Abstract
BackgroundThere is no available data on the occurrence rate of a converged alveolar canal, the detailed three-dimensional (3D) courses of alveolar canals/grooves (ACGs), or the contribution of each superior alveolar nerve to each area in the maxilla. This study aimed to clarify the 3D courses of ACGs, the relationship between ACGs and superior alveolar nerves, and the contribution of posterior superior alveolar nerves (PSANs) using computed tomography (CT) with histological analysis. MethodsDuring the gross anatomy course at Niigata University, we investigated nine human cadavers. ResultsAll anterior and posterior ACGs converged into the common alveolar canal, which contained blood vessels and several nerve bundles surrounded by perineurium, located at the nasal floor near the pyriform aperture. Histometrical analysis clarified that 16.3% of the nerve bundles in this canal were derived from PSANs, and 67% of the bundles were dispersed while they coursed down to the nasal floor. There seems to be no relationship between the density of nerve bundles in the canal and the number of remaining anterior teeth. ConclusionsData obtained from observing the detailed 3D courses of anterior and posterior ACGs, and their relationship with superior alveolar nerves, suggest that PSANs partially contribute to the nociception of the anterior teeth.
Highlights
It is of paramount importance to understand the three-dimensional (3D) relationship between the posterior superior alveolar nerves (PSANs) and the maxillary sinus in order to avoid complications such as nerve injury during antrotomy and sinus augmentation surgery 1–4
This understanding may change if we obtain more information on the courses of anterior superior alveolar nerves (ASANs) and PSANs in the anterior alveolar canals which run in the anterior walls of the sinus or within sinus grooves 5
Superior alveolar nerves are composed of ASANs and middle superior alveolar nerves (MSANs), which arise from the infraorbital nerve, a branch of a maxillary nerve that runs from the inferior orbital fissure to the orbita, and PSANs, which are branches of the maxillary nerve that run from the alveolar foramina into the maxillary sinus
Summary
It is of paramount importance to understand the three-dimensional (3D) relationship between the posterior superior alveolar nerves (PSANs) and the maxillary sinus in order to avoid complications such as nerve injury during antrotomy and sinus augmentation surgery (sinus floor elevation) 1–4. The concept of maxillary innervation states that the anterior superior alveolar nerves (ASANs) and PSANs innervate the maxillary anterior and posterior teeth, respectively. This understanding may change if we obtain more information on the courses of ASANs and PSANs in the anterior alveolar canals which run in the anterior walls of the sinus or within sinus grooves 5. The sinus has thin walls, with grooves and/or canals for the infraorbital, anterior, middle, and posterior superior alveolar nerves and vessels, and their small unnamed branches 7. Regarding the topographical relationships between the superior alveolar nerves and the maxillary sinus, the branches of the PSAN run through canaliculi in the lateral wall of the sinus (62.3%) or under the mucous membranes of the sinus (37.8%) 8. It is difficult to macroscopically elucidate the three-dimensional (3D) courses of the superior alveolar nerves in the maxillary sinus owing to their location in the sinus wall or under the mucous membrane of the sinus
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