Alveolar Process (Maxilla & Mandible) Bones of the skull developed by: 1.

Endochondral Ossification cartilage is replaced by bone bones of the base of the skull 2. Intramembranous Ossification Developed directly from membranous capsule (desmocranium) or in proximity to cartilaginous portion of the skull All bones of the upper face including maxilla and mandible Maxilla 1) Premaxilla- median nasal process 2) Maxilla Proper- palatine process of maxilla bone *intermaxillary suture or median palatine suture Mandible -develops lateral to meckels cartilage(cylindrical rod of cartilage that give rise to bones of ears namely malleus and incus) *mandibular symphysis Composition of Alveolar Bone -inorganic: hydroxyapatite 65% -organic: 35% *collagen 88- 89% *non-collagen 11-12% glycoproteins : 6.5-10%

Proteoglycans: 0.8% Sialoproteins-: 0.35% Lipids: .4 % Development of alveolar process 2nd month of fetal life - A groove that is open towards the surface of the oral cavity develops - -within the grove are the tooth germs - Dental sac Alveolar Process- only develop upon eruption of teeth and it diminishes in height after loss of teeth Alveolar Process -part of maxilla and mandible that forms and supports the sockets of the teeth 2 main parts of alveolar process 1. Alveolar bone proper 2. Supporting alveolar bone 1. Alveolar Bone Proper - Thin lamella of bone that surrounds the root of tooth and gives attachment to the principal fibers of periodontal ligament *Cribriform Plate-perforated with many openings (Volkmanns canal) that carry nerves and blood vessels to the periodontal ligament Parts of the alveolar bone a. Bundle bone

-part in which the bundles of principal fibers of periodontal ligaments are anchored to Sharpeys fibers -contain more calcium salts than other portion(lamina dura) b. lamellated bone -surrounds bundle bone and are arranged in parallel manner to marrow spaces -from haversian systems Supporting alveolar bone -surrounds the alveolar bone process Parts: a. Cortical plates - Thin in labial surface of anterior teeth (thinnest in mandibular anterior teeth) - Thicker in mandible than in maxillary bone(thickest in mandibular PM and Molar areas) b. Spongy bone -fills the area between the outer and inner alveolar plates -contains marrow spaces *level of crest alveolar bone from CEJ is 1-2mm *perforating canals of Zuckerkandl and Hirschfeld (nutrient canal) houses the interdental and interradicular arteries and veins, lymphatics and nerves Types of Spongiosa Type 1

-regular and horizontal ladder like arrangement -mandible Type II -irregularly arranged and numerous trabeculae -maxilla Physiologic changes in the bone -osteoblast(immature cells) -osteocyte (more mature) -osteoclast(defends cells; mature) Internal reconstruction of bone *bone of the mandible and maxilla are in constant tate of flux Bone deposition -all outer surfaces of the cortical plates -Thickening of lamellae from inside by haversian bone Bone resorption -outer surfaces Process in bone resorption 1. Decalcification 2. Degradation of matrix 3. Transport of degraded matrix to extracellular fluid or blood vascular system *Osteoclast resorb the canals closest to the surface -resorbed bone is replaced by proliferating loose connective tissue

*cutting cone/resorption tunnel - area of resorption *Reversal line- scalloped outline of howships lacuna that turn their convexity towards the old bone -between old bone and area of new born deposition/apposition *resting lines- cementing lines that correspond to a rest period in an otherwise continuous process of bone apposition Clinical considerations 1. The biologic plasticity of the bone enables the orthodontist to move the teeth without disrupting their relations to the alveolar bone 2. Increase in functional forces leads to formation of new bone and decrease function leads to decrease in bone volume 3. Immature or coarse fibrillar bone is formed in areas of fracture or extraction wounds *increased number of cells and decreased volume of calcified intercellular substance *2-3weeks before the bone is visible in x-ray 4. The progressive loss of alveolar bone in periodontal disease is difficult to control. Once loss, this bone is even more difficult to repair or regenerate 5. Synthetic materials may replaced bone tissue- ridge augmentation and filling of bony defect *nonresorbable hydroxyapatite *resorbable tricalcium phosphate 6. When teeth are loss, the alveolar process under goes gradual atrophy