Alveolar bone

• The alveolar process is the part of the maxilla

and mandible that supports the roots of teeth
and is composed of alveolar bone proper and
supporting bone.
• Alveolar bone proper is the bone lining the
tooth socket. In clinical radiographic terms,
it is defined as the lamina dura.
• Supporting bone is, as the name implies, the
bone that serves as a dense cortical plate
to sustain the alveolar bone proper. This
cortical plate covers the surface of the maxilla
and mandible and supports the alveolar bone
proper.
• The existence of alveolar bone is entirely
dependent on the presence of teeth. Alveolar
bone develops initially as a protection for the
soft developing primary teeth and later, as the
roots develop, as a support for the teeth. Finally,
as the teeth are lost, the alveolar bone resorbs.
• Teeth are responsible not only for the
development but also for the maintenance of
the alveolar process of the mandible.
 Alveolar bone proper
• It is the compact or dense bone that lines the
tooth socket is of two types when viewed
microscopically.
• Perforating fibers or Sharpey’s fibers are
bundles of collagen fibers embedded in the
alveolar bone proper.
• Because bone of the alveolar process is
regularly penetrated by collagen fiber bundles,
it can be appropriately termed bundle bone.
Bundle bone, being synonymous with alveolar
bone proper or lamina dura, appears more
dense radiographically than the adjacent
supportive bone.
• Not all alveolar bone proper appears as
bundle bone, because the bone lining the
socket is constantly being remodeled for
adaptation to the stresses of occlusal
impact. Newly formed bone does not have
perforating fibers.
 Supporting compact bone
• Supporting compact bone of the alveolar
process is similar to Haversian bone found
elsewhere in the body.
• Haversian and Volkmann canals form a continuous
system of nutrient canals that radiate throughout
the bone, which also includes a rich nerve supply.
• The Haversian canals extend through the long axis of
the bone, and Volkmann canals enter Haversian
canals at right angles. These canals form a
nutrient network throughout bone.
• Bone cells or osteocytes are present in many of the
lacunae and provide the maintenance and
viability of the bone
 Supporting cancellous bone
• The cancellous or spongy bone supporting the
alveolar bone proper of the alveolar process is
composed generally of heavy trabeculae or
plates of bone with bone marrow spaces
between them.
• Bone marrow contains blood-forming
elements, osteogenic cells, and adipose
tissues.
• The supporting bone of the maxilla in
particular is filled with marrow tissue, which
contains immature red blood cells and
leukocytes, especially in the molar region
posterior to the maxillary sinus.
• Bone marrow, found in bones throughout the
body, is one of the largest organs in the body
and represents approximately 4.5% of body
weight.
 Tooth movement
• Physiologic movement
• The eruptive process involves major
remodeling of the alveolar process to
compensate for root growth and changes
in positional relations of the primary and
permanent teeth.
• Repositioning of teeth occurs, during facial
growth. Movement occurs in facial and buccal
directions as the arches increase in dimension.
• Orthodontic movement
• Tooth movement by orthodontics is possible only if
bone resorption takes place in the direction in which
the tooth is being moved. Such movement causes
pressure on the surface of the alveolar bone in the
direction of tooth movement. Tooth movement also
causes tension on the periodontal ligament on the
opposite surface of the root. These stresses cause
activation of cells and changes in the vascular and
neural tissue along the bone and cemental surfaces.
• The alveolar bone and cementum show
remarkable ability to be modified. As bone
resorption occurs on one surface, the tooth is
allowed to move in that direction, and bone
consequently forms on the opposite side of
the socket. This stabilizes the tooth in a new
position.
• If a tooth is tipped, several areas of the
periodontium are compressed and several
exhibit tension. The tipping movement is
necessary to accomplish the change in
occlusion desired. Pressure applied on a
specific point on the tooth causes
compression in a limited area between the
root and the bone.
• However, a tooth may need to be moved by
bodily movement, in which case the root
is moved in the same direction, affecting the
entire surface of the socket. Compression
changes occur in the ligament along the
advancing root surface, and tension changes
occur in the ligament fibers, bone, and
cementum along the opposite surface.
 Aging
• Aging brings bone loss with fewer fiber
bundles inserted in the bone and cementum.
Hard tissue then forms around the fibers in
support of these bundles, thus creating a
scalloped surface.
• During aging, fewer viable cells are in the
lacunae, and the marrow spaces become
infiltrated with fat cells. Osteoporosis then
becomes more apparent, and the support of
the teeth is further diminished.
 Edentulous jaws
• Tooth loss has several impacts:
• First, it is recognized that alveolar bone
volume decreases. This is evident from the
general loss of the alveolar process with tooth
extraction.
• Some loss of the internal structure of the bone
occurs, resulting in open spaces and fewer
trabeculae in the cancellous supporting bone
• Osteoporosis may then become more
evident.
• Little change occurs in the location of blood
vessels, nerves, glands, and fatty zone in
the aging edentulous jaws or in dense
compact bone of the mandible beneath
the alveolar bone.