Mandibular nerve dental surgery

Ophthalmic nerve dental surgery Maxillary nerve Mandibular nerve

2. Largest of the three divisions of the fifth.
Made up of two roots:
A large - sensory root proceeding from the inferior angle
of the semilunar ganglion.
A small motor root which passes beneath the
ganglion - unites with the sensory root - just after its exit
- foramen ovale.
Immediately beneath the base of the skull - gives off a
recurrent branch (nervus spinosus) and the nerve to the
Pterygoideus internus - then divides into two trunks - an
anterior and a posterior.

4. SUPPLIES –
1. Teeth and gums of the mandible,
2.The skin of the temporal region
3. The auricle.
4. The lower lip.
5.The lower part of the face.
6. The muscles of mastication ,
7. It also supplies the mucous
membrane of the anterior two-
thirds of the tongue.

5. A. Main trunk
Medial pterygoid
Nervus spinosus
(meningeal branch)
Nerve to tensor veli
palatine.
Nerve to tensor tympani
B. Anterior division-
Messetric
External Pterygoid
Deep Temporal
Buccinators
C. Posterior division.-
Auriculotemoral
Lingual
Inferior alveolar.

7. Nerve to Medial pterygoid
Nervus spinosus (meningeal
branch)- enters the skull
through foramen spinosum.
Supplies duramatter of middle
cranial fossa.
Nerve to tensor veli palatine.
Nerve to tensor tympani

8. The anterior and smaller division of the Mandibular nerve
receives nearly the whole of the fibers of the motor root of
the nerve.
 Supplies - Muscles of mastication
- Skin and mucous membrane of the cheek
Its branches are
Messetric
Deep temporal
Buccal nerve (sensory)
External pterygoid.

9. MESSETRIC NERVE:
Arises from the upper border of lateral pterygoid muscle.
Passes through Mandibular notch.
Enters the deep part of messeter.
Also supplies TMJ (temporomandibular joint).
BUCCAL NERVE:
Only sensory branch from anterior division.
Passes btn 2 heads of lateral pterygoid.
Supplies skin and mucous membrane related to Buccinator.
DEEP TEMORAL:
2 Nerve anterior and posterior.
Passes btn skull and lateral pterygoid.
Enters the deep surface of temporalis muscle.
EXTERNAL PTERYGOID NERVE:
Arises in conjunction with the Buccinator nerve.
But may be given off separately from the anterior division of the Mandibular nerve.
It enters the deep surface of the muscle. .

10. The posterior and larger division of the
Mandibular nerve - sensory but receives a few
filaments from the motor root.
It divides into
Auriculotemoral
Lingual
Inferior alveolar nerves

12. Arises by two roots – b/w which the middle
meningeal artery ascends.
Runs backward beneath to the medial side of the
neck of the mandible.
Then turns upward with the superficial temporal
artery b/w the auricula and condyle of the
mandible.
It ascends over Zygomatic arch - divides into
superficial temporal branches.

13. BRANCGES OF DISTRIBUTION:
Anterior auricular branches
Branches to the external acoustic meatus
Articular branches
Parotid branches
Superficial temporal branches.

14. Supplies - mucous membrane of the anterior two-thirds
of the tongue.
Lies at first beneath the lateral Pterygoid - medial to and
in front of the inferior alveolar nerve.
The nerve then passes b/w the medial Pterygoideus and
the ramus of the mandible - then between the Hyoglossus
and deep part of the submaxillary gland.
Finally runs across the duct of the submaxillary gland and
along the tongue to its tip.

16. BRANCHES OF DISTRIBUTION:
 Supply
- sublingual gland
-mucous membrane of the mouth, the gums, and
the anterior two-thirds of the tongue.
The terminal filaments communicate - at the tip of
the tongue with the hypoglossal nerve.

17. Largest branch of the Mandibular nerve.
Descends with the inferior alveolar artery - at first beneath the
lateral Pterygoid - then b/w the sphenomandibular ligament and
the ramus of the mandible to the Mandibular foramen.
Then passes forward in the Mandibular canal - beneath the teeth as
far as the mental foramen - where it divides into two terminal
branches - incisive and mental.
Branches of the inferior alveolar nerve are the
Mylohyoid Dental
Incisive Mental.

19. MYLOHYOID NERVE:
Derived - inferior alveolar just before it enters the
mandibular foramen.
It descends - groove on the deep surface of the ramus of the
mandible - reaching the under surface of the Mylohyoid -
supplies this muscle and the anterior belly of the Digastric.
DENTAL BRANCHES:
Supply - molar and premolar teeth
Above the alveolar nerve they form an inferior dental
plexus.

20. INCISIVE BRANCH:
Continued onward within the bone and supplies the canine
and incisor teeth.
MENTAL NERVE:
Emerges at the mental foramen - divides beneath the
Triangularis muscle into three branches.
One descends to the skin of the chin.
Two ascend to the skin and mucous
membrane of the lower lip.
these branches communicate freely with the facial nerve.

21. OTIC GANGLION –
Peripheral parasympathetic ganglion
Relay secret motor fibers to parotid gland.
Topographically related to Mandibular nerve
but functionally related to glossopharyngeal
nerve.

22. Motor part of the nerve is tested by asking
the patient to clench his teeth.- look for
contraction of messeter muscle.
In case of the cancer of the tongue, pain
radiates to ear and temporal fossa due to
Auriculotemoral nerve.
Trigeminal neuralgia commonly seen with
Mandibular branch can be treated by cutting
the sensory root.

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