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The Maxilla - want to learn more about it?

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The Maxilla

The maxilla, also known as the upper jaw, is a vital structure of the viscerocranium. It is involved in the formation of the orbit, nose and palate, holds the upper teeth and plays an important role for mastication and communication.

This bone consists of five major parts, one being the body and four being projections named processes (frontal, zygomatic, palatine, alveolar). Bordered by several other bones of the viscerocranium, the maxilla on one side pairs with the corresponding bone on the opposite side via the intermaxillary suture.

This article will describe every nook, crack, and cranny of the maxilla, together with its development and clinical knowledge about periodontal disease and various fractures.

Key facts about the maxilla
Borders

Superiorly: frontal bone

Posteriorly: sphenoid, palatine, lacrimal, ethmoid bones

Medially: nasal bone, vomer

Inferior: nasal concha

Laterally: zygomatic bone

Body of the maxilla It contains the maxillary sinuses and contributes to the floor of the orbit, anterior wall of the nasal cavity, and inferior part of the infratemporal fossa
Alveolar process It forms the maxillary dental arch.
Frontal process It forms the medial border of the orbit and contributes to the lacrimal groove.
Zygomatic process It contributes to the zygomatic arch together with the zygomatic bone.
Palatine process It constitutes the roof of the mouth and floor of the nasal cavity. This process also contains the incisive foramen and features an anterior nasal spine.
Osseous Intramembranous ossification

Anatomy

Maxilla - ventral view

The maxilla consists of the body and its four projections:

  • frontal process
  • zygomatic process
  • palatine process
  • alveolar process

The body of the maxilla is the largest part of the bone and shaped like a pyramid. It contributes to the anterior margin and floor of the bony orbit, the anterior wall of the nasal cavity and the inferior part of the infratemporal fossa. It contains the maxillary sinuses which extend from the orbital ridge to the alveolar process and drain to the middle meatus of the nose. The infraorbital foramen is located underneath the orbital ridge and serves as a pathway for the infraorbital nerve and vessels.

The alveolar process is an inferior extension of the maxilla with a rather porous structure. It forms the maxillary dental arch containing eight cavities where the upper teeth are held.

The frontal process has a vertical ridge which constitutes the medial border of the orbit (anterior lacrimal crest). Posteriorly it forms the lacrimal groove together with the lacrimal bone. Superomedially it is in close contact with the anterior ethmoidal sinuses.

The zygomatic process of the maxilla grows laterally and meets the zygomatic bone.

Lastly, the palatine process is a horizontal extension on the medial side of the bone constituting the roof of the mouth and the floor of the nasal cavity. Together with the palatine bone it forms the hard palate. Anteriorly it features a small process, the anterior nasal spine. The incisive foramen can be found on the median line just posteriorly to the incisor teeth where the nasopalatine nerve and greater palatine vessels pass through.

Borders

The maxilla articulates with numerous bones: superiorly with the frontal bone, posteriorly with the sphenoid bone, palatine and lacrimal bones and ethmoid bone, medially with the nasal bone, vomer, inferior nasal concha and laterally with the zygomatic bone.

Note that the maxilla may look like a single bone but is truly paired forming a delicate suture in the middle line known as the median palatine (or intermaxillary) suture. Furthermore the bone comes in contact with the septal and nasal cartilages.

Recommended video: Anterior and lateral views of the Skull
Structures seen on the anterior and lateral views of the skull.

Osseous Development

All five parts of the maxilla undergo intramembranous ossification through two ossification centers. In the 7th week of fetal life one differentiates between the maxilla and premaxilla (or incisive bone).

In the third month both parts fuse around the area of the alveolar process after which the premaxilla becomes the anterior part of the maxilla. In newborns the maxilla is horizontally much longer than vertically compared to adults. Furthermore their teeth sockets extend almost far up until the orbital ridge.

As all paranasal sinuses the maxillary sinuses are relatively small and become larger during the development of the maxilla and the other skull bones. In old age the alveolar process is increasingly absorbed and the teeth fall out. Since the maxilla becomes smaller it seems to come 'forward' in elderly people.

Clinical aspects

Periodontal disease is a common cause for bone resorption within the alveolar process which may result after a severe inflammation of the gums (gingivitis). Children, older people and people with poor oral hygiene are particularly affected. Certain bacteria or immunosuppression may also contribute to the progress of this disease. Another causes for alveolar ridge resorption can be an aplastic tooth or missing tooth (e.g. after extraction).

As the maxilla is the central bone of the midface it can fracture through various accidents, most commonly the Le Fort fractures which are subclassified into three types:

  • Le Fort I fracture: detachment of the alveolar process from the maxilla in a rectangular form, with the center being at the inferior border of the bony nasal cavity. This leaves the patient with a mobile upper jaw.
  • Le Fort II fracture: pyramidal in shape, involving the alveolar process, midface and nasal bones. The midface is mobile.
  • Le Fort III fracture: separation of the viscerocranium from the neurocranium. The entire maxilla and nasal bones detach from the skull, leaving the face in its entirety to hang at the discretion of the facial tissues.

The Maxilla - want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

Sign up for your free Kenhub account today and join over 931,206 successful anatomy students.

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

Reference:

  • Neil S. Norton, Frank H. Netter: Netter’s Head and Neck Anatomy for Dentistry, 2nd edition, Elsevier Saunders, p.43, 47, 50, 53, 55
  • R. H. Whitaker, N. R. Borley: Instant Anatomy, 4th edition, Wiley-Blackwell (2010), p.193
  • J. Lang: Clinical Anatomy of the Masticatory Apparatus and Peripharyngeal Spaces, Thieme (1995), p.3

Author:

  • Dr. Alexandra Sieroslawska

Illustrators:

  • The maxilla - anterior view - Yousun Koh
© Unless stated otherwise, all content, including illustrations are exclusive property of Kenhub GmbH, and are protected by German and international copyright laws. All rights reserved.

Related diagrams and images

Anterior view of the skull

Main bones of the head

Midsagittal skull

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