alveolar bone dr naveen reddy
TRANSCRIPT
GOOD MORNING…GOOD MORNING…
ALVEOLAR BONE
Presented by
DR NAVEEN PARVATHAREDDYI MDS, NARAYANA DENTAL COLLEGE
contents•Bone – introduction, classification, composition, functions , histology & bone cells
• Introduction of AB•Development of AB•Structure of AB•Blood supply & nerve supply of AB•Functions of AB•Age changes of AB•Clinical considerations of AB•Therapeutic considerations of AB•Summary•References
Introduction
BONE – It is a living specialized connective tissue with calcified inter cellular substance, which makes up the body skeleton and is one of the hardest structures of human body.
Based on location
CLASSIFICATION OF BONES
Axial skeleton Appendicular skeleton
80 126+
206
Based on shape
Based on developmental origin Intra-membranous Intracartilagenous / Endochondral
Based on cross section Compact bone
Spongy bone
Based on Matrix arrangement Lamellar bone Woven bone
Woven bone
•Immature(Woven) Bone •Mature (Lamellar )Bone•Collagen fibers oriented in many directions
•Fibers are orderly arranged
•Interfibrillar space is more
•Interfibrillar space is less
•H&E- Matrix shows blue •H&E- Matrix shows Acidophilic
•Deposition & Mineralization rates are fast.
•Deposition & Mineralization rates are slow.
• Bone sialoprotein present
•Osteocalcin present
Based on Maturity
Immature(Woven) Bone Mature (Lamellar )BoneMineral density is lower &water content higher
Low water content
Entirely removed by osteo clasts.
Portion of lamellar matrix resorbed at one time
Matrix vesicles participate in mineralization
Collagen mediated mechanism is involved in calcification
Composition
Non collagenous proteins
osteocalcin
sialoprotein
phosphoprotein
osteonectin
bone specific protein
bone morphogenic protein
functions•Supportive•Anchorage•Protective•Hematopoietic•Storage•Locomotive
Bone histologyPeriosteum: thin ,tough fibrous membrane
Endosteum: thin , delicate connective tissue membrane
Lamellae of bone:• circumferential lamellae: these lamellae are arranged in parallel layers surrounding bone.
• concentric lamellae: these lamellae are arranged in concentric layers.
• Interstitial lamellae: these are present in between osteons.
• TRABECULAE- spongy bone consists of large slender spicules
Osteon/ haversian system: haversian canal and concentric lamellae are together called as osteon.
Haversian canal: the vascular canal present at the centre of concentric lamellae.
Volkmann’s canals: adjacent haversian systems are connected by volkmann’s canals.Contain vascular network
Lacunae:
Osteocytes: osteocytes are present in the lacunae at the junctions of lamellae.
Canaliculi:
Resting lines: this line has more regular appearence which denotes period of rest during formation of bone. Deliniates haversion system
Reversal lines: irregular lines which indicate previous area of bone resorption.
Hemopoietic tissue• Red marrow – young bone Spongy bone of long and flat bones Contain stem cells of fibroblasts and blood cells• Yellow marrow – old bone Seen in epiphysis of long bones Loss of hemopoietic potential Increased accumulation of fat cells
Bone cells Osteogenic cells: 1. Osteoprogenitor cells. 2. Osteoblasts. 3. bone lining cells 4. Osteocytes. Osteoclasts
Osteoprogenitor cellsStructure : these
are angular shaped cells with centrally placed nuclei.
Function: these cells differentiate in to osteoblasts which form bone.
osteoblasts•Derivation•Reservoir •Morphology•functions
Bone lining cells•The osteoblasts that have completed their function and lie on bony surface as bone lining cells
•These cells contain few cell organelles
osteocytes•As the osteoblasts form bone matrix , they get entrapped within the matrix they secrete are called osteocytes
•Number of osteoblasts that become osteocytes , depends on rapidity of bone formation
•Woven bone, repair bone shows more osteocytes
•Osteocytes are 1o times more than osteoblasts
•Half life •Lacunae , canaliculi
osteoclasts• It is a type of bone cell that removes bone tissue by removing mineralized matrix of bone
•Osteoclasts lie in resorption bays
•Multinucleated•Exhibits 2 zones•Acid phosphatase
Alveolar boneAlveolar Bone (Process) is the part of maxilla & mandible that forms & supports the sockets (alveoli) of the teeth•Also known as Processes Alveolaris
•Pars Alveolaris
Development of AB•At the end of 2nd month of iu life, maxilla and mandible forms a groove
•As tooth germs start to develop , bony septa form gradually
•As root develop, alveolar process increases in height
•During rapid growth period, chondroid bone is formed
alv. Process forms with development and eruption of teeth Morphology of Alv. Bone depends on
Size Shape position of teeth
alv bone attains max thickness Alv. bone undergoes atrophy If teeth congenitally missing – Alv. Bone not developed
BoundariesNo distinct boundary
Certain areas Alveolar bone fused with basal bone
Anterior maxillary region
Posterior Mandibular region.
Structure of ABALVEOLAR BONE
ALVEOLAR BONE PROPER
LAMELLATED BONE
BUNDLE BONE
SUPPORTING ALVEOLAR BONE
CORTICAL PLATE
SPONGY BONE
Structure of ABTwo Parts:
Alveolar Bone proper:
Thin lamellated bone that surrounds the root of the tooth
Gives attachment to the PDL Fibres
Supporting alveolar Bone:
Surrounds the alveolar bone Proper
Gives support to the socket
Alveolar bone proper That lines the socket or alveolusForms the inner wallConsists of two parts0.1 – 0.4 mm thickOtherwise called as cribriform plate
Cribriform plate
Anatomical name
Resembles a fine holed sieve
Perforated by – foramina
Transmit nerves &Vessels
Interdental septum
Inter –radicular septum
Lamellated boneLamellar bone consists of osteons
Concentric lamellae along with central blood vessel forms an osteon
Continuous with supporting alveolar bone
Mature bone
Bundle boneTerm bundle - Sharpey’s fibreThese fibers are inserted at 90
deg angle into ABPConsists of fibrils in the
intercellular substance and are arranged at right angles to sharpey’s fibers
These fibrils are less in number compared to lamellated bone and therefore it appears dark in H&E
Silver stain
Lamina dura Radiologic name
appears as radiopaque line
Is lost
Alveolar Crest alveolus
distance b/n CEJ and free border of ABP
ABP meets cortical plates
Most cervical rim = alveolar crest
It is slightly apical to CEJ in healthy patients
If neighburing teeth is inclined
Alveolus
Rim
Floor
Alv. crest
Fundus
Supporting alveolar bone
Two Parts
Cortical Bone
Spongiosa
Supporting alveolar bone
Cortical BoneCompact bone
Forms inner &outer plates of the alveolar process
Variations:
Maxilla –thinner
Mandible -Thicker
Premolar, Molar region –Thicker
Anterior region -Thin
Buccal cortical plate – Thick
Lingual Cortical plate -Thinner
Relation to Local anaesthesia maxilla
perforated by many openingsInfiltration is sufficient
Mandible Dense cortical plateNerve Blocks required
SpSpongiosaongiosa Fills space b/n ABP and Cortical
bone
Variations;
Maxilla –More
Mandible -Less
In ant region –both jaws :
Spongiosa is absent
Cortical plate is fused with ABP
Spongy boneSpongy bone
Two types –R/AType I
Trabeculae –
Regular
Horizontal
Thick
Ladderlike
Mandible
Trajectorial pattern
Along lines of stress
Type II
Irregular
Fine/Delicate
Maxila
No trajectory pattern , More marrow space
Nutrient Canals Zuckerkandl & Hirschfeld
Interdental &Inter-radicular septum
Contain –BV, lymph vessels and nerves
Appear as radioluscent lines or shadows
Parallel to long axis of tooth
Surface structures
Ju'ga alveolaria mandibulae
Ju'ga alveolaria maxillae
Blood supply
Nerve supply
Lymphatic drainage
Bony defects• Fenestration•Dehiscence•Central buttressing•Peripheral buttressing•Osseous craters
Functions of AB•Houses the roots of teeth•Anchorage•Helps to move teeth•Helps to absorb and distribute occlusal forces•Supplies vessels to pdl•Protects developing permanent teeth•Organizes eruption of
Age changes•Alveolar sockets appear jagged and uneven
•Marrow spaces have fatty infiltration
• In Edentulous jaws•Loss of maxillary bone • Internal trabecular arrangement is more open,
•Distance b/n alveolar crest and CEJ
•Brittleness •Osteoporosis •Alveolar crest slope distally due to mesial tilting of teeth
•With loss of teeth ,resorption of alveolar ridge
Pattern of bone resorption•Maxilla •Mandible•Alv crest
Clinical considerationsMaxillary teeth Fractured tooth Abscessloss of lamina duraAB lossOrthodontic TreatmentEffect of hormones
•Proximity of AB to sinus cavities or major nerves
•Dental implants•Surgical procedures•Periodontal disease
Therapeutic considerations•Bone grafting – used to bone deposition in periodontal surgery
•Autografts, allografts , xenografts•Guided tissue regeneration – collagen is used to support natural bone formation
•Enamel matrix proteins – used as an adjunct to periodontal surgery
summary
References ORBAN'S ORAL HISTOLOGY : S.N. BHASKAR.TENCATE’S ORAL HISTOLOGYHISTOLOGY (A TEXT AND ATLAS), MICHEAL H. ROSS, WOJCIEH PAWLINAHAM’S GENERAL HISTOLOGYGLICKMANN'S CLINICAL PERIODONTOLOGY : CARRANZA.BASIC HISTOLOGY TEXT AND ATLAS- LUIZ CARLOS JUNQUEIRA, JOSE CARNEIRO
ORAL STRUCTURAL BIOLOGY : H.E.SCHROEDER. . TEXT BOOK OF HISTOLOGY : ROSS & REITH.INTERNET ACCESS
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