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Anterior Superior Alveolar Nerve

nervus alveolaris superior anterior

The anterior superior alveolar nerve is a branch of the infraorbital nerve (V2) arising within the infraorbital canal before it emerges at the infraorbital foramen. It descends in a canal in the anterior maxillary wall to supply the upper incisor and canine teeth, their roots, the adjacent buccal gingiva, and the mucoperiosteum of the anterior maxillary sinus floor. It communicates with the middle superior alveolar nerve to form the superior dental plexus.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The anterior superior alveolar nerve block provides anaesthesia for upper incisor and canine procedures and is performed by infiltrating local anaesthetic near the infraorbital foramen (approaching from above) or by supraperiosteal infiltration in the labial sulcus above the relevant teeth. Le Fort I osteotomies and anterior maxillary vestibular incisions risk injury to this nerve, producing post-operative numbness of the upper lip and anterior teeth. The nerve's canal in the anterior maxillary sinus wall is relevant in sinus surgery and tooth extraction with sinus communication.

Pathology

Common Injuries & Conditions

Le Fort I Osteotomy Numbness

Anterior superior alveolar nerve injury during Le Fort I osteotomy for orthognathic surgery produces numbness of the upper incisors and adjacent labial gingiva, which usually improves over 6-12 months as the nerve regenerates through its bony canal but may be permanent in some patients.