Alveolar bone

 Structure and function

 Age changes
 Alveolar process is the portion of the
maxilla and mandible that forms and
supports the tooth sockets ( alveoli)

 Forms when the tooth erupts to provide

osseous attachment to the forming
periodontal ligament.

 Disappears gradually after the tooth is lost.

 An external plate of cortical
bone formed by haversian
bone and compacted bone
lamellae.

 Inner socket wall – called

alveolar bone proper.

Cancellous bone
 Cancellous trabaculae –
between these compact
layers.

 Jaw bone consist of basal

bone located apically,
unrelated to the teeth.
Socket wall: consist of

Dense lamellated bone - arranged in

Haversian system and

Bundle bone.
Alveolar bone proper:
Alveolar wall is perforated by channels
through which blood vessels and nerve fibers
connect the marrow spaces
to the periodontal ligament.

Also called as cribriform plate

Contain series of openings
histologically
 Bone lining the walls of the sockets is often
continuous with the compact or cortical bone
at the lingual and buccal aspects of the
alveolar process
Buccal and lingual aspects of the alveolar process
varies in thickness from one region to another.
“Bundle bone” –
 Bone adjacent to the periodontal ligament 
greater number of Sharpey’s fibers.
 Characterized by  thin lamellae arranged in
layers parallel to the roots with intervening
appositional lines.
 Sharpey’s fibers are completely calcified but 
contain un calcified central core within calcified
outer layer.
 Occurs wherever ligaments and muscles are
attached.
 Bundle bone covers the whole socket

the layer of bundle bone is thin –100 to 200um.

 The compact bone which lines the tooth socket,
appear in radiograph as “lamina dura”
The cancellous portion of alveolar bone  trabaculae
that enclose irregularly shaped marrow spaces
lined with thin flattened endosteal cells.

Cancellous bone is found in

 inter-radicular and
 interdental spaces.
 Limited amount facially & lingually except in palate.
 More cancellous bone in maxilla than in mandible.
Bone marrow:

 In embryo / newborn: bone occupied by red

hematopoietic marrow.

 It undergo physiologic change to fatty /

yellow inactive type of marrow.

Location of foci of red bone marrow 

 Maxillary tuberosity

 Maxillary and mandibular molar & premolar

 Mandibular symphysis

 Ramus angle of the mandible.

Radiographic ally visible as zone of radiolucency.

Periosteum and Endosteum:

Periosteum  tissue covering outer surface of

bone.

Endosteum  tissue lining the internal bone

cavities.
Periosteum consists 

 Inner layer
 Osteoblasts surrounded by osteoprogenitor
cells

 Outer layer
 Rich in blood vessels & nerves
 Collagen fibers and fibroblasts.

 Bundles of periosteal collagen fibers penetrate

the bone binding the periosteum to the bone.
Endosteum 

Single layer of osteoblasts

Small amount of connective tissue.

Inner layer  Osteogenic layer

Outer layer  Fibrous layer.

 OUTER

Periosteum

 outer layer rich in blood vessels

 inner layer osteoblasts surrounded by
osteoprogenitor cells.

Bundles of collagen fibers penetrate bone – binding

periosteum to bone.

BONE

Endosteum
› Inner osteogenic layer
› Outer fibrous layer
Interdental septum consist of:

 Cancellous bone bordered by socket wall

cribriform plate (lamina dura) of approximating
teeth and
 Facial and lingual cortical plates.

If interdental space is narrow septum consist of

only cribriform plate.

Roots are close together  boneless window

appear between adjacent roots.
Importance of determining root proximity
radiographically:
 Mesio-distal angulation of the crest of the
interdental septum usually parallels a line drawn
between CEJ of approximating teeth.
 Distance between crest of alveolar bone and CEJ
in adult  0.75 and 1.49mm (average – 1.08)
 Distance increase with age – 2.81mm
Mesiodistal & faciolingual dimension and shape of

interdental septum is governed by:

 Size and convexity of the crown of two

approximating teeth

 Position of teeth in jaw

 Degree of eruption
 Composition of alveolar bone

Bone consist of

2/3 rd of inorganic matrix

1/3 rd of organic matrix

Inorganic matrix :
 Minerals, calcium & phosphate
 Hydroxyl
 Carbonate
 Citrate
 Trace amount of ions like
› Sodium,

› magnesium

› Flourine.
Hydroxyappatite crystals constitute 2/3rd of the
bone structure.
Organic matrix  90% collagen type I

Small amounts of non collagenous protein like

Osteocalcin

Osteonectin

Bone morphogenic protein

Phosphoprotein

Proteoglycans
Two substrate adhesion molecules
 Fibronectin,
 Tenascin

Cell adhesion protein ( adhesion of osteoblast &

osteoclast)
 Osteopontin and
 Bone sialoprotein
Osseous topography:

Bone contour conforms to prominence of roots.

Height and thickness of the facial and lingual bony

plates are effected by

 alignment of the teeth

 Angulation of root to the bone

 Occlusal forces
Isolated area in which root is denuded of bone +
root surface is covered by only Periosteum and
gingiva is termed  fenestration (Window like
defect)
Denuded area extends through the marginal
bone Dehiscence
Remodeling of the alveolar bone:
 Internal remodeling takes place by means of
resorption and formation
 Regulated by local and systemic influence.

Local influence:
 Functional requirements on the tooth
 Age related changes in bone cells

Systemic influences:
 Hormonal (parathyroid hormone,
 Calcitonin or Vitamin D 3
Remodeling affects:
 Height,
 contour, and
 density of bone.

Its manifested in 3 areas:

 Adjacent to periodontal ligament
 Periosteum of facial & lingual plates
 Endosteal surface of marrow spaces.
Remodeling  pathway of bony changes in

 shape

 Resistance to force

 Repair of wounds

 Calcium and phosphate homeostasis in blood

Coupling of bone resorption and formation  bone

remodels through out life.
Regulation of bone remodeling:

Bone contains 99% of body’s calcium ions.

Major source for calcium release when calcium

blood level decrease.

Monitored by parathyroid gland

Decrease in blood calcium is mediated by 

receptors on chief cells of parathyroid gland.

They release parathyroid hormone

Stimulates osteoblasts to release IL-1 and IL-6

This stimulate monocyte to migrate into bone area.

Leukemia inhibiting factor secreted by osteoblasts

coalesces monocytes into multi-nucleated
osteoclasts

They resorb bone releasing calcium ions from

hydroxyappatite into the blood

This release normalizes the blood levels of calcium

Feed back mechanism of normal blood levels of
calcium turns off the secretion of PTH.

Osteoclasts resorb organic matrix along with

hydroxyapatite.

Breakdown of collagen from organic matrix releases

various osteogenic substrate which bind covalently
to collagen
This stimulates differentiation of osteoblsts 

which deposit bone

Interdependency of osteoblasts and osteoclasts

in remodeling is called Coupling.

Bone resorption  appearance of the eroded bone

surface (Howships lacunae)

Large multinucleated cells (osteoclasts)

Osteoclasts originate from the hematopoietic

tissues,

formed by the fusion of mononuclear cells of

asynchronous population.
Osteoclasts are active

posses a elaborately ruffled border from which

hydrolytic enzymes are secreted.

They digest organic portion of the bone

Activity of the osteoclasts and morphology of the

ruffled border can be modified and regulated by :

Hormones like parathormone( indirectly), calcitonin,

which has receptors on osteoclast membrane.
Mechanism of bone resorption:
Creation of acidic environment on the bone surface 
dissolution of the mineral component of the bone.

Produced by different conditions among them

 A proton pump through the cell membrane of the
osteoclast,
 bone tumor,
 local pressure, translated through the secretory
activity of the osteoclast.
Ten cate described the sequence of the events in
the resorptive process :

 Attachment of osteoclasts to the mineralized

surface of the bone.
 Creation of sealed acidic environment through
action of proton pump, which demineralizes the
organic matrix.
 Degradation of the exposed organic matrix to
its constituent amino acids by the action of
released enzymes such as acid phosphatase and
cathepsin.
 Sequestering of mineral ions and amino acids
within osteoclasts.
AGE CHANGES
 Tissue dessication
 Diminished reparative ability
 Reduced elasticity
 Altered cell permeability
 Decreased vascularity
 Gingival Epithelium
 Gingival connective tissue
 Periodontal Ligament
 Alveolar Bone
 Cementum
 Tooth – Periodontium relationships
 Osteoporosis (the bone mineral density
(BMD) is reduced. Increased risk of
fracture.)
 Decreased vascularity
 Reduction in metabolic rate & healing
capacity
 Resorption activity is increased & the rate
of bone formation is decreased.
Aging also brings an increased prevalence of
gingival recession.

This finding appears to be largely due to the

cumulative environmental effects of
vigorous toothbrushing than due to
inflammatory periodontal disease or aging
Despite the histologic changes in the
periodontium with aging no differences in
response to nonsurgical or surgical treatment
have been shown for periodontitis
Thank you….