Anatomy and Variations of the Posterior Superior Alveolar Artery and Nerve

Abstract

The posterior superior alveolar artery is a terminal branch of the maxillary artery supplying the maxillary sinus, the upper molars and premolars, and parts of the buccal gingiva. As this artery enters the maxilla from the posterior superior alveolar foramen, it runs with the posterior superior alveolar branch of the maxillary nerve that innervates the upper molars. Their course through the maxillary sinus and surface of the maxilla can vary markedly, and this should be kept in mind during operations in this area. Their anatomy is especially important for dental procedures, e.g., maxillary implant placement, sinus floor augmentation, anesthesia of the maxillary molars, Le Fort I osteotomy, and Le Fort I fracture repairs. In this chapter we describe the commonly encountered variants in the anatomy of the posterior superior alveolar nerve and artery and the superior alveolar canals associated with the neurovascular bundle and discuss the clinical significance of these structures and the potential effects of variants on clinical practice.