Anterior superior alveolar artery

The Anterior Superior Alveolar Artery (ASAA) is a branch of the infraorbital artery, itself a terminal branch of the maxillary artery (from the external carotid system). It arises within the infraorbital canal and descends through a bony canal in the anterior wall of the maxillary sinus.

Course and Distribution

The ASAA travels inferiorly through the canalis sinuosus (a small bony canal in the anterior maxilla) and supplies the following structures:

• Anterior teeth (incisors and canines) of the upper jaw, including their pulp and periodontal ligaments

• Anterior alveolar bone and the labial gingiva of the maxillary anterior region

• Anterior wall of the maxillary sinus and its mucosal lining

• Nasal floor and anterior nasal septum, where it anastomoses with branches of the sphenopalatine artery and the septal branch of the superior labial artery

Anatomical Relationships

The artery forms an anastomotic arcade with the posterior superior alveolar artery along the lateral wall of the maxillary sinus, creating a vascular network known as the alveolar antral artery or the intraosseous anastomosis. This anastomosis is clinically significant during procedures such as sinus floor elevation (sinus lift surgery), Le Fort I osteotomies, and dental implant placement in the anterior maxilla, as inadvertent damage may result in hemorrhage.