ALVEOLAR BONE

Bone one of the hardest tissue. Both elastic & tough

a.
b.
c.
d.
e.

Functions:
Provides shape & support
Provides site of attachment of muscles & tendons
Protects vital organs
Storage site for minerals
Marrow development & storage of blood cells

CLASSIFICATION:
1. Based on shape LONG: have shaft composed of compact bone with central
medullary cavity containing marrow tissue. Ends are called
epiphysis
Eg: humerus, radius, ulna, femur, tibia, fibula, fingers & toes
SHORT: cube shaped with equal length & width. Spongy bone
covered with thin layer of compact bone. Marrow space is
present but no marrow tissue
Eg: carpals & tarsals
FLAT: thin, flat, curved. No marrow cavity
Eg: sternum, ribs, scapula, clavicle, skull roof, parietal, frontal,
temporal & occipital
IRREGULAR: various shapes notched or ridges. Mainly
composed of spongy bone with marrow but no marrow cavity
Eg: vertebrae, ethmoid, sphenoid, pelvic bones, heel bone,
mandible
SESAMOID BONES: develop in tendons patella (knee cap)

2. Based on development
ENDOCHONDRAL: formed by replacement of hyaline cartilage
Eg: bones of trunk & extremities
INTRAMEMBRANOUS: replacement of CT with bony tissue
Eg: cranial & facial bones, mandible, clavicles
3. Based on microscopic structure
WOVEN/IMMATURE: irregularly oriented collagen fibers
Seen in alveolar bone & during healing of fracture
Bone formation is rapid- incorporates osteocytes
MATURE:
Compact / lamellar bone: tightly packed osteons. Arrange in
layers
Cancellous / spongy bone: honey comb appearance large
marrow cavity with plates of trabecular bone

composition

MINERAL COMPONENT:

Made of hydroxyapatite crystals carbonate and calcium

phosphate content is less than normal hydroxyapatite
crystals

Arranges as plates or leaf like structures

Closely packed with long axis parallel to collagen fibers

Gaps between are filled with water and organic molecules

Contain Ca, P, OH, CO3, Mg, Zn, Na, Pb, K, etc

ORGANIC MATRIX: also called as osteoid

Contain both collagenous and noncollagenous proteins

Collagen:

Collagen I: Major component in bone. Along with collagen V

forms basic structure in CT

Elasticity of collagen provides resilience to bone preventing

fracture

Alveolar Bone collagen I, V, III, XII

Sharpeys fibers: type III & V
type XII: present in bone. Expressed only in mechanical strain
type III & XII: in PDL (fibroblasts)
type I, V, XII: by osteoblasts

Collagen imparts pink/red color in H&E stain

In wove bone: arranged as interwoven with more interfibrillar space
In mature bone: fibers are arranged as sheets. Fibers are arranged
perpendicular to each other. Little interfibrillar space

 Non collagenous proteins: 10% of organic matrix

Endogenous produced by osteoblasts
Exogenous albumin derived from blood incorporated
into matrix during osteosynthesis

OSTEOCALCIN:

First to be identified
Also called as bone gla protein
Contains carboxy glutamic acid
Regulated by Vit D and PTH
Bone resorption as carboxy terminal
chemoattractants to osteoclast precursors
Bone deposition: Ca binding protein

acts

as

OSTEOPONTIN & SIALOPROTEIN:

Termed as bone sialoprotein I & II

Glutamic acid more in sialoprotein
Aspartate more in osteopontin

BSP restricted to mineralized tissue

Functions to in initiation of mineral crystal formation
Suppressed by Vit - D

OSTEOPONTIN inhibitor of crystal growth

More at cell matrix interface mediates attachment of bone
cells
Upregulated by Vit - D

OSTEONECTIN:

Binds to hydroxyapatite crystals

Calcium binding glycoprotein

Interacts with extracellular matrix

Regulates cell adhesion and proliferation

Also modulates cytokine activity

PROTEOGLYCANS:

Chondroitin sulfate glycoprotein non mineralized bone

Biglycan & decorin EDTA bone extracts. Decreases with

bone maturation
Biglycan more in developing bone & mineralized adj to
pericellular areas. Binds to TGF beta- regulates
fibrillogenesis
Decorin found in gap btwn fibers. Calcification occurs by
fusion of collagen fibrils & removal of decorin

Chondrotin sulfate proteoglycan crystals

seen in mineral

LYSYL OXIDASE & TRAMP:

Components of demineralized dentin and bone

Lysyl oxidase needed for collagen cross linking

TRAMP also called dermatopontin. Binds decorin and TGF

beta

MATRIX GLA PROTEINS & 2HS GLYCOPROTEINS:

not secreted by osteoblasts
Matrix GLA protein mineral binding protein
Mineralized by vascular smooth muscle cells and chondrocytes
2HS produced by liver
Compromises inhibition of apatite formation

Other
are:

proteins

secreted

Proteases
Protease inhibitors

IGF I, PDGF and TGF-

increases rapidity of bone

Cytokines
BMP: BMP 2, BMP 7, TGF

IGF- I and II
PDGF
FGF

formation and bone repair

BONE HISTOLOGY:

Dense outer sheet compact bone

Central medullary cavity. Show network of bone trabeculae

Outer layer periosteum. Outer fibrous, inner bone cells

Inner layer endosteum

Periosteal & endosteal suurfaces: lamellae are arranged in

parallel to bone surface circumferential lamellae

Deep to circumferential lamellae lamellae are arranged in

small concentric layers around vascular core osteon
(concentric lamellae)

Interstitial lamellae: remnants of osteons left behind during

remodelling

BONE HISTOLOGY:
Reversal line marks limit of bone
erosion and bone formation
More irregular in outline
Resting line denotes rest period during
bone formation
Regular appearance

OSTEOBLASTS:

Mononucleated cell derived from osteoprogenitor mesenchymal

cells

Formed from bone marrow, CT

Periosteum acts as reservoir child growth, fractures, osteo

tumors

MORPHOLOGY:
Basophilic, plump cuboidal or elongated cells

Produce osteoid composed of collagen I and non collagenous

proteins

Abundant protein synthesizing organelles basophilia is due to RER

Nucleus is eccentrically placed far from osteoid

Canaliculi due to deposition of org matrix around cell bodies

and cytoplasmic processes

Canaliculi connect with each other and other osteocytes gap

& adherens junctions. Aids in intercellular adhesion & cell cell
communication

Contain prominent bundles of actin , myosin & cytoskeletal

proteins maintaining cell shape, motility and attachment

FORMATION:
Undifferentiated pluripotent stromal stem cells
inducible osteoprogenitor cells
determined osteoprogenitor cells
osteoblasts

FUNCTIONS:
Formation of new bone
Regulate bone remodelling & mineral metabolism
Mineralization of osteoid
Secrete collagen I, V, osteonectin,
osteopontegrin , proteoglycans etc

osteopontin,

Show high levels of AlkP on outer surface differentiates

preosteoblasts from fibroblasts
Resorbing factors PTH, Vit D, IL 1, TNF. Osteoblasts
contain receptors for these transfers to osteoclast

Overall function is regulated by harmones, proteins of

hematopoietic marrow and bone cells

 PTH: regulates serum calcium levels by bone resorption

indirectly by osteoblasts initiation (osteoclasts are devoid of
PTH receptors). Also by TGF and IGF I
Vitamin D: increases serum Ca levels by
1. Ca absorption from intestine
2. promote bone resorption stimulates osteopontin & osteocalcin secretion by
osteoblasts suppresses collagen formation
Growth harmone: required for deposition. Mediated via receptors on
osteoblast surface
Insulin: directly stimulates osteoblasts - aid in deposition
BMP: induce new bone formation aid in migration, aggregation,
proliferation of mesenchymal cells & aid in osteogenic differentiation. No
effect on matrix formation
TGF- and IGFs have same effects

 FGF: increase cell proliferation & osteogenic differentiation

Glucocorticoids: aid in differentiation & matrix formation
PDGF: promotes osteogenesis
BONE LINING CELLS:
On completing osteoblastic function 1. entrapped in bone osteocytes
2. remain on surface lining cells flattened, non bone
forming
Very few organelles. Retain gap junctions with osteocytes for vitality
50-60% of osteoblasts: undergo apoptosis due to TNF and
glucocorticoid & estrogen withdrawl

OSTEOCYTES:
o

Number of osteoblasts becoming osteocytes depend on

rapidity of bone formation woven & repair bone (more)
than mature bone

Osteocyte reduced in size space around is called lacunae

Lacuna ovoid / flattened. Extensions are called canaliculi

which contain osteocytic processes

Canaliculi dont extend beyond an osteon. No

communication with adjacent osteon. Maintain contact
with osteoblasts and lining cells. Aid in maintaining bone
integrity and bone vitality failure causes death of bone

Canaliculi penetrate matrix for diffusion of gases,

nutrients and waste

Have ellipsoidal cell body parallel to adj lamellae

Oval nucleus with narrow rim of basophilic cytoplasm

Very few organelles with few matrix protein synthesis

Old cells retract the canaliculi

Dead cells lacunae & canaliculi are filled with debris

OSTEOCLASTS:
o

Involved in bone resorption

MORPHOLOGY:
Lie in resorption bays - howships lacunae
Large multinucleated cell 15 to 20 nuclei. More nucleus more
resorption
Variable shape due to motility
Cytoplasm acid phosphatase granules and vesiscles
Extensive mitochondria throughout except at ruffled end
RER is less and golgi is abundant along with microtubules
Cathepsin containing granules are close to ruffled end involved in
resorption

FORMATION:

Hematopoietic cell
multinucleated giant cells
osteoclast differentiation via cell cell interactions with
osteoblasts

REGULATORS:

RANK & RANKL are receptor and ligands present on

osteoclasts differentiation into mature osteoclasts and
osteoclastic activity

M- CSF: for both proliferation & differentiation of osteoclasts

Osteoprotegerin: RANKL antagonist. Inhibits osteoclast

formation & bone formation. Produced by active osteoblasts

Estrogen: inhibits bone resorption decreases life span

of osteoclast by promoting apoptosis

Vit D & PTH: stimulate bone resorption.

Calcitonin: inhibits resorption

1. by inhibiting proliferation & differentiation
osteoclastic precursors.
2. reduces ruffled border dimension
3. aid in dissociation from bone surface

of

bisphosphonates: inhibits resorption

osteoblasts. Used in treating bone disorders

PGE2: potent stimulators for resorption. Can also induce

bone formation

induces

BONE FORMATION:
INTRAMEMBRANOUS:

Direct formation of bone within condensed primitive

tissue

Occurs in following steps:

1. Formation of matrix in fibrous membrane

2. Formation of woven bone
3. Appositional growth & formation of compact bone
4. Formation of osteon

FORMATION OF MATRIX:

Initial site where bone develops CT is loosely arranged

(pale stellate cells with cytoplasmic processes)
Development of center of osteogenesis associated
with capillaries growing into mesenchyme
Cells proliferate & condense into compact nodules
Cells in center differentiate in to osteoblasts round &
basophilic
Form org matrix which later calcifies
Develop as small irregular shaped spicules

FORMATION OF WOVEN BONE:

Spicules grow in size long anastomosing structures

trabeculae. Stain bright pink on H & E.
Covered by large osteoblasts which are intensely basophilic
Trabeculae extend in radial pattern enclosing the bv
Forms the immature / woven bone

External to woven bone condensation of mesenchyme

periosteum
Mesenchymal cells disappear but leave a layer of flat cells on
trabeculae osteogenic cells
Osteogenic cells form bone in vascular areas & cartilage in
avsacular areas

APPOSITIONAL GROWTH & FORMATION OF COMPACT BONE:

Osteoblasts deposit new layers of matrix on preexisting bone

appositional growth
as osteoblasts have their own canaliculi osteocytes of each
layer are linked to bone surface above and to osteocytes below
as trabeculae increase in width new capillaries are inserted
to provide nutrition to deeper osteocytes
gradual remodeling of trabeculae occurs maintain shape and
size
continued apposition and remodeling can result convert
cancellous bone to compact bone
vascularity in cancellous bone differentiates in to red bone
marrow

FORMATION OF OSTEON:
as cancellous bone converts into compact bone narrow
canals are formed lined by osteogenic cells
canals enclose the vascularity existing in the cancellous
bone
Lamellae of bone is added by apposition to walls of the
spaces osteons / haversian systems
called primitive osteons short compared to those seen
in long bones

WOVEN / IMMATURE BONE

MATURE / LAMELLAR BONE

Intertwined collagen fibers oriented

in various directions

Orderly arranged fibers. Collagen

fibrils of one lamellae are
perpendicular to adj lamellae

Large interfibrillar space filled with

minerals and org matrix

Interfibrillar space is less

Matrix appears blue indicating high

proteoglycan content

More uniform acidophilic staining

Rate of deposition & mineralization

are rapid more osteocytes

Rate of deposition & mineralization

are slow less osteocytes

Rich in BAG 75 and BSP

Rich in osteocalcin

Low mineral density and high water

content

high mineral density and low water

content

Can be entirely removed by

osteoclasts at a time

Only a part of it can be removed

Matrix vesicels initiate

mineralization

Collagen initiate mineralization

BONE FORMATION:
ENDOCHONDRAL:

Replacement of cartilage by bone

Occurs in following steps:

1. Formation of cartilage
2. Formation of bone collar
3. Formation of periosteal bud
4. Formation of medullary cavity
5. Formation of secondary ossification center

FORMATION OF CARTILAGE:

Mesenchymal cells condense & differentiate

chondroblasts form cartilage (hyaline)

into

perichondrium: outer fibrous & inner chondrogenic

no osteoblasts are produced in chondrogenic layer
becoz of avascular environment
growth is by both interstitial & appositional growth
length increases by interstitial growth & width by
appositional growth

FORMATION OF CARTILAGE:
Cells organize into 3 zones:
1. Zone of proliferation: cells are small & flat. Act as new source of cells
2. Zone of hypertrophy & maturation: broadest zone. Chondrocytes are
hypertrophic. Secrete type II collagen and proteoglycans
3. Zone of provisional mineralization: begins by matrix vesicles. Vesicles bud off
forming independent units
FORMATION OF BONE COLLAR:
.

Capillaries grow into perichondrium inner cells differentiate into osteoblasts

forms a thin collar of bone matrix around mid region of cartilage
chondroclasts resorb most of the mineralized cartilage matrix
bone collar holds the shaft together
more space is created for vascular in growth

FORMATION OF PERIOSTEAL BUD:

Periosteal capillaries are accompanied by osteogenic cells invade the calcified
cartilage PERIOSTEAL BUD
Initiate ossification center
Osteogenic cells are transformed into osteoblasts bone matrix formation
Formation of cancellous bone & bits of calcified cartilage mixed spicule
Network of mixed spicule primary spongiosa

FORMATION OF MARROW CAVITY:

ossification center enlarges osteoclasts destroy the bone create space in the shaft
(medullary cavity)

Hematopoietic stem cells enter cavity marrow tissue

2 ends are composed of cartilage (epiphysis) while middle region is bony - diaphysis

FORMATION OF SECONDARY OSSIFICATION CENTER:

Before or after birth secondary ossification center

Periosteal buds carry bv & mesenchymal cells retain the

cancellous bone unlike primary ossifcation

Ossification spreads from secondary center

Finally cartilage remains only in 2 sites: articular cartilage &

epiphyseal cartilage

Aids in increasing the length.

Long bones have 2 centers and short bones have 1 center
Union of 2 ossification centers epiphyseal line

MMP 9,
ossification

osteoclasts

&

VEGF

regulate

endochondral

CALCIFICATION: process of deposition of insoluble calcium salts

THEORIES OF MINERALIZATION:
1. NUCLEATION THEORY:
. Proposed by Neumann & Neumann
. Collagen acts as nucleus aggregates Ca & P ions hydroxyapatite
crystals grow in size spontaneously
. Various nucleation sites include:
a. Ground substance sulfated GAGs and proteoglycans
b.

Collagen dimensions of pores in between fibrils are imp for

ingress of ions, formation of ion clusters & aggregation of ion
clusters aid in crystal growth. Along with collagen
phosphoproteins induce crystal formation, control the size shape
and orientation of crystals

c.

Mitochondria storage sites for Ca & P. releases ions extracellularly

2. MATRIX VESICLE THEORY:

Small membrane bound structures. Lie free in the matrix

Rounded outgrowths from the

chondrocytes and odontoblasts

Rich in phospholipids affinity for Ca

Vesicles accumulate Ca & surface act as nucleation site for crystal

formation

cell

memb

of

osteoblasts,

3. ALKALINE PHOSPHATASE THEORY:

hydrolyses phosphate containing substrates and increases the local

inorganic phosphate concentration.

resides in matrix vesicles budding from

chondrocytes, osteoblasts and odontoblasts

used as a marker of active tissue mineralization

cell

membranes

of

INHIBITORS OF CALCIFICATION:

Pyrophosphate
diphosphonates
adenosine triphosphate
delay or prevent the transformation
calcium phosphate to hydroxyapatite

of

amorphous

Citrate
magnesium

proteins like albumin.

Components of the bone matrix may act locally and inhibit

mineralization - proteoglycans

 BONE RESORPTION:
removal of mineral and organic components of
extracellular matrix of bone under the action of osteolytic
cells
Sequence of events:
first phase - the formation of osteoclast progenitors in
the hematopoietic tissues, followed by their vascular
dissemination and the generation of resting preosteoclasts
and osteoclasts in the bone itself
second phase - consists of activation of osteoclasts at the
surface of mineralized bone
Alterations in the osteoclast:
Immediately before the resorption event, the osteoclasts
undergo changes by assuming a polarity of structure and
function - development of a ruffled border and a sealing
zone at the plasma membrane
changes occur only in the region of the cell that is next to
the bone surface.

At the periphery of the ruffled border the adjacent

cytoplasm is devoid of cell organelles contains contractile
actin microfilaments - clear (sealing) zone.

This zone serves to attach the cell very closely to the

surface of bone and creates an isolated microenvironment
- resorption can take place without diffusion of the
hydrolytic enzymes

sealing zone to attach themselves to the bone surface

Removal of hydroxyapatite:

Initial phase involves the dissolution of the mineral phase

by the action of hydrochloric acid (HCl).

The protons for the acid arise from the activity of

cytoplasmic carbonic anhydrase II, synthesized in the
osteoclast.

protons are then released across the ruffled border into the
resorption zone by an ATP consuming proton pump.

fall in pH to 2.53.0 in the osteoclast resorption space.

Degradation of organic matrix:

Proteolytic enzymes are synthesized by osteoclasts cathepsin-K and MMP-9 (matrix metalloproteinase)

enzymes are synthesized in rough endoplasmic reticulum,

transported to Golgi complexes and moved to the ruffled
border in transport vesicles

contents are released into sealed compartment, creating

extracellular lysosomes

a visible depression or Howships lacunae is excavated into

the bone.

Removal of degradation products from lacunae:

Once liberated from bone, the free organic and nonorganic

particles of bone matrix are taken in or endocytosed from the
resorption lacunae, across the ruffled border, into the osteoclast.

These are then packed in membrane bound vesicles within

cytoplasm of osteoclast.

These vesicles and their contents pass across the cell

Then the vesicles are released by exocytosis

Following resorption, osteoclasts undergo apoptosis, which

provides a mechanism for limiting resorptive activity.

Factors like TGF- and estrogen promote apoptosis.

PTH and IL-1 act as suppressors prolonging osteoclast activity.

 BONE RESORPTION:

1.
2.
3.

STAGES:
Activation stage
Resorption stage
Reversal stage

Mediators of bone
remodeling:

B. Local factors:

A. Harmonal:
. Parathyroid hormone (PTH)
. Calcitonin
. Vitamin D metabolites

. Estrogen receptors
. Growth hormones
. Glucocorticoids

IL 1
TNF
Prostaglandins
IGF I & II
BMPs
PDGF, FGF, EGF
Bacterial products
lipopolysaccharides, capsule,
lipotechoic acid,
peptidoglycans
Mechanical factors

MARKERS OF BONE
TURNOVER:

A. SERUM MARKERS:
. alkaline phosphatase
(total)
. alkaline phosphatase
(skeletal isoenzymes)
. osteocalcin
. procollagen I extension
peptide
B.
.
.
.

URINARY MARKERS:
urine calcium
urinary hydroxy proline
collagen crosslink
fragments (first to be
hydrolysed)
. urine N-telopeptide (N

urine C-telopeptide (C
terminus of collagen fibrils)
urine total pyridinoline
urine free
deoxypyridinoline

Pathologies caused by
improper control of
remodeling are:

Osteoporosis
Osteopetrosis
malignant bone tumors
inflammatory joint diseases
hyperparathyroidism
Pagets disease
hyperthyroidism.

ALVEOLAR BONE:

alveolar process - defined as that part of the maxilla and

the mandible that forms and supports the sockets of the
teeth

Functions of alveolar bone:

Houses the roots of teeth.
Anchors the roots of teeth to the alveoli - by the insertion
of Sharpeys fibers into the alveolar bone proper.
Helps to move the teeth for better occlusion.
Helps to absorb and distribute occlusal forces generated
during tooth contact.
Supplies vessels to periodontal ligament.
Houses and protects developing permanent teeth, while
supporting primary teeth.
Organizes eruption of primary and permanent teeth.

major changes in the alveolar process begin to occur with

development of roots and tooth eruption.

As roots develop, the alveolar process increases in height.

the cells in the dental follicle start to differentiate into

periodontal ligament and cementum.

simultaneously some cells in the dental follicle

differentiate into osteoblasts and form alveolar bone
proper

During growth, part of the alveolar process is gradually

incorporated into the maxillary or mandibular body while
it grows at a fairly rapid rate at its free borders

The alveolar process forms with the development and the

eruption of teeth, and gradually diminishes in height after
the loss of teeth

Structure of alveolar bone

Anatomically, no distinct line exists between the body of the jaws
and their respective alveolar processes.
Occasionally, the alveolar process is fused with underlying bone

ALVEOLAR BONE
ALVEOLAR BONE
SUPPORTING ALVEOLAR
PROPER
BONE
LAMELLATED BONE

CORTICAL PLATE

BUNDLE BONE

SPONGY BONE

ALVEOLAR BONE PROPER: surrounds

attachment to principal fibers

the

tooth

and

gives

Lamellated bone:
The lamellar bone contains osteons each of which has a blood
vessel in a haversian canal.

Blood vessel is surrounded by concentric lamellae to form osteon.

Some lamellae of the lamellated bone are arranged roughly

parallel to the surface of the adjacent marrow spaces, whereas
others form haversian systems

Bundle bone:
Bone in which the principal fibers of the PDL are anchored.

Term bundle was chosen because, the bundles of the principal

fibers continue into the bone as Sharpeys fibers

The bundle bone is characterized by the scarcity of the fibrils in

the intercellular substance

These fibrils are arranged at right angles to Sharpeys

fibers.

The bundle bone contains fewer fibrils than does

lamellated bone, and therefore it appears dark in H&E
sections

fibers are mineralized at the periphery and have a larger

diameter.

These fibers are less numerous than bundles in the

cementum on the opposite side of the PDL

collagen adjacent to bone is always less mature than that

adjacent to cementum

Radiographically, it is also referred to as the lamina dura,

because of increased radiopacity - due to the presence of
thick bone without trabeculations (X-rays must penetrate

alveolar bone proper lining the inner wall of the socket is

perforated by many openings that carry branches of the
interalveolar nerves and blood vessels into the
periodontal ligament - cribriform plate

Bone between the teeth is called interdental septum and

is composed entirely of cribriform plate.

The interdental and interradicular septa contain the

perforating canals - Zuckerkandl and Hirschfeld (nutrient
canals) which contain interdental and inter radicular
arteries, veins, lymph vessels and nerves

Supporting alveolar bone consists of two parts:

(a) Cortical plates
(b) Spongy bone
Cortical plates:
Cortical plates consist of compact bone and form outer
and inner plates of the alveolar processes.

These are continuous with the compact layers of the jaw

bodies.
much thinner - maxilla, thick - mandible.

thickest in the premolar and molar region of the lower

jaw, especially on the buccal side

In the maxilla, the outer cortical plate is perforated by

many small openings through which blood and lymph
vessels pass

In anterior region of both jaws, the supporting bone

usually is very thin.

No spongy bone is present in that region, and the cortical

plate is fused with the alveolar bone proper

Bone underlying the gingiva is the cortical plate.

Both cribriform plate

compact bone separated
by spongy bone.

and

cortical

plate

Histologically, the cortical plates consist

longitudinal lamellae and haversian systems

are

of

Spongy bone:

Spongy bone fills the area between the cortical plates and
the alveolar bone proper

These are surrounded by marrow that is rich in adipocytes

and pluripotent mesenchymal cells

trabeculae contain osteocytes in the

osteoblasts or osteoclasts on the surface.

These trabeculae of the spongy bone bears the functional

forces to which alveolar bone proper is exposed.

The cancellous component in maxilla is more than in

mandible

interior

and

Spongiosa is classified into two main types:

Type I:

the interdental and interradicular trabeculae are regular

and horizontal in a ladder like arrangement
Type II:
shows irregularly arranged, numerous, delicate interdental
and interradicular trabeculae.

Both types show a variation in thickness of trabeculae and size of

marrow spaces.

The architecture of type I is seen most often in the

mandible and fits in to trajectory pattern of spongy bone.

Type II, although functionally satisfactory, lacks a distinct

trajectory pattern, which seems to be compensated for by the
greater number of trabeculae in any given area. This is more
common in the maxilla.

ALVEOLAR CREST:

shape of the outlines of the crest of alveolar septa on

radiograph is dependent on the position of the adjacent
teeth.

In a healthy mouth the distance between the CEJ and

the free border of the alveolar bone proper is constant.

If the neighboring teeth are inclined, the alveolar crest

is oblique.

the inclination is most pronounced in the premolar and

molar regions, with the teeth being tipped mesially

Cortical bone and alveolar bone meet at the alveolar

crest usually 1.5 to 2 mm below the level of CEJ on the
tooth it surrounds.

INTERNAL RECONSTRUCTION OF ALVEOLAR BONE:

During mesial drift of tooth, bone is apposed on the distal

and resorbed on the mesial alveolar wall

The distal wall is made up almost entirely of bundle bone.

However, the osteoclasts in the adjacent marrow spaces

remove part of the bundle bone, when it reaches a certain
thickness.

In its place, lamellated bone is deposited

On the mesial alveolar wall of a drifting tooth, the sign of

active resorption is the presence of Howships lacunae
containing osteoclasts

periods of resorption alternate with periods of rest and

repair

Bundle bone is always present in some areas on resorbing

side but forms merely a thin layer

Islands of bundle bone are separated from the lamellated

bone by reversal lines that turn their convexities towards
the lamellated bone

During these changes, compact bone may be replaced by

spongy bone or spongy bone may change into compact
bone

Alterations in the structure of the alveolar bone are of

importance during physiologic eruptive movements of the
teeth which are directed mesioocclusally

AGE CHANGES:

Alveolar sockets appear jagged and uneven.

marrow spaces have fatty infiltration

The alveolar process in edentulous jaws decreases in

size.

Loss of maxillary bone is accompanied by increase in

size of the maxillary sinus.

Internal trabecular arrangement is more open, which

indicates bone loss.

The distance between the crest of the alveolar bone and

CEJ increases with ageapproximately by 2.81 mm

CLINICAL CONSIDERATIONS:

Bone when covered by a vascularized connective tissue exceedingly sensitive to pressure, whereas tension acts
generally as a stimulus to the production of new bone. this
biologic plasticity that enables the orthodontist to move
teeth without disrupting their relations to the alveolar
bone.

The labial aspect of the alveolar crest is the principal site of

resorption, which reduces first in width and later in height

pattern of resorption is different in the maxilla and

mandible.
downward and outward - mandible
upwards and inwards - maxilla

Nontraumatic loss of anterior maxillary teeth is followed by

a progressive loss of bone mainly from the labial side

In deciduous dentition, loss of a retained second deciduous

molar with no succedaneous permanent tooth to replace it,
is also associated with bone loss.

The cause for resorption of alveolar bone after tooth loss

has been assumed to be due to disuse atrophy, decreased
blood supply and localized inflammation

Alveolar ridge defects and deformities can also be the

result of congenital defects, trauma, periodontal disease or
surgical ablation, as in the case of tumor surgery.

Lamina dura is an important diagnostic landmark in

determining health of the periapical tissues.

Loss of density usually means infections, inflammation and

resorption of bone socket