Alveolar bone

Dr Sandeep
Gupta
Oral Pathologist
ALVEOLAR PROCESS
It is defined as the parts of the maxilla and mandible that
form and support the sockets of the teeth.
It forms when the tooth erupts to provide the osseous
attachment to the forming periodontal ligament;
It disappears gradually after the tooth is lost.
ALVEOLAR PROCESS

Alveolar bone
Spongy bone
Cortical plate
 ALVEOLAR BONE PROPER
It surrounds the roots of the tooth & gives attachment
to the principal fibers of the periodontal ligament.

Histologically bundle bone & lamellaler bone

 ALVEOLAR BONE PROPER (cont,d)

A-BUNDLE BONE:
The bone which lines the socket in which sharpey’s
fibers are embedded is known as bundle bone.
Is perforated with many small foramina for B.v and
nerves , thus its also called cribriform plate.
Contains more calcium salts per units area than other
bone.
It also known as lamina dura because of its radiopacity.

b- Lamellated bone.
Is also compact but with haversian system.
Bundle bone

Lamina Dura
 SUPPORTING ALVEOLAR BONE
It is the bone that surrounds the alveolar bone proper
& gives support to the socket.

Consists of cortical plates & spongy bone ( cancellous

bone)
A-CORTICAL PLATES
Consists of compact bone &
form the outer & inner plates
of the alveolar process.

Thinner in maxilla than in the

mandible.

Thickest in the premolar &

molar region of the mandible.

●Buccal plates are thin but lingual are heavy.

A-CORTICAL PLATES(cont,d)

In maxilla the outer cortical plate is perforated by many

small opening through which blood & lymph vessels
pass, But is dense in lower jaw.

In anterior region of both jaws the cortical plate is fused

with the alveolar bone proper,no spongy bone

is found.
plates are covered by periosteum.
 B-SPONGY BONE

It is the bone which fills the

space between the outer &
inner plates &the alveolar
bone proper.

Consists of heavy trabeculae

with bone marrow spaces.
Trabeculae
There are 2 main type:
A-Type 1:
*The interdental &interradicular trabeculae are
regular&horizontal in a ladder like arrangment.

*This type is seen most often in the mandibule.

B-Type 2:
*Shows irregularly arranged,numerous,delicate
interdental &interradicular trabeculae.
*This type is more common in the maxilla.
 Bone marrow

The bone marrow is red in

young bone and yellow in old.

-histologicalhy consists of:

1- blood forming elements
2- Osteogenic cells.
3- Adipose tissue.
 THE INTERDENTAL SEPTUM

Consists of cancellous bone bordered by the socket walls of

approximating teeth & the facial & lingual cortical plates.

If roots are too close together, an irregular window can

appear in the bone adjacent roots.
 EMBRYOLOGY OF ALVEOLAR BONE
• Near the end of the 2nd
month of fetal life,
mandible and maxilla
form a groove that is
opened toward the
surface of the oral cavity
• As tooth germs start to
develop, bony septa form
gradually.
Origin

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 OSTEOGENESIS

The process of bone formation is called osteogenesis.

A-Intra- membranous B-Endochondral

bone formation bone formation

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 OSTEOGENESIS (cont,d)
• Alveolar bone is formed during fetal growth by intramembranous
ossification and consists of a calcified matrix with osteocytes
enclosed within spaces called lacunae.

• The osteocytes extend processes into canaliculi that radiate from

the lacunae.

• The canaliculi form an anastomosing system through the

intercellular matrix of the bone, which brings oxygen and nutrients
to the osteocytes through the blood and removes metabolic waste
products.

• Bone growth occurs by apposition of an organic matrix that is

deposited by osteoblasts.
 A-INTRA-MEMBRANOUS BONE FORMATION
In this type of ossification, the formation of
bone is not preceded by the formation of a cartilagenous
model, Instead bone is laid down directly in a fibrous
membrane.

Loose mesemchymal tissue

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Intra- membranous bone formation (cont,d)
At the site of bone formation,
mesenchymal cells become
aggregated.

Some mesenchymal cells lay

down bundles of collagen fibres.

Some mesenchymal cells

differentiated into osteoblasts. 0
Intra- membranous bone formation (cont,d)
These osteoblasts secrete a
gelatinous matrix called osteoid
around the collagen fibres.

They deposit calcium salts into the

osteoid leading to conversion of
osteoid into bone lamellae.

Now the osteoblasts move away from

the lamellae & a new layer o osteoid
is secreted which also gets calcified
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 B-ENDOCHONDRAL BONE FORMATION
In this type, the bone formation of a
cartilagenous model which is subsequently
replaced by bone.
Mesenchymal cells become condensed at the site of
bone formation.

Some mesenchymal cells differentiate into

chondroblasts & lay down hyaline cartilage.
The cartilage is surrounded by a membrane called
perichondrium.This is highly vascular & contains
osteogenic cells.
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ENDOCHONDRAL BONE FORMATION (cont,d)

The intercellular substance

surrounding the cartilage cells

becomes calcified due to the influence

of enzyme alkaline phosphatase

secreted by the cartilage cells.

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ENDOCHONDRAL BONE FORMATION (cont,d)

Thus the nutrition to the cartilage cells is

cut off leading to their death which results

in formation of empty spaces called

primary areolae.
 ENDOCHONDRAL BONE FORMATION (cont,d)

The blood vessels & osteogenic cells from the perichondrium

invade the calcified matrix which is now reduced to bars or

walls due to eating away.

of the calcified matrix. this

leaves large empty spaces

between the walls called

secondary areolae
 ENDOCHONDRAL BONE FORMATION (cont,d)
The osteogenic cells from the perichondrium become
osteoblasts & arrange themselves along the surface of
there bars of calcified matrix.

The osteobleasts lay down osteoid which later becomes calcified

to form a lamella of bone.

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MICROSCOPIC STRUCTURE OF BONE

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 PERIOSTEUM
The outside of all compact bone is
covered by a thin connective tissue
membrane called the periosteum.

Is rich in blood vessels and nerves.

Is composed of collagen fibers and

fibroblasts. Bundles of periosteal
collagen fibers penetrate the bone,
binding the periosteum to the bone.
 OSTEON
It is the structural & metabolic unit of the lamellar
bone.

It consists of haversian canal in the center which harbors a

blood vessels.
This is surrounded by concentric, mineralized lamellae to
form the osteon; known as concentric lamellae.
Spaces between the different osteon is filled with
interstitial lamellae.

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 HAVERSIAN SYSTEM

Consists of the haversian canal & the volkmann’s canal.

Haversian canal located in the center of the osteon.
Volkmann’s canal are the connecting vessels which connect
the haversian canal.
FUNCTION: provides nutrition to the bone.

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 LAMELLAE
Made up of osteocytes found within empty spaces called
lacunae.
Mainly 3
types:

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 LAMELLA
E
1-CIRCUMFERENTIAL LAMELLAE :
They are bony lamellae that surround the entire bone,

forming its outer surface.

2-CONCENTRIC LAMELLAE :

They form the bulk of the bone & osteon.

3-INTERSTITIAL LAMELLAE :

They are lamellae that found between adjacent concentric lamellae. they

fill the space between the concentric lamellae.

 BONE MARROW
RED BONE MARROW :

Mainly found in the embryo & newborn.

They help in formation on RBCs & WBCs.
In the oral cavity, it is found in the maxillary tuberocity, the
maxillary molars, the mandibular molars, the mandibular
premolar areas, the mandibular symphysis & the ramus angle.
Radiographically seen as a zones of radiolucency

YELLOW BONE MARROW :

It is a fatty marrow that does not produces red &white

blood cells.
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 Bone cells
Osteoblasts , osteocytes , and osteoclasts
 OSTEOBLASTS
These are bone forming cells
Origin: stem cells
These are mononucleated cells that
synthesize collagenous & non -
collagenous bone matrix proteins.
It exhibits a high level of alkaline
phosphatase on their outer plasma
membrane.
When active……. They are plump,
cuboidal in shape.
When non-active……. They becomes
slight flattened.
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 OSTEOBLASTS (cont,d)

Function:-

- Synthesize collagen (type I and V) and non-collagen pt.

- Mineralization

- Rich in alkaline phosphate enzyme.

- Its maturation stage lining cells that they maintain transport

and glycopt synthesis.

 OSTEOCYTES
As the osteoblasts secrete the bone matrix, some of the
osteoblasts get entrapped in lacunae; they are called
osteocytes.

The space in the matrix occupied by an osteocyte is called the

osteocytic lacuna.

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 OSTEOCYTES (cont,d);

Function –
Maintain bone as living
tissue because of their
metabolic activity

Maintain exchange of
calcium between bone &
ECF
 OSTEOCLASTS
These are bone resorbing cell that are
multinucleated , large & generally found in
cluster.
Origin: circulating monocytes & local
mesenchymal cells.
The osteoclasts are found against the one
surface occupying shallow depressions
called howship’s lacunae.

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 OSTEOCLASTS (cont,d)

-function :
-Is degradation of bone causing
resorption
Upon arrival, active enzymes, such as
tartrate resistant acid phosphatase, are
secreted against the mineral substrate.
 BONE COMPOSITION

67% 33%
Inorganic Organic
Hydroxyapetite
crystals Non collagenous Collagen
proteins
calcium type I
phosphates Osteocalcin
hydroxyl Osteonectin
carbonate Phosphoproteins
sodium proteoglycans
magnesium Sioloprotein
fluorine Bone morphologic
protein
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 FENESTRATIONS & DEHISCENCES

Isolated areas in which the root is denuded of bone & the root
surface is covered only by periosteum & overlying gingiva are
termed fenestrations.

When the denuded areas extends through the marginal bone then
defect is called a dehiscence.
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 FENESTRATIONS & DEHISCENCES (cout,d)

Etiology… unknown
Predisposing Factors :
•Prominent root contour.
•Malposition.
•Labial portion of the root combined
with a thin bony plate.

Seen more often on facial bone than on lingual bone

More common on anteriorly than posteriorly
Occurs bilaterally
BONE TURNOVER (REMODELLING)
It's the replacement of old bone by new bone it
Occurs in physiologic growth movements .
• It's rapid during childhood
• It's slow in young but continuous throughout life
Influencing factors

local systemic
Functional requirements on Parathyroid hormone
the tooth
Calcitonin
Age related changes in the
Vitamin D3
bone cells
 BONE TURNOVER (REMODELLING) (cout,d)
Remodeled alv.b. when

stained shows incremental

lines called

Resting lines and

Reversal lines:
 Resting lines :
are hypocalcified lines represent

phasic formation of bone.

Reversal lines :
are hypocalcified lines , mark the change

from bone resorption to bone deposition.

 Sequences of resorptive events
Attachment of osteoclasts to the mineralized surface of bone.

Creation of a sealed acidic microenvironment through the action

of the proton pump, which demineralizes bone &exposes the
organic matrix.

Degradation of the exposed matrix by the action of released

enzymes such as acid phosphatase & cathespin B.

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Thank You