Vous êtes sur la page 1sur 32

ALVEOLAR

BONE

1
Definitio
n
Osteogenes
is
Compositio
n
Gross structure of
bone
microscopic structure of
bone
Osseous
topography
Fenestrations & dehiscence
Remodeling ( bone
turnover )
Blood supply, lymphatic drainage of the
bone
Bone changes associated with the
orthodontic forces
References
2
BONE:
Bone is a mineralized connective tissue that
performs the function of support, protection and
locomotion

ALVEOLAR PROCESS :
It is defined as the parts of the maxilla and
mandible that form and support the sockets of
the teeth.

3
4
OSTEOGENESIS :
The process of bone formation is
called osteogenesis.

Endocondral Intra- membranous


bone formation bone formation

5
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.
6
The intercellular substance surrounding
the cartilage cells becomes calcified
due to the influence of enzyme alkaline
phosphatase secreted by the cartilage
cells.

Thus the nutrition to the cartilage


cells is cut off leading to their death
which results in formation of empty
spaces called primary areolae.

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.
7
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.
Then another layer of osteoid is secreted &
this goes on & on. Thus the calcified matrix of
cartilage acts as a support for bone formation.

8
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

9
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.

10
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

11
COMPOSITION : BONE

67% 33%
Inorganic Organic
Hydroxyapetite
crystals Non Collagen
collagenous
calcium type I
proteins
phosphates
Osteocalcin
hydroxyl
Osteonectin
carbonate
Phosphoprote
sodium ins
magnesium proteoglycans
fluorine Sioloprotein
Bone 12
morphologic
protein
GROSS STRUCTURE OF BONE ;

Alveolar Supporting
bone proper alveolar
bone

The interdental septum


Periosteum
Endosteum

13
ALVEOLAR BONE PROPER :

It surrounds the roots of the tooth & gives attachment to


the principal fibers of the periodontal ligament.
It also known as the cribiform plate as it is perforated by
many openings; through which branches of the
interalveolar nerve & vessels pass into the periodontal
ligament.
Histologically bundle bone & lamellaler bone
BUNDLE BONE
:
The bone which lines the socket in which sharpey’s
fibers are embedded is known as bundle bone.
Contains more calcium salts per units area than other
bone.
It also know as lamina dura because of its radiopacity.
14
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)
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.

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.
15
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.

PERIOSTEUM :
The outside of all compact bone is covered by a thin
connective tissue membrane called the periosteum.
ENDOSTEUM :
The internal surface of compact bone as well as the
entire surface of the cancellous bone are covered by a
single layer of bone cells called the endosteum.
16
MICROSCOPIC STRUCTURE OF
BONE ;

17
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.
18
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.

19
LAMELLAE :
Made up of osteocytes found within empty spaces called
lacunae.
Mainly 3 types:

CIRCUMFERENTIAL LAMELLAE :
They are bony lamellae that surround the entire bone,
forming its outer surface.

CONCENTRIC LAMELLAE :
They form the bulk of the bone & osteon.

INTERSTITIAL LAMELLAE :
They are lamellae that found between adjacent
concentric lamellae. they fill the space between the
concentric lamellae.
20
BONE MARROW :
RED BONE MARROW :

Mainly found in the embryo & newborn.


They help in formation on RBCs & WBCs.
In adults, it is found in the ribs, sternum, vertebrae, skull &
humerus.
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.
Radiographic
YELLOW ally seen as: a zones of radiolucency
BONE MARROW
It is a fatty marrow that does not produces red &white
blood cells.

21
CELLS :
OSTEOBLASTS ;
These are bone forming cells
Origin: pluripotent 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.
22
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.

23
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.

24
OSSEOUS TOPOGRAPHY :

Normally : prominence of the


roots with the intervening vertical
depressions that taper toward the
margin.

On the labial version ; the


margins of the labial bone is
thinned to a knife edge &presents
an accentuated arc in the
direction of the apex.

On the lingual version ; the


margins of the labial bone is blunt
&rounded & horizontal rather
than arcuate.
25
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.
Etiology… unknown
Predisposing factors… prominent root contours, malposition, labial
protrusion 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 26
BONE TURNOVER (REMODELLING) :
The process by which the overall size & shape of bones
is established is referred to as bone remodeling.
Alveolar bone is a east stable of the periodontal tissues
because its structure is in a constant state of flux.

Influencing
factors

local systemic
Functional requirements Parathyroid hormone
on the tooth
Calcitonin
Age related changes in
Vitamin D3
the bone cells
27
Manifested in 3 areas :
Adjacent to the periodontal ligament.
In relation to the periosteum of the facial & lingual
plates.
Endosteum surface of the marrow spaces.
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.
28
Endocytosis at the ruffled border of inorganic &
organic bone degradation products.
Translocation of degradation products in transport
vesicles & extra cellular release along the membrane
opposite the ruffled border. (transcytosis)

Osteoblasts produce osteoid which later calcified.


Bundle bone has the highest turnover rate.
In lamellar, cancellous or spongy bone; half – moon
resorption cavity is created by osteoclasts &then filled in
with bone matrix by osteoblasts.

29
VASCULAR SUPPLY :
Derived from blood vessels branching off of the
superior or inferior alveolar arteries.

LMPHATIC DRAINAGE ;
Smallest lymph vessel ……. Lymph capillaries.
All third molars ……. Jugulodigastric lymph
nodes.
Mandibular incisors ……. Sub mental lymph
nodes.
Rest ……. Sub mandibular lymph nodes.

30
BONE CHANGES ASSOCIATED WITH THE
ORTHODONTIC FORCES :

31
REFERENCES:

Fermin A. Carranza , Newmann , Takei ; clinical


periodontology ; 9th edition ; 45 – 51.
Glickman , Fermin A. Carranza , Dr. Odont ; clinical
periodontology ; 7th edition ; 62 – 73.
Jan Lindhe , Thorkild Karring , Niklaus P. Lang ; clinical
periodontology & implant dentistry ; 4th edition ; 34 –
43.
A. R. Tencate , Antonio Nanci ; oral histology,
development, structure & function ; 6th edition ; 111
– 143.
S. I. Bhalajhi ; dental anatomy ,histology, & development
; 1st edition ; 323 – 328.
S. I. Bhalajhi ; orthodontics- the art & science ; 3rd edition
; 183- 185. 32