oral and maxillofacial anatomy tashkent medical academy treatment faculty

Oral and Maxillofacial Oral and Maxillofacial AnatomyAnatomy

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Oral and Maxillofacial Oral and Maxillofacial AnatomyAnatomy

OralOral and Maxillofacial Systematic Anatomyand Maxillofacial Systematic AnatomyOralOral and Maxillofacial Systematic Anatomyand Maxillofacial Systematic Anatomy

Oral Topographic AnatomyOral Topographic AnatomyOral Topographic AnatomyOral Topographic Anatomy

Maxillofacial Topographic AnatomyMaxillofacial Topographic AnatomyMaxillofacial Topographic AnatomyMaxillofacial Topographic Anatomy

Oral and Maxillofacial Oral and Maxillofacial Systematic AnatomySystematic Anatomy

Key points:1. pillars and processes of maxilla2. weak regions of mandible3. composition of the temporomandibular joint4. How to distinguish the internal and external carotid artery?5. pterygoid plexus6. distribution of trigeminal nerve in oral region7. branches of facial nerve

Oral and Maxillofacial Oral and Maxillofacial Systematic AnatomySystematic Anatomy

BonesBones ：： maxilla and mandible maxilla and mandible BonesBones ：： maxilla and mandible maxilla and mandible

Joints ： temporomandibular joint Joints ： temporomandibular joint

VesslesVessles ：： carotid artery and jugular veincarotid artery and jugular veinVesslesVessles ：： carotid artery and jugular veincarotid artery and jugular vein

NervesNerves ：： V VII IX XIIV VII IX XIINervesNerves ：： V VII IX XIIV VII IX XII

Oral and Maxillofacial systematic anatomy

Oral and Maxillofacial systematic anatomy bonebone

There’re totally fourteen bones making up the maxillofacial bony framework.

Single bone: Single bone: mandiblemandible 、、 vomervomer pairing bones: pairing bones: maxillamaxilla 、、 zygomatic boneszygomatic bones、、 palatine bonespalatine bones 、、 inferior inferior nasal conchanasal conchanasal bonesnasal bones 、、 lacrimal lacrimal bonesbones

MaxillaMaxilla

boneboneboneboneOral and Maxillofacial systematic anatomy


maxillamaxillamaxillamaxillabonebone

One bodyOne body （（ four surfacesfour surfaces））Four processesFour processes

One sinusOne sinus

three pairs of three pairs of

pillarspillars



Anterior Anterior surface (facial surface (facial surface)surface)

infraorbital forameninfraorbital foramen

maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 boneboneOral and Maxillofacial systematic anatomy


maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 bonebone

Posterior Posterior surfacesurface

Zygomatico-alveolar Zygomatico-alveolar ridgeridgeMaxillary tuberosity Maxillary tuberosity



Upper surface Upper surface (orbital surface)(orbital surface)

infraorbital grooveinfraorbital groove

maxillamaxilla口腔颌面部系统解剖口腔颌面部系统解剖 boneboneOral and Maxillofacial systematic anatomy


Medial surfaceMedial surface

（（ nasal surfacenasal surface））

maxillamaxillaboneboneOral and Maxillofacial systematic anatomy


maxillamaxillabonebone Four Four processesprocesses

Four Four processesprocesses

Four processesFour processesfrontal processzygomatic processpalatine processalveolar process



maxillary sinusmaxillary sinusThe inferior wall of the maxillary sinus covers the root apexes from the maxillary second premolar to the third molar, and the root apex of the first molar is the nearest to it.

maxillamaxillabonebone One sinusOne sinusOne sinusOne sinusOral and Maxillofacial systematic anatomy


maxillary sinusmaxillary sinus

three pairs of three pairs of pillarspillars

Frontonasal pillarFrontonasal pillar (canine pillar)(canine pillar)

Zygomatic Zygomatic process pillarprocess pillarPterygoid Pterygoid process pillarprocess pillar

maxillamaxillabonebone three pairs ofthree pairs of pillarspillars

three pairs ofthree pairs of pillarspillars



MandibleMandible

boneboneboneboneOral and Maxillofacial systematic anatomy


The unique bone which is The unique bone which is mobile on the maxillofacial mobile on the maxillofacial regionregion ！！

Body of mandibleBody of mandible

Ramus of mandibleRamus of mandible

angle of mandibleangle of mandible

MandibleMandibleMandibleMandibleOral and Maxillofacial systematic anatomy

Oral and Maxillofacial systematic anatomy bonebonebonebone

The external surface The external surface of the body of of the body of mandiblemandible

Meso-combinationMeso-combination

mental tuberclemental tubercleexternal oblique lineexternal oblique linemental foramenmental foramen

MandibleMandible Body of Body of mandiblemandible

Body of Body of mandiblemandible


Oral and Maxillofacial systematic anatomy bonebonebonebone

The internal surface The internal surface of the body of of the body of mandiblemandible

Mental spinesMental spines

Internal oblique line Internal oblique line (mylohyoid line)(mylohyoid line)

Sublingual fossaSublingual fossa

Digastric fossaDigastric fossa

Submandibular fossaSubmandibular fossa


Oral and Maxillofacial systematic anatomy bonebonebonebone MandibleMandible Body of Body of

mandiblemandible

Body of Body of mandiblemandible

Ramus of mandibleRamus of mandiblecoronoid process

（ muscular process ） Condylar process

(articular process ）simoid notch

(mandibular notch)The internal surface of the ramus of mandble

mandibular foramenmandibular lingulaMandibular canal

Ramus of Ramus of mandiblemandible

Ramus of Ramus of mandiblemandible


Oral and Maxillofacial systematic anatomy bonebonebonebone MandibleMandible

angle of mandible

Internal surface ： pterygoid

tuberosityExternal surface ：masseteric tuberosity

angle of mandible

angle of mandible



The weak regions The weak regions of mandibleof mandible

Meso-combinationMeso-combination

mental foramenmental foramenAngle of mandibleAngle of mandible

neck of condyleneck of condyle

Weak regionWeak regionWeak regionWeak regionOral and Maxillofacial systematic anatomy


Temporomandibular jointTemporomandibular joint

Temporomandibular joint




condylar condylar processprocess

articular fossaarticular fossa

articular disarticular diskk





articular capsulearticular capsule

articular ligamentsarticular ligaments





Blood vessel

Blood vessel

blood vesselblood vessel



arteryInternal carotid arteryExternal carotid arteryDistinguish the two arteries （ location 、 branch 、 pulsation ）

veinSuperficial veinDeep vein

Blood vessel

Blood vessel



common carotid artery →Internal carotid artery frontonasal part intra-orbit encephalon

→External carotid artery →superior thyroid artery →lingual artery →facial artery (external

maxillary artery) →maxillary artery (internal

maxillary artery ) →superficial temporal

artery

arteryarteryarteryarteryBlood vessel

Blood vessel



Distinguish internal and Distinguish internal and external carotid arteryexternal carotid arterylocationlocation ：： the internal is at the post-lateral side of the external first and then at its post-intra side branchbranch ：： the internal has no branch at the cervical partPulsation: Pulsation: external maxillary artery and superficial temporal artery have no pulsation when blocking the external carotid artery

arteryartery distinguishingdistinguishingBlood vessel

Blood vessel



superficial vein at oral superficial vein at oral maxillo-facial regionmaxillo-facial region

facial veinsuperficial temporal vein

deep vein at oral maxillo-deep vein at oral maxillo-facial regionfacial region

pterygoid plexusmaxillary veinretromandibular veincommon facial vein

veinveinveinveinBlood vessel

Blood vessel



pterygoid plexus:

Is a venous network situated behind the mandibular ramus between the muscles of mastication. It has extensive connections with the adjacent veins which are clinically important because they may allow infectious organisms to enter the cranial cavity.

veinveinveinveinBlood vessel

Blood vessel



nervesnervesnervesnerves

nervesnerves



olfactory nerveoptic nerveoculomotor nervetrochlear nerveV.trigeminal nerve －branch 、 distributionabducent nerveVII.facial nerve －branch 、 distributionvestibulocochlear nerveIX.glossopharyngeal nerve － distributionvagus nerveaccessory nerveXII.hypoglossal nerve－ distribution

Cranial nervesCranial nerves



nervesnervesnervesnerves

trigeminal nerve



Prin

cipal sen

sory P

rincip

al sensory

nu

cleus

nu

cleus

（（to

uch

-pre

ssure

se

nsa

tion

））

spin

al nu

cleus

spin

al nu

cleus

（（p

ain an

d

pain

and

tem

peratu

re tem

peratu

re sen

sationsen

sation

））

Motor n

ucleu

sM

otor nu

cleus

（（m

otoe room

otoe roott

））

Trigeminal ganglionTrigeminal ganglion

Op

hth

almic n

erveO

ph

thalm

ic nerve

（（sen

sory nerv

sensory n

ervee

））

Maxillary n

erve M

axillary nerve

（（sen

sory nerv

sensory n

ervee

））M

and

ibu

lar M

and

ibu

lar n

erven

erve（（

mixed

nerv

mixed

nerv

ee

））

trigeminal nerve

trigeminal nerve


Oral and Maxillofacial systematic anatomy Cranial

nervesCranial nerves

lacrimal gland

eyeballeyeball

eyelideyelid

skin of foreheadskin of forehead

nasal mucosanasal mucosa

OphthalmOphthalmic ic divisiondivision




trigeminal nerve

trigeminal nerve

nervus meningeus mediusnervus meningeus medius—— cerebral cerebral dura materdura materzygomatic nervezygomatic nerve——skin of the cheek skin of the cheek and tempus and tempus

sphenopalatine nervesphenopalatine nerve——mucosa of the mucosa of the nose and palatenose and palate

Posterior superior alveolar nervePosterior superior alveolar nerve—— distoside distoside

Middile superior alveolar nerveMiddile superior alveolar nerve—— mesial sidemesial side

Anterior superior alveolar nerveAnterior superior alveolar nerve——

infraorbital nerveinfraorbital nerve——facial sectionfacial section

MaxillaMaxillaryry nervenerve

Middle Middle cranial cranial sectiosectio

nn

PterygopalPterygopalatine atine fossa fossa sectionsection

Orbital Orbital sectisectionon




trigeminal nerve

trigeminal nerve

Facial sectio

n

nervesnervesnervesnervesOral and Maxillofacial systematic anatomy


Maxillary nerve

trigeminal nerve

trigeminal nerve

nervus spinosus─nervus spinosus─cerebral dura matercerebral dura matermedial pterygoid nerrvemedial pterygoid nerrve──medial pterygoidmedial pterygoid

deep temproal ngervesdeep temproal ngerves──temporalistemporalismasseteric nervemasseteric nerve──massetermasseterlateral pterygoid nervelateral pterygoid nerve──lateral pterygoidlateral pterygoidbuccal nervebuccal nerve──skin and mucosa of the skin and mucosa of the posterior toothposterior tooth’’s buccal sides buccal side

auriculotemporal nerve

lingual nerve

temporomandibular jointtemporomandibular jointexternal acoustic meatusexternal acoustic meatusexternal acoustic meatusexternal acoustic meatusSkin of temporal regionSkin of temporal region

Lingual gum of the mandibleLingual gum of the mandibleTwe-thirds mucosa of the fore tongueTwe-thirds mucosa of the fore tongueMucosa of the oral floorMucosa of the oral floorsublingual glandsublingual gland

inferior alveolar nerve

Gum of the mandibleGum of the mandibleMylohyoidMylohyoidanterior belly of digastricanterior belly of digastric

Fore

-trun

k o

f Fore

-trun

k o

f th

e

the

man

dib

ula

r m

an

dib

ula

r n

erv

en

erv

e

Meta

-trun

k o

f the

Meta

-trun

k o

f the

man

dib

ula

r m

an

dib

ula

r n

erv

en

erv

e




trigeminal nerve

trigeminal nerve

Man

dib

ula

r n

erv

e

Motor branches: for the muscles of mastication

Sensory branches: Buccal nerveAuriculotemporal nerveLingual nerveInferior alveolar nerve




trigeminal nerve

trigeminal nerve

Mandibular nerve

nervesnervesnervesnervesOral and Maxillofacial systematic anatomy


Mandibular nerve

8 7 6 5 4 8 7 6 5 4 3 2 13 2 1 1 2 31 2 3 4 54 5 66 7 87 8

8 7 6 5 4 3 2 18 7 6 5 4 3 2 1 1 2 3 4 1 2 3 4 5 6 7 85 6 7 8

Cranial nervesCranial nervesOral and Maxillofacial

systematic anatomy


trigeminal nerve

trigeminal nerve

PmA

Palatal/lingual

Lingual n.Buccal n./Mental

n.

/Inferior alveolar n.

L-B/teeth

Nasopalatine n.

anter. pala.n

.

Distribution of n. in oral region

nervenervenervenerve

Facial nerveFacial nerve



Motor fiberMotor fiber ：： mainly dominate the muscles of facial mainly dominate the muscles of facial expressionexpression

submaxillary gland, sublingual glandsubmaxillary gland, sublingual glandlacrimal glandlacrimal gland 、、 mucosal glands of the mucosal glands of the nasal cavity and palatenasal cavity and palate

Taste fiberTaste fiber ：： taste bud of the anterior twe-thirds of the taste bud of the anterior twe-thirds of the tonguetongue

Facial Facial nervenerve


ParasympatheParasympathetic fibertic fiber ：：




nervenervenervenerve Facial nerveFacial nerveOral and Maxillofacial systematic anatomy


Tem

poral facial trun

kT

emp

oral facial trunk

Cervicofacial

Cervicofacial

trunk

trunk

temporal branchestemporal branches

zygomatic brancheszygomatic branches

buccal branchesbuccal branches

marginal marginal mandibular branchmandibular branch

cervical branchcervical branch

Com

men

trun

k o

f the fa

cia

l n

erv

e

muscular branchesmuscular branches











Central paralysis and peripheral paralysis

Central paralysisCentral paralysisLoss of the upper neurpns, in this case

on the left side.presents clinically with paralysis of the contralateral muscles of the facial expression in the lower half of the face , while the contralateral forehead and extra-ocular muscles remain functional. Thus, the corner of the mouth sags on the right (contralateral) side, but the patient can still wrinkle the forehead and close the eyes on both sides. Speech articulation is impaired.






Peripheral paralysisPeripheral paralysis (Loss of the lower neurpns, in this

case on the right side).is characterized by complete paralysis of the ipsilateral muscles. The patient cannot wrinkle the forehead, the corner of the mouth sags, articulation is impaired, and the eyelid cannot be fully closed. A Bell phenomenon is present (the eyeball turns upward and outward, exposing the sclera, when the patient attempts to close the eyelids), and the eyelids closure reflex is abolished. Depending on the site of the lesion, additional deficits may be present such as decreased lacrimation and salivation or loss of taste sensation in the anterior two-thirds of the tongue.






glossopharyngeal nerve (mixed nerve)(mixed nerve)

Motor fiber:Motor fiber: Parasympathetic fiberParasympathetic fiber ：： secretion of parotid glandsecretion of parotid glandSensory fiber:

pharyngeal mucous pharyngeal mucous membrane, membrane,

carotid sinus,carotid sinus, carotid body,carotid body,

one-third mucosa of the one-third mucosa of the post tongue,post tongue,palatine tonsil palatine tonsil Taste fiber: Taste fiber: one-third of one-third of the post tonguethe post tongue

Glossopharyngeal nerve

Glossopharyngeal nerve




Hypoglossal Hypoglossal nerve nerve

(motor nerve)(motor nerve)

intrinsic and intrinsic and extrinsic muscles extrinsic muscles of the tongueof the tongue

Hypoglossal Hypoglossal nervenerve

Hypoglossal Hypoglossal nervenerve




L-1

local anatomy of the oral local anatomy of the oral cavitycavity

Key points1. features of the soft tissue of the hard palatefeatures of the soft tissue of the hard palate

2. papillae and their functions of the tongue 2. papillae and their functions of the tongue

3. lymphatic drainage of the tongue3. lymphatic drainage of the tongue

local anatomy of the oral local anatomy of the oral cavitycavity

Boundary of the oral cavityBoundary of the oral cavityBoundary of the oral cavityBoundary of the oral cavity

Anatomy of the lipAnatomy of the lipAnatomy of the lipAnatomy of the lip

Anatomy of the tongueAnatomy of the tongueAnatomy of the tongueAnatomy of the tongue

Surface markerSurface markerSurface markerSurface marker

Anatomy of the cheekAnatomy of the cheekAnatomy of the cheekAnatomy of the cheek

Anatomy of the palateAnatomy of the palateAnatomy of the palateAnatomy of the palate

Boundary of the oral Boundary of the oral cavitycavity

Lips are the anterior wallLips are the anterior wall

Fauces is the posterior Fauces is the posterior erathemerathem

Palate is the upper boundPalate is the upper bound

Oral floor is the lower bound Oral floor is the lower bound

The dental arches with the The dental arches with the alveolar processes of the alveolar processes of the maxilla and mandible maxilla and mandible subdivide the oral cavity subdivide the oral cavity into oral vestibule and oral into oral vestibule and oral cavity proper.cavity proper.

local anatomy of the oral cavity


Boundary of the oral cavity

Boundary of the oral cavity

oral vestibular groovefrenulum of the upper and lower lipbuccal frenumopening of the Stensen's duct—Parotid glandretromolar area Pterygonmandibular foldlingual frenulum

Surface Surface markermarker

Surface Surface markermarker



lipslips

Anatomy ofAnatomy of the lipsthe lips




boundaryboundary ：：basis nasi is the upper basis nasi is the upper boundboundmentolabial sulcus is the mentolabial sulcus is the lower boundlower boundlabial sulccus is the labial sulccus is the lateral boundlateral bound

anatomic landmark ：：angle of mouthangle of mouthvermilion vermilion vermilion bordervermilion borderlabial archlabial archlabial peaklabial peakvermilion tuberclevermilion tuberclenasal columellanasal columellaphiltrumphiltrum 、、 philtrum philtrum ridgeridge 、、 philtrun philtrun incisureincisure





cheekscheeks

Anatomy of Anatomy of the cheeksthe cheeks




boundaryinferior margin of the zygomatic bone is the upper boundinferior border of mandible is the lower boundanterior border of masseter is its posterior border

layerskinhypodermis ： buccal pad, vascular nerveBuccinator ， fascia buccinatorsubmucosa ： contain mucous glandmucosa ： have thw opening of the Stensen's duct





palatepalate

Anatomy ofAnatomy of the palatethe palate




Anatomic landmark

Palatine rapheIncisive papillaPalatine foldsHard palate Greater palatine foramenPterygoid hamulusFoveola palatina





Feature of the soft Feature of the soft tissue of the hard tissue of the hard palatepalate

submucosasubmucosa ：： there are no glands in the anterior part ， and a lot of mucous glands in the posterior part.Periosteum adhere to mucosa and submucosa more tightly than to bone surfaceMucoperiosteum is not easy to move,and can tolerate scrape and masticatory pressure





Muscle of the soft Muscle of the soft palatepalate

tensor veli palatinilevator veli palatinipalatoglossuspalatopharyngeusuvular muscle





tonguetongue

Anatomy ofAnatomy of the tonguethe tongue




The V-shaped The V-shaped terminal sulcus terminal sulcus divides tongue divides tongue to an anterior to an anterior two-thirds two-thirds (boby) and a (boby) and a posterior one-posterior one-third (root)third (root)

tonguetonguetonguetonguelocal anatomy of the oral cavity




Body of tongue has four Body of tongue has four kinds of papillakinds of papilla

filiform papilla-filiform papilla-sensitive sensitive to tactile to tactile stimulistimuli

fungiform papilla-fungiform papilla-mechanical/thermal mechanical/thermal receptors,taste budsreceptors,taste buds

vallate papilla-vallate papilla- abundant taste budsabundant taste buds

foliate papilla-foliate papilla- taste taste budsbuds

TongueTongueTongueTonguelocal anatomy of the oral cavity




Root of tongue:Root of tongue:

no papillano papilla ，， a lot of a lot of nodosity lymphatic nodosity lymphatic tissue called tissue called lingual tonsil.lingual tonsil.





muscles:muscles: extrinsic:4 musclesextrinsic:4 muscles

intrinsic:intrinsic:

superior longitudinal m.superior longitudinal m.

inferior –inferior –

transverse m.transverse m.

vertical m.vertical m.





apex of tongue lymphatic vessel

submental lymph nodes

nodi lymphaticus juguloomohyoideus

ante- lateral tongue

Submaxillary L.N

lymphonodi cervicales profundi craniales

center of tongue

lymphonodi cervicales profundi craniales

submaxillary L.N

part cross to opposite side

posterior tongue lymphonodi cervicales profundi craniales

Lymphatic Lymphatic drainagedrainage

Lymphatic Lymphatic drainagedrainage





lingual frenulumfimbriated foldsublingual carunclesublingual fold

Lingual Lingual abdomenabdomenLingual Lingual

abdomenabdomenlocal anatomy of the oral cavity




dentitiondentition

Anatomy ofAnatomy of the dentitionthe dentition








Permanent Permanent teethteeth

Deciduous Deciduous teethteeth

Orifxon.marufxonov [email protected]

oral and maxillofacial anatomy tashkent medical academy treatment faculty

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