Maxillary aperture. Upper jaw: structure, functions, possible damage

The shape of the upper jaw is individual. It can be narrow and high, which is typical for people with an elongated, narrow face, or wide and low - for broad-faced people.

upper jaw- paired massive bone of the facial skull, forms the walls of the eye sockets, nasal and oral cavities, participates in the work of the chewing apparatus.

The human upper jaw consists of a body and 4 processes. It is immobile due to fusion with the bones of the face and has almost no connection points for the masticatory muscles.

The body of the bone has four surfaces:

• front,
• infratemporal,
• nasal
• orbital.

The anterior surface of the body of the upper jaw is slightly curved, it is bounded from above by the infraorbital margin and the medial-nasal notch, and from below by the alveolar process and laterally by the zygomatic-alveolar ridge. Her body inside contains a large air-bearing maxillary cavity that communicates with the nasal cavity.

On the front surface of the body, approximately at the level of the 5th or 6th tooth, there is an infraorbital foramen, up to 6 mm in diameter. The thinnest blood vessels pass through it, as well as processes trigeminal nerve.

Below, the anterior surface, without a noticeable border, passes into the anterior-buccal surface of the alveolar process, on which there are alveolar elevations. Towards the nose, the anterior surface of the body of the upper jaw passes into the edge of the nasal notch.

The infratemporal surface is convex, part of the infratemporal and pterygopalatine fossae. It distinguishes two or three small alveolar openings leading to the alveolar canals through which the nerves pass to the posterior teeth of the upper jaw.

The nasal surface has a hole - the maxillary cleft leading to the maxillary sinus. Behind the cleft, the rough nasal surface forms a suture with the perpendicular plate of the palatine bone. Here, a large palatine sulcus runs vertically along the nasal surface of the upper jaw, which forms one of the walls of the large palatine canal. From the maxillary cleft there is a lacrimal groove, limited by the edge of the frontal process. The lacrimal bone is adjacent to the lacrimal sulcus at the top, and the lacrimal process of the inferior concha is below. In this case, the lacrimal sulcus closes into the nasolacrimal canal. On the nasal surface there is a horizontal protrusion - the shell crest, to which the lower nasal shell is attached.

The orbital surface participates in the formation of the lower wall of the orbit and continues into the anterior surface of the upper jaw.

The following bone processes are distinguished:

• frontal,
• palatine,
• zygomatic,
• alveolar

The frontal process of the maxilla connects to the nasal part of the frontal bone. It has a medial and lateral zone. In the medial region of the frontal process is the lacrimal crest. The back part borders on the lacrimal groove.

The palatine process of the upper jaw is part of the system of hard tissues of the palate. It connects to the process of the opposite side and the plates of the bones with a median suture. A nasal ridge forms along this suture.

The upper surface of the palatine processes is smooth and slightly concave. The lower surface is rough, near its posterior end there are two palatine furrows, which are separated from one another by small palatine awns.

The posterior surface of the body of the upper jaw is connected to the anterior with the help of the zygomatic process, has an uneven, often convex shape. Here is the tubercle of the upper jaw, in which the alveolar canals open. A large palatine sulcus is also located on the side of the tubercle of the posterior surface of the body. The zygomatic process of the upper jaw refers to the lateral side of the surface, has a rough end. The zygomatic process of the frontal bone connects to the temporal process.

The alveolar process of the upper jaw consists of an external (buccal), internal (lingual) wall, as well as dental alveoli from a spongy substance where the teeth are placed. The complex structure of the alveolar process also includes bony septa (interdental and interradicular).

The alveolar process develops as the teeth develop and erupt, and is turned downwards. In an adult, the edge of the process of each upper jaw has 8 dental alveoli for the roots of the teeth. After the teeth fall out, the corresponding holes atrophy, and after the loss of all teeth, the entire alveolar process undergoes atrophy.

Upper jaw, maxilla, a paired bone with a complex structure due to its diverse functions: participation in the formation of cavities for the sense organs - the orbit and nose, in the formation of a septum between the cavities of the nose and mouth, as well as participation in the masticatory apparatus.

The transfer of the grasping function from the jaws (as in animals) to the hands in a person in connection with his labor activity led to a decrease in the size of the upper jaw; at the same time, the appearance of speech in a person made the structure of the jaw thinner. All this determines the structure of the upper jaw, which develops on the soil of the connective tissue.

upper jaw consists of a body and four processes.

A. Body, corpus maxillae, contains a large airway sinus maxillaris(maxillary or maxillary, hence the name of inflammation of the sinus - sinusitis), which wide opening, hiatus maxillaris opens into the nasal cavity. There are four surfaces on the body.

Front surface, facies anterior, in modern man, due to the weakening of the chewing function due to artificial cooking, it is concave, while in Neanderthals it was flat. At the bottom, it passes into the alveolar process, where a row is noticeable elevations, juga alveolaria, which correspond to the position of the dental roots.
The elevation corresponding to the canine is more pronounced than the others. Above it and laterally located canine fossa, fossa canina. At the top, the anterior surface of the upper jaw is delimited from the orbital infraorbital margin, margo infraorbitalis. Immediately below it is noticeable infraorbital foramen, foramen infraorbital, through which the nerve and artery of the same name exit the orbit. The medial boundary of the anterior surface is nasal notch, incisura nasalis.

Infratemporal surface, facies infratempordlis, separated from the anterior surface by means of the zygomatic process and bears maxillary tubercle, tuber maxillae, and Sulcus palatinus major.

Nasal surface, facies nasalis, below passes into the upper surface of the palatine process. It has a noticeable comb for the lower turbinate (crista conchalis). Visible behind the frontal process lacrimal sulcus, sulcus lacrimalis, which, with the lacrimal bone and lower concha, turns into nasolacrimal canal - canalis nasolacrimalis, which communicates the orbit with the lower nasal passage. Even more posterior is a large opening leading to sinus maxillaris.

Smooth, flat orbital surface, facies orbitalis, has a triangular shape. On its medial edge, behind the frontal process, is lacrimal notch, incisura lacrimalis where the lacrimal bone enters. Near the posterior edge of the orbital surface begins infraorbital groove, sulcus infraorbitalis, which becomes anteriorly canalis infraorbitalis, opening mentioned above foramen infraorbital on the anterior surface of the upper jaw.
Depart from the infraorbital canal alveolar canals, for the nerves and vessels going to the front teeth.

B. Processes.
1. Frontal process, processus frontalis, rises upward and connects with the pars nasalis of the frontal bone. On the medial surface there is crest, crista ethmoidalis- trace of attachment of the middle turbinate.

2. Alveolar process, processus alveolaris, on his lower edge, arcus alveolaris, It has dental cells, alveoli dentales, eight upper teeth ; cells are separated partitions, septa interalveolaria.

3. Palatine process, processus palatinus forms the majority hard palate, palatum osseum, connecting with the paired process of the opposite side with a median suture. Along the median suture on the upper side of the process facing the nasal cavity is nasal crest, crista nasalis connecting to the bottom edge of the opener.

near the front end crista nasalis on the upper surface there is a hole leading to incisive canal, canalis incisivus. The upper surface is smooth, while the lower one, facing the oral cavity, is rough (imprints of the glands of the mucous membrane) and bears longitudinal furrows, sulci palatini for nerves and blood vessels. Often seen in the anterior incisal suture, sutura incisiva.

It separates the merged with the upper jaw incisor bone, os incisivum, which in many animals occurs in the form of a separate bone (os intermaxillare), and in humans only as a rare variant.

4. Zygomatic process, processus zygomaticus, connects to the zygomatic bone and forms a thick support through which pressure is transmitted to the zygomatic bone during chewing.

Upper jaw, maxilla, a paired bone with a complex structure due to its diverse functions: participation in the formation of cavities for the sense organs - the orbit and nose, in the formation of a septum between the cavities of the nose and mouth, as well as participation in the masticatory apparatus. The transfer of the grasping function from the jaws (as in animals) to the hands in a person in connection with his labor activity led to a decrease in the size of the upper jaw; at the same time, the appearance of speech in a person made the structure of the jaw thinner. All this determines the structure of the upper jaw, which develops on the soil of the connective tissue.

The upper jaw consists of a body and four processes.

Body, corpus maxillae, contains a large airy sinus, sinus maxillaris (maxillary or maxillary, hence the name of inflammation of the sinus - sinusitis), which with a wide opening, hiatus maxillaris, opens into the nasal cavity.

There are four surfaces on the body.

Anterior surface, fdcies anterior, in modern man, due to the weakening of the chewing function due to artificial cooking, is concave, while in Neanderthals it was flat. Below, it passes into the alveolar process, where a series of elevations, juga alveolaria, are visible, which correspond to the position of the dental roots. The elevation corresponding to the canine is more pronounced than the others. Above it and laterally is the canine fossa, fossa canina. At the top, the anterior surface of the upper jaw is delimited from the orbital by the infraorbital margin, margo infraorbitalis. Immediately below it, the infraorbital foramen, foramen infraorbital, is noticeable, through which the nerve and artery of the same name emerge from the orbit. The medial boundary of the anterior surface is the nasal notch, incisura nasalis.

Infratemporal surface, facies infratempordlis, separated from the anterior surface by means of the zygomatic process and bears the tubercle of the upper jaw, tuber maxillae, and sulcus palatinus major. The nasal surface, facies nasalis, below passes into the upper surface of the palatine process. It shows a crest for the inferior nasal concha (crista conchalis). Behind the frontal process, a lacrimal groove, sulcus lacrimalis, is visible, which, with the lacrimal bone and lower concha, turns into a nasolacrimal canal - canalis nasolacrimalis, which communicates the orbit with the lower nasal passage. Even more posterior is a large opening leading to the sinus maxillaris.

Smooth, flat orbital surface, facies orbitalis, has a triangular shape. On its medial edge, behind the frontal process, is the lacrimal notch, incisura lacrimalis, which includes the lacrimal bone. Near the posterior edge of the orbital surface, the infraorbital sulcus, sulcus infraorbitalis, begins, which anteriorly turns into canalis infraorbitalis, opening with the foramen infraorbitale mentioned above on the anterior surface of the upper jaw. From the infraorbital canal depart the alveolar canals, canales alveolares, for nerves and blood vessels, going to the front teeth.

Branches.

• Frontal process, processus frontalis, rises up and connects with the pars nasalis of the frontal bone. On the medial surface there is a crest, crista ethmoidlis - a trace of attachment of the middle turbinate.
• Alveolar process, processus alveolaris, on its lower edge, arcus alveolaris, has dental cells, alveoli dentales, eight upper teeth; cells are separated by partitions, septa interalveolaria.
• Palatine process, processus palatinu s forms most of the hard palate, palatum osseum, connecting with the paired process of the opposite side with a median suture. Along the median suture on the upper side of the process facing the nasal cavity, there is a nasal crest, crista nasalis, which connects to the lower edge of the vomer. Near the anterior end of the crista nasalis, a hole is visible on the upper surface leading to the incisive canal, canalis incisivus. The upper surface is smooth, while the lower one, facing the oral cavity, is rough (impressions of the glands of the mucous membrane) and bears longitudinal grooves, sulci palatini, for nerves and blood vessels. An incisive suture, sutiira incisiva, is often visible in the anterior section. It separates the incisor bone, os incisivum, which has merged with the upper jaw, which in many animals occurs as a separate bone (os intermaxillare), and in humans only as a rare variant.
• The zygomatic process, processus zygomaticus, connects to the zygomatic bone and forms a thick support through which pressure is transmitted to the zygomatic bone during chewing.

Which doctors to contact for examination of the Upper jaw:

Dentist

Maxillofacial Surgeon

What diseases are associated with the upper jaw:

What tests and diagnostics need to be done for the Upper jaw:

X-ray of the upper jaw

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Other anatomical terms starting with the letter "B":

Upper jaw, maxilla , a steam room, is located in the center of the face and connects to all its bones, as well as to the ethmoid, frontal and sphenoid bones. The upper jaw takes part in the formation of the walls of the orbit, nasal and oral cavities, pterygopalatine and infratemporal fossae. It distinguishes the body and four processes, of which the frontal is directed upward, the alveolar is directed downward, the palatine is directed medially, and the zygomatic is laterally. Despite the significant volume, the upper jaw is very light, since in its body there is a cavity - sinus, sinus maxillaris (volume 4-6 cm3). This is the largest sinus among those in (Fig. 1-8,1-9, 1-10).

1 - frontal process, processus frontalis; 2 - front surface, facies anterior

Rice. 1-9. The structure of the right upper jaw, maxilla (view from the lateral side): 1 - frontal process, processus frontalis; 2 - infraorbital margin; 3 - infraorbital foramen, foramen infraorbitale; 4 - nasal notch, incisura nasalis; 5 - canine fossa, fossa canina; 6 - anterior nasal spine, spina nasalis anterior; 7 - alveolar elevations, juga alveolaria; 8 - incisors; 9 - canine; 10 - premolars; 11 - molars; 12 - alveolar process, processus alveolaria; 13 - zygomatic process, processus zygomaticus; 14 - alveolar openings, foramina alveolaria; 15 - tubercle of the maxillary bone, tuber maxillare; 16 - infraorbital groove; 17 - orbital surface of the body of the maxillary bone, facies orbitalis; 18 - lacrimal groove, sulcus lacrimalis

Rice. 1-10. : 1 - frontal process of the maxillary bone; 2 - lattice comb, crista ethmoidalis; 3 - lacrimal groove, sulcus lacrimalis; 4 - maxillary sinus, sinus maxillaris; 5 - large palatine sulcus; 6 - nasal crest; 7 - palatine grooves; 8 - alveolar process; 9 - molars; 10 - palatine process, processus palatinus; 11 - premolars; 12 - canine; 13 - incisors; 14 - incisive channel; 15 - anterior nasal spine, spina nasalis anterior; 16 - nasal surface (facies nasalis) of the maxillary bone; 17 - shell comb, crista conchalis

Body of the upper jaw(corpus maxillae) has 4 surfaces: anterior, infratemporal, orbital and nasal.

Front surface at the top it is limited by the infraorbital margin, below which there is an opening of the same name through which the vessels and nerves exit. This hole is 2-6 mm in diameter and is located at the level of the 5th or 6th teeth. Under this hole lies the canine fossa (fossa canim), which is the site of the beginning of the muscle that raises the corner of the mouth.

On the infratemporal surface there is a tubercle of the upper jaw (tuber maxillae), on which there are 3-4 alveolar openings leading to the roots of large molars. Vessels and nerves pass through them.

Orbital surface contains a lacrimal notch, limits the lower orbital fissure (fissura orbitalis inferior). At the posterior edge of this surface is the infraorbital sulcus (sulcus infraorbitalis), which passes into the canal of the same name.

nasal surface largely occupied by the maxillary cleft (hiatus maxillaris).

Alveolar process (processus alveolaris) . It is, as it were, a continuation of the body of the upper jaw from top to bottom and is an arcuately curved bone roller with a bulge facing anteriorly. The greatest degree of process curvature is observed at the level of the first molar. The alveolar process is connected by an intermaxillary suture with the process of the same name of the opposite jaw, from behind without visible borders it passes into the tubercle, medially into the palatine process of the upper jaw. The outer surface of the process, facing the vestibule of the mouth, is called the vestibular (facies vestibularis), and the inner, facing the sky, is called the palatine (facies palatinus). The arc of the process (arcus alveolaris) has eight dental alveoli (alveoli dentales) for the roots of the teeth. In the alveoli of the upper incisors and canines, the labial and lingual walls are distinguished, and in the alveoli of the premolars and molars, the lingual and buccal. On the vestibular surface of the alveolar process, each alveolus corresponds to alveolar elevations (juga alveolaria), most pronounced in the alveoli of the medial incisor and canine. The alveoli are separated from each other by bony interalveolar septa (septa interalveolaria). The alveoli of multi-rooted teeth contain inter-root partitions (septa interradicularia) that separate the roots of the tooth from each other. The shape and size of the alveoli correspond to the shape and size of the roots of the tooth. In the first two alveoli lie the roots of the incisors, they are cone-shaped, in the 3rd, 4th and 5th alveoli - the roots of the canine and premolars. They are oval in shape and slightly compressed from front to back. The canine alveolus is the deepest (up to 19 mm). In the first premolar, the alveolus is often divided by the interradicular septum into the lingual and buccal root chambers. In the last three alveoli, small in size, are the roots of the molars. These alveoli are divided by interradicular septa into three root chambers, two of which face the vestibular, and the third - the palatine surface of the process. The vestibular alveoli are somewhat compressed from the sides, and therefore their dimensions in the anteroposterior direction are smaller than in the palatobuccal direction. The lingual alveoli are more rounded. Due to the variable number and shape of the roots of the 3rd molar, its alveolus is diverse in shape: it can be single or divided into 2-3 or more root chambers. At the bottom of the alveoli there is one or more openings that lead to the corresponding tubules and serve to pass the vessels and nerves. The alveoli are adjacent to the thinner outer plate of the alveolar process, which is better expressed in the region of the molars. Behind the 3rd molar, the outer and inner compact plates converge and form an alveolar tubercle (tuberculum alveolare).

The section of the alveolar and palatine processes of the upper jaw, corresponding to the incisors, in the embryo represents an independent incisor bone, which is connected to the upper jaw by means of an incisal suture. Part of the incisal suture at the border between the incisor bone and the alveolar process is overgrown before birth. The suture between the incisor bone and the palatine process is present in the newborn, and sometimes remains in the adult.

The shape of the upper jaw is individually different. There are two extreme forms of its external structure: narrow and high, characteristic of people with a narrow face, as well as wide and low, usually found in people with a wide face (Fig. 1-11).

Rice. 1-11. Extreme forms of the structure of the upper jaw, front view: A - narrow and high; B - wide and low

Maxillary sinus- the largest of the paranasal sinuses. The shape of the sinus basically corresponds to the shape of the body of the upper jaw. The volume of the sinus has age and individual differences. The sinus can continue into the alveolar, zygomatic, frontal and palatine processes. In the sinus, the superior, medial, anterolateral, posterolateral, and inferior walls are distinguished.

Materials used: Anatomy, physiology and biomechanics of the dental system: Ed. L.L. Kolesnikova, S.D. Arutyunova, I.Yu. Lebedenko, V.P. Degtyarev. - M. : GEOTAR-Media, 2009

The upper jaw, a paired bone, is associated with the zygomatic, frontal, nasal, ethmoid, sphenoid, and lacrimal bones. It distinguishes the body and four processes: frontal, alveolar, palatine and zygomatic. In the body of the upper jaw there is an air-bearing maxillary sinus, the walls of which are represented by thin bone plates from a compact substance. There are four surfaces of the body of the upper jaw: anterior, infratemporal, orbital, nasal.

The anterior surface, fades anterior, is bounded by the infraorbital margin (above), the zygomatic-alveolar crest and zygomatic process (laterally), the alveolar process (below), and the nasal notch (medially). Below the infraorbital margin is the infraorbital foramen, for infraorbitale, through which the terminal branch of the nerve and vessels of the same name emerges. The infratemporal surface, fades infratemporalis, forms the border of the infratemporal and pterygopalatine fossae and is represented by a tubercle of the upper jaw. The oblique head of the lateral pterygoid muscle is attached to it. The tubercle of the upper jaw has 3-4 openings through which the posterior upper alveolar branches enter the thickness of the bone tissue, which take part in the formation of the posterior section of the upper dental plexus.

The orbital surface, facies orbitalis, takes part in the formation of the lower wall of the orbit and forms the infraorbital margin. In the posterior region, together with the orbital margin of the large wings sphenoid bone creates a lower orbital fissure, fissura orbitalis inferior. Through it, the infraorbital nerve enters the orbit, n. infraorbitalis, a branch of the maxillary nerve. The latter is located in the infraorbital groove and in the infraorbital canal. These anatomical formations are located on the orbital surface of the body of the upper jaw. On the lower wall of the canal there are small anterior and middle upper alveolar openings - foramina alveolaria superiora anteriora et media. They lead to small bony tubules that extend to the roots of the incisors, canines, and small molars. Vessels and nerves pass through them to these teeth. The medial edge of the orbital surface articulates with the lacrimal bone, with the orbital plate of the ethmoid bone, and with the orbital process of the palatine bone. Sometimes it forms cells that are directly adjacent to the cells of the labyrinth of the ethmoid bone.
The nasal surface, facies nasalis, is connected to the perpendicular plate of the palatine bone, the inferior nasal concha and the hook-shaped process of the ethmoid bone. On this surface, between the lower and middle shells, there is an opening of the maxillary sinus - the maxillary cleft, hiatus maxillaris. Anterior to the cleft is the nasolacrimal canal, which opens into the nasal cavity. The lacrimal bone and the lacrimal process of the inferior turbinate take part in its formation. Behind the maxillary cleft there is a large palatine canal formed by the palatine bone and the pterygoid process of the sphenoid bone.

The frontal process, processus frontalis, is connected with the nasal bone by the inner edge, with the nasal part of the frontal bone, the posterior with the lacrimal bone. Consists mainly of compact matter. It is able to withstand a compressive load from bottom to top up to 470-500 kg, which is much more than the pressure force developed by the masticatory muscles.

The zygomatic process, processus zygomaticus, connects with an uneven surface to the zygomatic bone. Downward from it towards the hole of the first molar is the zygomatic-alveolar crest. The zygomatic process also consists mainly of a compact substance.

The palatine process, processus palatinus, is a horizontal bone plate. Anteriorly and outwards, it passes into the alveolar process, the inner surface is connected to the palatine process of the opposite side, behind - with the horizontal plate of the palatine bone. Along the inner edge of the process is the nasal crest, crista nasalis, which connects to the cartilaginous part of the nasal septum. The medial edge of the process from the side of the palatal surface is thickened. On the upper surface of the palatine process, on the side of the nasal crest, there is an incisive opening that leads to the incisive canal, canalis incisivus. In the anterior 2/3, the process consists of a compact and spongy substance. There is no spongy substance in the posterior third, and in this section it is much thinner than in the anterior one. The palatine process is marked by increased strength.

The alveolar process, processus alveolaris, is a downward continuation of the body of the upper jaw and consists of the outer and inner plates of a compact substance. Between them is a spongy substance. The outer plate is thinner than the inner one, at the level of the premolars - thicker than that of the frontal group of teeth. Behind the third large molar, the outer and inner plates converge, forming an alveolar tubercle, tuber alveolaris. The edge of the process, limbus alveolaris, has 8 dental holes (alveoli) for the roots of the teeth. The latter are separated from each other by bony interalveolar septa. The shape and size of the holes correspond to the shape and size of the roots of the teeth.
The maxillary sinus is the largest of the paranasal sinuses. It can spread to the alveolar, zygomatic, frontal and palatine processes. In the sinus, the upper, lower, medial, anterolateral, posterolateral walls are distinguished, covered with a mucous membrane. Top wall separates the maxillary sinus from the orbit. Over a large extent, it is represented by a compact substance, its thickness is from 0.7 to 1.2 mm. It thickens at the infraorbital margin and the zygomatic process. The lower wall of the infraorbital canal and the sulcus of the same name passing here is very thin.

The lower wall of the sinus - the bottom - has the shape of a gutter, where the medial, anterolateral and posterolateral walls are connected. The bottom of the gutter is either flat or is represented by tuberculous protrusions above the roots of the teeth. The thickness of the compact plate separating the bottom of the maxillary sinus from the socket of the second large molar may not exceed 0.3 mm.

The medial wall consists entirely of a compact substance and borders on the nasal cavity. It has a large thickness (about 3 mm) in the region of the anteroinferior angle, the smallest (1.7-2.2 mm) - in the middle of its lower edge. Posteriorly passes into the posterolateral wall. At the point of this transition, it is very thin. Anteriorly, the medial wall passes into the anterolateral, where it thickens. In the upper posterior part of the wall there is a hole - the maxillary cleft (hiatus maxillaris), which connects the sinus with the middle nasal passage.

The anterolateral wall of the sinus in the area of ​​the canine fossa consists entirely of a compact substance and in this place is the thinnest (0.2-0.25 mm). It thickens as it moves away from the fossa, reaching a greater thickness (up to 6.4 mm) at the infraorbital margin of the orbit. The alveolar, zygomatic, frontal processes of the inferolateral edge of the orbit have a spongy substance. In the anterolateral wall there are several alveolar tubules, where the nerve trunks and vessels pass to the anterior teeth and premolars.

The posterolateral wall is represented by a compact plate, which bifurcates at the point of transition into the zygomatic and alveolar processes. There is a spongy substance here. In the upper section, it is thinner than near the alveolar process. In the thickness of the wall are the posterior alveolar tubules, where the nerve trunks are located, going to the large molars. The structural features of the upper jaw determine the places of least resistance to the impact force, which determines the nature of the fracture. Therefore, it should be emphasized once again that the upper jaw takes part in the formation of the orbit, nasal cavity and mouth and is associated with the zygomatic, palatine, frontal, nasal, lacrimal, ethmoid, sphenoid bones. The frontal, ethmoid and sphenoid bones, together with the temporal bones, form the anterior and middle cranial fossae.
The walls of the maxillary sinus are represented by thin bone plates. Nevertheless, the upper jaw is able to withstand significant mechanical stress. This is due to the fact that the trabeculae of its spongy substance have a predominantly vertical type of structure, and the compact substance has thickenings in certain areas, or buttresses. There are four of them.

▲ The fronto-nasal buttress corresponds to the anterior group of teeth. It rests on the somewhat thickened walls of the alveoli of the canines, located along the edge of the nasal opening and the frontal process of the upper jaw to the nasal process of the frontal bone.

▲ Sculoalveolar - starts from the second premolar, first and second molars. It continues along the zygomatic-alveolar ridge towards the body of the zygomatic bone and the zygomatic process of the frontal bone. Through the zygomatic arch, pressure is transmitted to the temporal bone. It is the most powerful buttress that perceives the pressure that occurs in the above teeth.

▲ Pterygopalatine - begins at the posterior sections of the alveolar process and corresponds to the tubercle of the upper jaw and the pterygoid process of the sphenoid bone. The pyramidal process of the palatine bone also takes part in its formation, which fills the pterygoid notch of the pterygoid process.

▲ The palatine buttress is formed by the palatine process of the upper jaw and is represented by two longitudinal grooves running along the bottom of the nose. In the region of the nasal notch, it connects with the fronto-nasal buttress, which in turn is connected with the zygomatic-alveolar buttress in the region of the upper and lower edges of the orbit. The alveolar process combines the zygomatic-alveolar, pterygopalatine and palatine buttresses.

The above anatomical features determine the resistance of the upper jaw to chewing pressure and its ability to withstand significant mechanical stress.

, ) is located in the upper anterior part of the facial skull. Relates to the number air bones, since it contains an extensive cavity lined with a mucous membrane, - maxillary sinus, sinus maxillaris.

In the bone, a body and four processes are distinguished.

Body of the upper jaw corpus maxillae, has four surfaces: orbital, anterior, nasal and infratemporal.

The following bone processes are distinguished: frontal, zygomatic, alveolar and palatine.

eye surface, facies orbitalis, smooth, has the shape of a triangle, somewhat inclined anteriorly, outwards and downwards, forms the lower wall of the orbit, orbita.

Its medial edge is connected in front with the lacrimal bone, forming the lacrimal-maxillary suture, posteriorly from the lacrimal bone - with the orbital plate of the ethmoid bone in the ethmoid-maxillary suture and further posteriorly - with the orbital process of the palatine bone in the palatine-maxillary suture.

The anterior margin of the orbital surface is smooth and forms a free infraorbital margin, margo infraorbitalis, being the lower part of the orbital edge of the orbit, margo orbitalis, (see Fig. , ). Outside, it is serrated and passes into the zygomatic process. Medially, the infraorbital margin forms an upward bend, sharpens, and passes into the frontal process, along which the longitudinal anterior lacrimal crest runs, crista lacrimalis anterior. At the point of transition to the frontal process, the inner edge of the orbital surface forms a lacrimal notch (incisura lacrimalis), which, together with the lacrimal hook of the lacrimal bone, limits the upper opening of the nasolacrimal canal.

The posterior edge of the orbital surface, together with the lower edge of the orbital surface of the large wings of the sphenoid bone, which runs parallel to it, forms the inferior orbital fissure, fissura orbitalis inferior. In the middle part of the lower wall of the gap there is a groove - the infraorbital groove, sulcus infraorbitalis, which, heading anteriorly, becomes deeper and gradually passes into the infraorbital canal, canalis infraorbitalis, (in the furrow and to the pale lie the infraorbital nerve, artery and veins). The channel describes an arc and opens on the anterior surface of the body of the upper jaw. In the lower wall of the canal there are many small openings of the dental tubules - the so-called alveolar openings, foramina alveolaria, (see fig.), nerves pass through them to the group of anterior teeth of the upper jaw.

infratemporal surface, facies infratemporalis, facing the infratemporal fossa, fossa infratemporalis, and the pterygopalatine fossa, fossa pterygopalatina, uneven, often convex, forms a tubercle of the upper jaw, tuber maxillae. It distinguishes two or three small alveolar openings leading to the alveolar canals, canales alveolares, (see Fig.), through which the nerves pass to the posterior teeth of the upper jaw.

front surface, fades anterior, slightly curved. Below the infraorbital margin, a rather large infraorbital foramen opens on it, foramen infraorbital, below which there is a small depression - a canine fossa, fossa canina, (here originates the muscle that raises the corner of the mouth, m. levator anguli oris).

Below, the anterior surface without a noticeable border passes into the anterior (buccal) surface of the alveolar process, processus alveolaris, on which there are a number of bulges - alveolar elevations, juga alveolaria.

Inwardly and anteriorly, towards the nose, the anterior surface of the body of the upper jaw passes into the sharp edge of the nasal notch, incisura nasalis. At the bottom, the notch ends with the anterior nasal spine, spina nasalis anterior. The nasal notches of both maxillary bones limit the pear-shaped aperture (apertura piriformis) leading into the nasal cavity.

nasal surface, facies nasalis, (see Fig. ) the upper jaw is more complex. In its upper posterior corner there is a hole - the maxillary cleft, hiatus maxillaris leading to the maxillary sinus. Posterior to the cleft, the rough nasal surface forms a suture with the perpendicular plate of the palatine bone. Here, a large palatine sulcus runs vertically along the nasal surface of the upper jaw, Sulcus palatinus major. It forms one of the walls of the greater palatine canal, canalis palatinus major. Anterior to the maxillary cleft is the lacrimal sulcus, sulcus lacrimalis bounded anteriorly by the posterior margin of the frontal process. The lacrimal bone is adjacent to the lacrimal sulcus at the top, and the lacrimal process of the inferior concha is below. In this case, the lacrimal sulcus closes into the nasolacrimal canal, canalis nasolacrimalis. Even more anteriorly on the nasal surface is a horizontal protrusion - a shell comb, crista conchalis to which the inferior turbinate is attached.

From the upper edge of the nasal surface, at the place of its transition to the anterior, the frontal process straightens upward, processus frontalis. It has medial (nasal) and lateral (facial) surfaces. Lateral surface of the anterior lacrimal crest, crista lacrimalis anterior, divides into two sections - anterior and posterior. The posterior section passes downward into the lacrimal sulcus, sulcus lacrimalis. Its boundary from the inside is the lacrimal edge, margo lacrimalis, to which the lacrimal bone is adjacent, forming with it a lacrimal-maxillary suture, sutura lacrimo-maxillaris. On the medial surface, a cribriform ridge runs from front to back, crista ethmoidalis. The upper edge of the frontal process is serrated and connects with the nasal part of the frontal bone, forming the frontal-maxillary suture, sutura frontomaxillaris. The anterior edge of the frontal process joins with the nasal bone at the naso-maxillary suture, sutura nasomaxillaris, (see Fig. ).

cheekbone, processus zygomaticus, departs from the outer upper corner of the body. The rough end of the zygomatic process and the zygomatic bone, os zygomaticum, form the zygomatic-maxillary suture, sutura zygomaticomaxillaris.

palatine process, processus palatinus, (see Fig. , ), is a horizontally located bone plate that extends inside from the lower edge of the nasal surface of the body of the upper jaw and, together with the horizontal plate of the palatine bone, forms a bone septum between the nasal cavity and the oral cavity. Both maxillary bones are connected by the internal rough edges of the palatine processes, forming a median palatine suture, sutura palatina mediana. To the right and left of the suture is a longitudinal palatine ridge, torus palatinus.

In the median palatine suture, the palatine processes form a sharp marginal protrusion directed towards the nasal cavity - the so-called nasal crest, crista nosalis, which is adjacent to the lower edge of the vomer and the cartilaginous septum of the nose. The posterior edge of the palatine process is in contact with the anterior edge of the horizontal part of the palatine bone, forming with it a transverse palatine suture, sutura palatina transversa. The upper surface of the palatine processes is smooth and slightly concave. The lower surface is rough, near its posterior end there are two palatine grooves, sulci palatini, which are separated from one another by small palatine awns, spinae palatinae, (vessels and nerves lie in the furrows). The right and left palatine processes at their anterior edge form an oval-shaped incisive fossa, fossa incisiva. There are incisive holes at the bottom of the fossa, foramina incisiva, (two of them), which open the incisal canal, canalis incisivus, also ending with incisive holes on the nasal surface of the palatine processes (see Fig.). The channel can be located on one of the processes, in which case the incisal groove is located on the opposite process. The region of the incisive fossa is sometimes separated from the palatine processes by an incisive suture, sutura incisiva), in such cases, an incisor bone is formed, os incisivum.

The alveolar process (processus alveolaris) (see fig.,), the development of which is associated with the development of teeth, departs from the lower edge of the body of the upper jaw downward and describes an arc directed by a bulge forward and outward. The lower surface of this region is the alveolar arch, arcus alveolaris. It has holes - dental alveoli, alveoli dentales, in which the roots of the teeth are located - 8 on each side. The alveoli are separated from one another by alveolar septa. septa interalveolaria. Some of the alveoli are in turn divided by interradicular septa, septa interradicularia, into smaller cells according to the number of tooth roots.

The anterior surface of the alveolar process, corresponding to the five anterior alveoli, has longitudinal alveolar elevations, juga alveolaria. The part of the alveolar process with the alveoli of the two anterior incisors represents a separate incisor bone in the embryo, os incisivum, which merges early with the alveolar process of the upper jaw. Both alveolar processes are connected and form an intermaxillary suture, sutura intermaxillaris, (see Fig. ).

The correct structure and physiological capabilities of all organs and tissues of the human face determine not only health, but also appearance. What deviations can be in the development of the upper jaw, and what is this organ responsible for?

Features in the structure of the upper jaw

The upper jaw is a paired bone, which consists of a body and four processes. It is localized in the upper anterior part of the skull of the face, and it is referred to as an air bone, due to the fact that it has a cavity lined with a mucous membrane.

There are the following processes of the upper jaw, which got their name from the location:

• frontal process;
• zygomatic process;
• palatine ridge.

Features of the structure of processes

Also, the body of the upper jaw has four surfaces: anterior, orbital, infratemporal and nasal.

The orbital surface is triangular in shape, smooth to the touch and slightly inclined forward - it forms the wall of the orbit (orbit).

The front surface of the body of the jaw is slightly curved, the orbital opening opens directly on it, below which the canine fossa is located.

The nasal surface in its structure is a complex formation. Has a maxillary cleft that leads to the maxillary sinus.

The zygomatic process also forms the upper jaw, the structure and function of which depend on the normal operation of all processes and surfaces.

Functions and features

What processes in the body and skull can provoke pathological changes in the structure and function of bones?

The upper jaw is responsible for a number of processes:

• Participates in the act of chewing, distributes the load on the teeth of the upper jaw.
• Determines the correct location of all processes.
• Forms a cavity for the mouth and nose, as well as their partitions.

Pathological processes

The upper jaw, due to its structure and the presence of a sinus, is much lighter than the lower jaw, its volume is about 5 cm 3, therefore the chance of injuring the bone increases.

The jaw itself is motionless due to the fact that it fuses tightly with the rest

Among the possible pathological changes, a fracture of the jaw (upper or lower) is especially common. An upper injury fuses much easier than a bone because, due to its structure and location, it does not move, which accelerates the regeneration of its bone tissue.

In addition to all kinds of fractures and dislocations, a dental examination can reveal such a volumetric process as a cyst of the upper jaw, which requires surgical intervention to remove it.

On the body of the upper jaw there is a maxillary sinus, which, with improper dental treatment (and not only), can become inflamed and sinusitis occurs - another pathological process of the jaw.

Blood supply. innervation

The blood supply to the upper jaw comes from the maxillary artery and its branches. The teeth are innervated by the trigeminal nerve, and more specifically, by the maxillary branch.

With inflammation of the facial or trigeminal nerve, pain can spread to absolutely healthy teeth, which leads to a false diagnosis and sometimes even an erroneous extraction of a tooth in the upper jaw.

Cases of incorrect diagnosis are becoming more frequent, therefore, neglecting additional examination methods and relying only on the patient's subjective feelings, the doctor risks both the patient's health and his reputation.

Features of the teeth in the upper jaw

The upper jaw has a similar quantity to the lower jaw, or rather, their roots have their own differences, which lie in their number and direction.

According to statistics, the wisdom tooth in the upper jaw erupts first and more often on the right side.

Since the bone of the upper jaw is much thinner than the lower, the extraction of teeth has its own characteristics and a special technique. For this, dental tweezers are used to remove teeth in the upper jaw, which has another name - bayonet.

If the roots are removed incorrectly, a fracture can occur, because the upper jaw, the structure of which does not allow the application of force, needs additional diagnostic methods before surgical procedures. Most often, for such purposes, an x-ray examination is performed - orthopantomography or CT scan jaw bodies.

Operational interventions

Why is it necessary to remove the upper jaw, and how to restore normal function after surgery?

The presented procedure in dentistry is known as a maxillectomy.

Indications for the operation may be:

• Malignant neoplasms in the body of the upper jaw and its processes, as well as pathological growth of the tissues of the nose, paranasal sinuses and mouth.
• Benign neoplasms can also, with progressive development, become a reason for the removal of the body of the upper jaw.

The maxillectomy procedure also has a number of contraindications:

• General ailments of the patient, acute infectious diseases, specific diseases of the upper jaw in the acute stage and in the acute stage.
• With a significant spread of the pathological process, when the operation will not be a decisive step in the treatment of pathology, but will only burden the cancer patient.

Preoperative preparation of an oncological patient consists in a thorough preliminary examination aimed at identifying other pathologies in the patient's body, as well as determining the localization of a pathological neoplasm.

Before diagnostic measures, a complete history is taken, aimed at clarifying the etiological factor and genetic predisposition.

Before any surgical procedures, it is also necessary to undergo a full examination by other specialists. This is, first of all, an oculist - to determine the state of the eyes of their normal functioning and the possibility of complications after the operation.

The upper jaw has an eye fossa on its body and therefore their full examination is carried out before maxillectomy without fail.

During the operation, a complication may occur - (upper) or, if the incision is incorrect, it can affect facial nerve. Any complications can affect the development of a malignant formation, therefore, performing a maxillectomy is a risk for the condition of an oncological patient.

birth defects

The upper jaw can be damaged even in the prenatal period, which leads to congenital malformations of the jaw and the entire face.

What can cause its pathological development before birth?

• genetic predisposition. It is impossible to prevent this, but with proper orthodontic and orthopedic treatment after birth, it is possible to correct congenital deformities and restore the normal functioning of the upper jaw.
• Injuries while carrying a baby can change the physiological course of pregnancy and provoke pathological changes, to which the upper jaw is most susceptible. Also the bad habits of the mother and the use of certain medicines during pregnancy can become decisive factors in the occurrence of congenital pathology.

Types of pathologies

Among the main pathological processes that affect the development of the jaw, there are:

• Hereditary anomalies (anomalies that occur during the development of the fetus) - unilateral or bilateral cleft face, microgenia, complete or partial adentia (absence of teeth), underdevelopment of the nose and its sinuses, and others.
• Deformations of the apparatus of the dentition, which originate in the development of the jaw under the influence of various adverse factors: endogenous or exogenous.
• Secondary processes of deformation of the dentition, which occur as a result of a traumatic effect on the organs of the facial skull, as well as due to irrational surgical intervention, radiation therapy and chemotherapy in oncological diseases.

Anomalies of the teeth. Adentia

The most common in the upper jaw can be called adentia, which, depending on the cause, is partial (absence of several teeth) and complete (absence of all teeth).

It is also sometimes possible to observe the distal movement of the incisors with the formation of a false diastema.

To diagnose the presented pathology, an X-ray examination (orthopantomography) is used, which most accurately shows the localization and cause of the pathology.

Deformation of the jaw at - a possible outcome of the pathological process, which begins even in the intrauterine development of the fetus. What can entail the presence of additional teeth that do not perform any function in the process of chewing?

The presence of supernumerary teeth in the alveolar process of the upper jaw can provoke its deformation. This causes excessive growth of the alveolar process, which negatively affects not only the correct position of the teeth, but also the physiological development of the upper jaw.

Prevention of anomalies and damage to the jaw

It is especially important to monitor the development of the jaw system from an early age, undergo regular examinations at the dentist and treat all pathologies. oral cavity.

If the child has obvious anomalies in the location or growth of the teeth, you should immediately undergo a comprehensive examination, and not only with a dentist, but also with an endocrinologist, a neuropathologist. Sometimes anomalies in the development of the jaw are associated with a violation general condition organism.

The treatment of congenital anomalies is dealt with by such a section of dentistry as orthodontics, which studies the normal functioning of the organs of the oral cavity, as well as diagnoses and corrects pathological deviations from the norm. Treatment is best done at an early age, so it is not worth delaying a visit to the dentist until all the teeth have erupted or the jaw is completely destroyed.

Oral health is the key to the normal functioning of the digestive and respiratory system, as well as a guarantee of the mental health of the child and his normal development. Psychological factor plays an important role in this matter, since a person's face is his calling card. Launched deformations that disfigure the appearance leave an imprint on the psycho-emotional state and form many fears and phobias, up to a sociopathic state.

Proper nutrition, the use of solid food, rational hygiene and sanitation are the key to the healthy development of the upper jaw and all organs of the oral cavity.

The anatomy of the jaw of each person is individual. The harmony of the face depends on the accuracy of the fit of its elements to each other. In addition to the aesthetics of the profile, the correct structure of the jaw allows you to chew and swallow food, talk and breathe without problems. Knowing how the upper jaw is arranged is necessary in order to be able to prevent bone tissue pathologies.

Features of the structure of the human upper jaw - diagram

The upper jaw is a massive bone fused with facial bones. The immobility of the jaw allows it to participate in the formation of the orbital, nasal and oral regions. The jaw consists of the so-called body and four processes. Despite the general arrangement of its elements, the bone of each person has individual characteristics and may differ from the sample from the reference book.

Body

The body is characterized by an uneven shape. The maxillary cleft located inside it provides the transition of the maxillary sinus to the nasal region. The body has 4 surfaces (look at the photo with a description):

1. Front. It has a curved shape. On it are the canine fossa and the infraorbital foramen, through which the blood vessels and processes of the trigeminal nerve pass. The diameter of the infraorbital aperture reaches 6 mm. Muscles responsible for raising the corners of the mouth emerge from the canine fossa.
2. Infratemporal. It has a convex shape, which is why it was called the tubercle of the upper jaw. Nerve impulses from the back teeth are transmitted through its alveolar openings.
3. Nasal. It is a thin bone that separates the nasal cavity from the maxillary (maxillary) sinuses. A concha ridge passes through the surface, fixing the inferior nasal concha. Along the maxillary cleft is the lacrimal sulcus, which is involved in the organization of the nasolacrimal canal.
4. Orbital. It has a smooth, slightly concave shape. It borders on the anterior surface, limited by the inferoorbital margin, and posteriorly rests against the infratemporal surface.

Processes (frontal, zygomatic, alveolar, palatine)

The frontal process originates at the point of convergence of the orbital, nasal and anterior surfaces. The branch is directed upward to the frontal bone, has medial and lateral surfaces. The central part of the frontal process of the maxilla, facing the nasal cavity, has a cribriform crest, with which the middle part of the nasal concha fuses. Along the lateral side is a lacrimal crest.

The zygomatic branch of the body of the upper jaw has an uneven, convex surface. The zygomatic process begins at the top of the upper jaw and attaches to the zygomatic bone. On this process is a tubercle that opens the alveolar canals. The zygomatic alveolar ridge, located between the zygomatic process and the alveolus of the first molar, transfers the load from the teeth to the zygomatic bone.

The alveolar process is a plate directed downward from the body of the upper jaw. The lower surface of the branch is represented by an arc with 8 holes for the teeth, and the upper one by well-marked alveolar elevations. The branch develops as teeth erupt and completely atrophies after complete adentia.

The palatine process originates from the nasal surface of the body. It is a plate, the upper side of which has a smooth structure, and the lower one is rough.

The medial edge of the lower part of the palatine process forms the hard palate. At the bottom of the palatine process there are 2 grooves in which blood vessels and nerves are located.

Functions of the upper jaw

The functionality of the upper jaw is due to its immobility and interaction with the lower bone, similar to the work of a hammer and anvil. Together with the paranasal sinuses, they perform a sound-producing function. If the upper "anvil" is damaged, a person's diction is disturbed, the voice changes or even disappears.

The upper jaw is also involved in:

• the formation of the eye cavity and maxillary sinus, which provides heating of the inhaled air;
• creating the aesthetics of the face, determining its oval and the location of the cheekbones;
• the work of the chewing apparatus, during which the buttresses of the upper jaw interact with the buttresses of the lower jaw;
• implementation of the swallowing reflex.

blood supply

The blood supply to the maxillary bone involves 4 branches of the internal maxillary artery: the superior dental, infraorbital, palatine, and sphenopalatine arteries. Blood leaves through the plexus of the alveolar and pterygopalatine processes. These arteries are interconnected by many branches, which provides abundant blood supply to the jaw even when 2 vessels are blocked.

Features of the upper teeth

The teeth of the upper jaw have the same names as the teeth of the lower row, but differ in structure and shape from them. The following upper teeth have the following features:

Types of pathologies of the upper jaw

Differences between the structure of the upper jaw and the structure of the lower jaw cause more high risk maxillary bone injury. Fractures most often affect the bone plates that connect the buttresses - seals that perform shock-absorbing functions when walking and chewing. There are 4 buttresses of the upper jaw and 2 buttresses of the lower jaw.

A large group of diseases are anatomical defects - congenital or acquired pathologies, expressed in the decrease of bone and soft tissue. The incorrect structure of the bone entails a violation of the proportions of the face, the appearance of discomfort during chewing and breathing. The reduction in bone is due to the failure of the trajectory of the mandibular buttresses.

The upper jaw is affected cystic formations. When diagnosing volumetric formations, surgical intervention is required. A large cyst is accompanied by pain and swelling at the site of its localization. If you do not remove it, it begins to squeeze paranasal sinuses, provoking their inflammation - sinusitis.

A sluggish inflammatory process provokes the development of malignant tumors. Most often, the tumor affects the maxillary sinuses, less often - bone tissue, growing from the oral mucosa.

Tumor formation is facilitated by soft tissue injuries caused by deformed teeth and poorly polished orthopedic structures.

Operations on the upper jaw

The main array of operations is aimed at correcting malocclusion due to anatomical defects. Depending on the severity of the deformity, surgery is performed on one or simultaneously on two jaws. In addition to the aesthetic goal, a correctly performed operation prevents the development of concomitant pathologies, primarily respiratory disorders.

On the maxillary bone, an osteotomy is most often performed - cutting off and moving the bone to fix it in an anatomically correct position. The operation takes no more than 3 hours and is done under endotracheal anesthesia. Osteotomy is performed according to the following scheme:

1. Soft tissue incision. To gain access to the bone tissue, an incision is made on the inside of the cheek above the upper teeth. This avoids postoperative scarring.
2. Cutting the bone. The jaw is cut along pre-marked contours. If bone is required to replace the jaw row, material from the thigh is used to fill the maxillary aperture.
3. Movement of elements in accordance with the anatomy of the jaw. The divided parts of the jaw are placed in the correct position, fixed with titanium plates. The area of ​​intervention is sutured with dissolvable threads, which are absorbed after 2 weeks.

In the first days after the operation on the maxillary bone, the patient is in the hospital. The doctor correlates the new bone structure with previous photos of the human jaw. The patient is prescribed painkillers and cold compresses to reduce swelling. In the first weeks, a person experiences problems with swallowing and breathing, his throat may hurt. He returns to his usual activities, as a rule, after 3 weeks.