off several branches containing visceral motor and sensory fibers to the mucous membrane of the mouth, nose, and pharynx.

The maxillary nerve also has a posterior superior alveolar branch from its pterygopalatine portion. This nerve enters the alveolar canals on the infratemporal surface of the maxilla and, forming a plexus, it is distributed to the molar teeth and the supporting tissues. The maxillary nerve enters the orbit and, as the infraorbital nerve, runs forward on its floor, first in the infraorbital groove and then in the infraorbital canal. Finally, it terminates at the infraorbital foramen in branches distributed to the upper face.

At a variable distance, after it enters the orbit, a middle superior alveolar branch arises from the infraorbital nerve and runs through the lateral wall of the maxillary sinus. It is distributed to the premolar teeth and surrounding tissues and joins the alveolar plexus.

How Is the Nerve Supply to the Mandible?

The mandibular nerve leaves the skull through the foramen ovale. The chief branch of the lower jaw is the inferior alveolar nerve. It continues forward through the mandibular canal beneath the roots of the molar teeth to the level of the mental foramen. During this part of its course, it gives off branches to the molar and premolar teeth and their supporting bone and soft tissues. At the mental foramen, the nerve divides, and a smaller incisive branch continues forward to supply the anterior teeth and bone, and a larger mental branch emerges through the foramen to supply the skin of the lower lip and chin.

The buccal nerve, although chiefly distributed to the mucosa of the cheek, has a branch that is usually distributed to a small area of the buccal gingiva. They extend from the canine to the third molar.

The lingual nerve has mucosal branches to a variable area of lingual mucosa and gingiva. The mylohyoid nerve may sometimes continue its course forward on the lower surface of the mylohyoid muscle and enter the mandible through a small foramina on either side of the midline. In some individuals, it is thought to contribute to the innervation of central incisors and periodontal ligaments.

What Happens When the Arterial and Nerve Supply to the Teeth Is Cut Off?

When a tooth usually undergoes traumatic stress such as a fall, severe decay, injury, fracture, subluxation, or even avulsion, then the neurovasculature supply is likely to be cut off as a result of which the tooth may turn discolored, undergo internal root resorption or even turn completely non-vital. A vital tooth can still warranty endodontic treatment or root canal procedure. However, when the prognosis of the tooth to be saved is poor, it will eventually be indicated for extraction by the dental surgeon.

Conclusion:

The nerve supply and blood supply to the teeth both in the maxilla and mandible, that is, the upper and lower jaws, are the source of vitality and life to the whole dentition. Therefore, any damage or infection to this rich vasculature necessitates the need for endodontic or surgical treatment to restore dental functionality and form.

Frequently Asked Questions

1.

What Is the Vascular Supply of the Teeth?

As with every organ, teeth are also blood supply and nerve supply. The connective tissue portion at the center of the teeth is known as the pulp. This portion is rich in blood supply and contains nerve supply. Blood vessels to the pulp arise from arterioles that make their path from the periodontium into the pulp via the apical foramen. Each pulp chamber contains one to two arterioles and one large venule. Arteriovenous anastomoses are also seen in the pulp chamber.

2.

What Is the Nerve Supply of Different Teeth?

The maxillary nerve branch of the trigeminal nerve supplies the maxillary teeth. The mandibular nerve branch of the trigeminal nerve supplies the mandibular teeth. These nerves have two types of fibers; these are autonomic and afferent fibers.

3.

What Is the Nerve Supply to the Maxillary Teeth?

The maxillary nerve branch of the trigeminal nerve supplies maxillary teeth. The anterior superior alveolar nerve branch of the maxillary nerve supplies the anterior teeth. The middle superior alveolar nerve supplies the premolar teeth. The posterior superior alveolar nerve supplies the molar teeth.

4.

What Are the Blood Supply and Nerve Supply of Gingiva?

The maxillary nerve supplies the maxillary portion of the gingiva, and the mandibular nerve supplies the mandibular gingiva. The blood suply of the gingiva arives from the branches of maxillary artery.

5.

What Is the Vascular Supply to the Periodontium?

The blood vessels supplying the periodontium form a complex network of blood capillaries. Arteries arising from branches of the maxillary artery form numerous small branches. Branches like interseptal arteries inter ligamental arteries form a network of vessels that supply to the periodontium.

6.

What Is the Nerve Supply of Maxillary Molars?

Maxillary molars are multi-rooted teeth. They are supplied by the posterior superior branch of the maxillary nerve. Only the mesiobuccal root of the maxillary first molar is supplied by the middle superior branch of the maxillary nerve.

7.

What Is the Nerve Supply of the Gingiva?

The different branches of the trigeminal nerve supply different portions of the gingiva. The maxillary nerve supplies the maxillary gingiva and the mandibular gingiva is supplied by the mandibular nerve.

8.

What Artery Supplies Blood to All Teeth?

All teeth receive blood supply from different branches of the maxillary artery. The mandibular teeth are supplied by the inferior alveolar artery, which is the branch of the mandibular division. The maxillary teeth are supplied by the pterygopalatine segment of the maxillar artery.

9.

What Is the Blood Supply of Lower Dentition?

The maxillary artery's inferior alveolar artery branch supplies all the lower jaw's teeth. This artery is derived from the mandibular branch of the maxillary artery.

10.

What Is the Artery Supply of the Maxillary Teeth?

The anterior teeth receive blood supply from the anterior superior alveolar artery. The middle superior alveolar artery and posterior superior alveolar artery, respectively, supply premolars and molars. All these are branches of the maxillary artery.

11.

What Is the Blood Supply of the Maxillary Gingiva?

The branches of the maxillary artery supply the maxillary gingiva. Branches from the pterygopalatine segment of the maxillary artery supply different portions of the gingiva.

12.

Which Nerve Controls Tooth Pain?

The autonomic and afferent fibers of the maxillary and mandibular nerves control tooth pain. The sensation of pain travels through these nerves and reaches the brain.

13.

Which Is the Largest Cranial Nerve, Also Known as the Dentist’s Nerve?

The trigeminal nerve is called the dentist's nerve. The maxillary and mandibular branches of the trigeminal supply maxillary and mandibular teeth, respectively. Different branches of mandibular and maxillary nerves are anesthetized during dental procedures. That is why the trigeminal nerve is called the dentist’s nerve. 

14.

Which Nerve Do Dentists Numb?

Different branches of the maxillary and mandibular nerve are numbed during the procedure. The dentist makes this decision based on the procedure. For mandibular teeth, the inferior alveolar nerve is numbed. For maxillary teeth, depending on the teeth anterior, middle, or posterior alveolar nerve is anesthetized.  

15.

How Many Nerves Are There in the Teeth?

A single nerve supplies single-rooted teeth. For multi-rooted teeth, the number of nerves depends upon the number of roots present in the teeth. 
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Dr. Achanta Krishna Swaroop
Dr. Achanta Krishna Swaroop

Dentistry

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