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Superior dental plexus

The superior dental plexus is a network of interconnected nerve fibers formed primarily by branches of the superior alveolar nerves, which are divisions of the maxillary nerve (cranial nerve V2). This plexus innervates the maxillary teeth, associated gingiva, and adjacent mucosa, ensuring sensory perception of pain, pressure, and temperature. The plexus extends through the alveolar processes of the maxilla, giving rise to individual dental branches that enter the apices of the teeth via small foramina. Its configuration allows overlapping innervation, providing redundancy and contributing to the precise localization of dental pain. The superior dental plexus also communicates with the nasopalatine and greater palatine nerves, forming an intricate network within the maxillary region.

Synonyms

  • Superior alveolar nerve plexus

  • Maxillary dental nerve network

  • Plexus alveolaris superior

Function

  • Provides sensory innervation to maxillary teeth, including molars, premolars, and sometimes anterior teeth

  • Supplies the gingiva and alveolar mucosa of the maxilla

  • Transmits tactile, pain, and temperature sensations from its area of supply

  • Facilitates overlapping innervation, enhancing protective reflexes and pain localization

MRI Appearance
T1-weighted images:

  • The superior dental plexus appears as fine, linear low-to-intermediate signal structures within the maxillary alveolar bone

  • Surrounded by hyperintense marrow fat, providing contrast to the nerve fibers

  • Pathology such as nerve inflammation, tumors, or trauma may appear as hypo- to isointense disruptions or signal alteration

T2-weighted images:

  • Plexus fibers remain low-to-intermediate signal, while surrounding marrow or soft tissue edema appears hyperintense

  • Useful for detecting neuritis, cystic lesions, or periapical inflammation

STIR (Short Tau Inversion Recovery):

  • Suppresses marrow fat signal, highlighting pathological changes in the nerve or surrounding tissues

  • Normal nerve fibers remain low signal, while inflammation, trauma, or tumor appears hyperintense

CT Appearance

  • Individual nerve fibers of the superior dental plexus are not directly visualized on conventional CT

  • Their course can be inferred by the location of the alveolar foramina and surrounding bony structures

  • Maxillary alveolar bone appears hyperdense, while the dental pulp and air within the maxillary sinus provide hypodense contrast

  • CT is useful for assessing bony landmarks, fractures, dental implant planning, and periapical pathology

MRI images

Superior dental plexus mri axial image -img-00000-00000