Peridental branches of anterior superior alveolar artery

The peridental branches (also called dental branches) of the anterior superior alveolar artery (ASAA) are small terminal arterioles that arise from the ASAA as it courses through the canalis sinuosus and the anterior wall of the maxilla, penetrating the alveolar process to supply the periodontal structures including the periodontal ligament, alveolar bone, and dental pulp of the maxillary anterior teeth (incisors and canines).

Origin and Parent Vessel

The anterior superior alveolar artery originates from the infraorbital artery (IOA) itself a branch of the maxillary artery as it courses through the infraorbital canal. The ASAA then travels within a dedicated bony canal called the canalis sinuosus, which runs along the anterior wall of the maxillary sinus, courses downward and forward, passes below the infraorbital foramen, and follows a curvilinear path along the piriform aperture toward the anterior nasal spine. The canalis sinuosus measures approximately 5.5 cm in total length and is consistently present.

Branching Pattern

During its circumnarial course along the lateral wall of the nasal cavity, the ASAA gives off peridental (dental) branches that descend into the alveolar process to form a dental plexus. This plexus provides vascular supply to:

• The dental pulp of the upper incisors and canines (and occasionally the premolars in ~12% of cases when the middle superior alveolar artery is absent)

• The periodontal ligament surrounding these teeth

• The alveolar bone of the anterior maxilla

• The gingival mucosa of the anterior labial region

The terminal branch of the ASAA continues to supply the nasal septum, running in a small canal that opens at the foramen septale near the root of the anterior nasal spine.

Anastomotic Network

The peridental branches of the ASAA participate in a rich anastomotic network. The ASAA forms an intraosseous anastomosis with the posterior superior alveolar artery (PSAA) within the lateral wall of the maxillary sinus a connection present in 100% of cadaveric specimens. An extraosseous anastomosis is found in approximately 44% of cases. Together, these anastomoses create a double arterial arcade that supplies the lateral antral wall, the Schneiderian membrane, and parts of the alveolar process. Additionally, recent evidence demonstrates that the greater palatine artery and nasopalatine artery also contribute to the blood supply of the maxillary teeth and periodontal tissues via small palatal alveolar foramina.