Contemporary Oral Medicine A Comprehensive Approach to Clinical Practice

Anatomy, Histology, Biology, and their Normal Variations The maxillofacial region is an intricate anatomical region providing our main perceptual and communication interface with the outside world, as well as the first line of defense against inhaled or ingested infectious or toxic agents. The special senses of sight, smell, and taste have sensory receptors in the maxillofacial region.

This chapter begins with the scaffolding to which all other structures in the maxillofacial region are attached, the skull. Subsequently, the soft tissues of the maxillofacial region and superficial face are covered including their structure and function. Regions of the deep face are then presented. Throughout, special attention is paid to the oral cavity, its regions, and tissues, including anatomical and regional variations and changes occurring throughout the human lifespan. Innervation is discussed within each region, as well as vascular supply, drainage, and lymphatics. Comments on the embryological development are made if these are pertinent to the structure in the fully formed human, especially if the origin is related to anatomical variations. Oftentimes it is easier to study the anatomy of the maxillofacial region by compartmentalizing this by region or system; however, it must be borne in mind that anatomical components exist in close proximity and are intimately located. In recent times, there has been an increased reporting of occurrence of anatomical variations, particularly in the variability found in foramina, due to the use of highresolution 3D imaging techniques such as computerized tomography (CT) and cone beam CT (CBCT) scans (Eliades et al. 2016; Wolf et al. 2016) or high-resolution magnetic resonance imaging (MRI) (Jacobs et al. 2007). Conventional radiographs may not be sensitive enough to show small canals such as the incisive canal of the mandible or accessory foramina (Jacobs et al. 2007). CBCT has been shown to detect a higher rate of anatomical variations in the maxillary sinus compared with panoramic radiographs (Kazunobu et al. 2014). These high-resolution noninvasive techniques also enable investigators to visualize structures in great detail without risk of damaging or destroying the structures in question (Stratmann et al. 1996).