From the Research
The anterior superior incisors receive sensory innervation primarily from the anterior superior alveolar nerve, which is a branch of the infraorbital nerve, as confirmed by the most recent study in 2021 1.
Sensory Innervation of the Anterior Superior Incisors
The infraorbital nerve itself is a continuation of the maxillary division (V2) of the trigeminal nerve. These nerves carry sensory information from the teeth, including pain, temperature, and proprioception.
Anatomical Course of the Anterior Superior Alveolar Nerve
The anterior superior alveolar nerve branches from the infraorbital nerve while it travels through the infraorbital canal, and then descends through small canals in the anterior wall of the maxillary sinus to supply the upper incisors, canines, and associated gingiva.
Clinical Implications
This nerve forms part of a neural plexus with the middle superior alveolar nerve, creating a network that ensures comprehensive sensory coverage of the upper anterior teeth. Understanding this innervation pattern is crucial for achieving effective local anesthesia when performing dental procedures on the upper incisors, as the infraorbital nerve block or anterior superior alveolar nerve block would be the techniques of choice, as supported by studies such as 2 and 1. Some key points to consider include:
- The anterior superior alveolar nerve is a constant landmark in the lateral nasal wall, as found in a study published in 2021 1.
- The course of the ASAN should be assessed on a CT scan when a surgical approach through the pyriform aperture or anterior medial wall of the maxillary sinus is planned, according to the same study 1.
- Resection of the anterior superior alveolar nerve can be an effective treatment for refractory neuropathic pain, as reported in a case study published in 2018 3.