\\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png MAXILLA Upper jaw \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png § Anatomy § Clinical notes § § Dentoalveolar topography § Nerve and blood supply \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png §CORPUS MAXILLAE • MARGO INFRAORBITALIS • FOR. INFRAORBITALE • FOSSA CANINA • FOSSA INCISIVA • INCISURA NASALIS §PR. ALVEOLARIS • JUGA ALVEOLARIA §PR. FRONTALIS • CRISTA LACRIMALIS ANT. • SULCUS LACRIMALIS §PR. ZYGOMATICUS maxilla 004 \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png maxilla 026 Below pr. uncinatus form the medial wall of sinus the collagenous tissue = fontanella ant. et post. in which for. accessoria may be occure Sinus maxillaris - foramina accessoria \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png 25-30% § Solitary or multiple § Congenital or secondary to disease process Access Max Ostia.jpg \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png xr10 xr67 The edentulous jaw The toothed jaw CAVE! Opening of sinus maxillaris Sinus maxillaris – decrease of floor Variable layer of spongy bone between sinus and roots of teeth \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png maxilla 023 25% - 35% Sinus maxillaris - septa Primary: arising from the development of the maxilla Secondary: arising from the pneumatization of the sinus floor following tooth septa \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png CAVE! § The separately maxillary sinus puncture § Dental implants \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Corpus maxillae - facies ant. (fossa canina) maxilla 004 Caldwell-Luc antrostomy chirurgie-des-sinus-caldwell-luc-181-2 Caldwell Luc Operation Caldwell Luc operation is another method of treating sinusitis and is a surgical method that is especially used for clearing a blocked or infected maxillary sinus and involves entering the sinus through the mouth by way of an incision into the canine fossa above a canine tooth, cleaning the sinus, and creating a new and enlarged opening for drainage through the nose. The maxillary sinus is entered through the upper jaw above one of the second molar teeth. A route is created to connect the maxillary sinus with the nose, thus improving drainage. The operation is named after American physician George Caldwell and French laryngologist Henry Luc and is most often performed when a malignancy is present in the sinus cavity \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png maxilla 017 Corpus maxillae - facies post. (tuber maxillae) CAVE! § Alveolar foramens: a.,v.,n. alveolaris sup. post. - local anesthesia § Thin bone → during molar teeth extraction can occur maxillary tuberosity fractures \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png maxilla 009 Corpus maxillae – fac. orbitalis – infraorbital canal CAVE ! Maxillary sinus disease can lead to dehiscence of the orbital floor → secondary neuralgia of trigeminal nerve \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Palatum – zones of mucous membrane 1 – the marginal zone 2 – the incisive papilla 3 – the adipose zone 4 – the zone of the palatine seam, mucoperiosteum 5 – the glandular zone 6 – the soft palate \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Palatum: A and H line H A A line localized on the line between hard and soft palate H line line between mobile and immobile parts of the soft palate \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Important for anesthesia, extraction, injury, implantology, endodontic treatment ... 1. The transverse asymmetry of alveolus 2. The rate of the spongy and the compact bone 3. The relationship the roots the upper jaw to neighbouring structures Dentoalveolar topography \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png maxilla 018 1. The transverse asymmetry of alveolus § The dental and skeletal arch are asymmetric ! § Roots of the teeth: 1-5 eccentric by vestibular direction 6-7 in alveolar process axis \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png 2. The rate of the spongy/compact bone § The layer of compact bone is thinner than in the lower jaw § § Roots of the 1-5 are surrounded by the compact bone. Posterior there are variable layer of retroalveolar spongy bone. The width of the alveolus depend on the arching palate § § Roots of the molars are surrounded by thin layer of the compact bone (except infrazygomatic crest) \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png maxilla 003 Molars Only compact bone maxilla 006 maxilla 019 Incisivi, canini, premolars Compact bone and variable thickness of spongy bone lingually \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png 3. The relationship the roots the upper jaw to neighbouring structures § Nasal cavity § Infraorbital foramen § Maxillary sinus \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Nasal cavity Infraorbital foramen CAVE! Radices 1,2: periapical inflammatory may led to abscess of the floor of nasal cavity Radix 3: relation to a.,v., n. infraorbitalis and - possible trombophebitis of cavernous sinus § Variable layer of spongy bone between nasal cavity and roots of incisivi § § Root of 3 localized between nasal cavity and sinus maxillaris \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png CAVE! § Periapical inflammation developing at the root apices of maxillary molars and premolars are very close to the floor of the maxillary sinus - sinusitis or empyema § § Potential oro-antral communication by the extraction Maxillary sinus Variable layer of spongy bone between maxillary sinus and roots of posterior teeth \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Figure2a Inflammation in sinus maxillaris \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Nerve and blood supply \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Maxillar nerve - infraorbital nerve anterior sup. alv. nerve middle sup. alv. nerve posterior sup. alv. nerve Trigeminal nerve Obrázek1 \\DROBO-FS\QuickDrops\JB\PPTX NG\Droplets\LightingOverlay.png Droplets-SD-Content-R1d.png Post. sup. alveolar a. Infraorbital a. ant. sup. alveolar a. Maxillary artery