Periodontology Anatomy - Alveolar bone

Marin Contemporary Perio & Implant Concepts

The alveolar process, which is also called the alveolar bone, is the thick ridge of bone which contains the tooth sockets. The alveolar bone is located on the jaw bones which hold the teeth. In humans, these bones that contain the teeth are the maxilla and the mandible. The curved portion of each alveolar process on the jaw is the alveolar arch.

Structure

On the maxilla, the alveolar process is a ridge located on the inferior surface. On the mandible, it is a ridge located on the superior surface. It comprises of the thickest part of the maxillae.

The alveolar process includes a region of compact bone that is adjacent to the periodontal ligament (PDL). This is called the lamina dura when it is viewed on radiographs. It is the lamina dura which is attached to the cementum from the roots by the periodontal ligament. It is uniformly lighter. The integrity of the lamina dura is critical when studying radiographs for pathological lesions.

The alveolar process also has a supporting bone, both of which have the same components and includes the following: fibers, cells, intercellular substances, nerves, blood vessels and lymphatics.

The alveolar process is the lining of the tooth’s socket and referred to as the alveolus. Although the alveolar process is made up of compact bone, it may also be called the cribriform plate as it contains various holes where Volkmann canals pass from the alveolar bone and into the PDL. The alveolar bone proper is also called the bundle bone because of the Sharpey fibers. A portion of the fibers of the PDL are inserted here. Similar to that of the cemental surface, Sharpey fibers located in the alveolar bone proper, are inserted at 90 degrees or at a right angle. They are also fewer in number, however, thicker in the diameter compared to those present in the cementum. Similar to the cellular cementum, Sharpey fibers are typically mineralized partially at their periphery.

The alveolar crest is the most cervical rim found in the alveolar bone proper. When it is healthy, the alveolar crest is slightly apical to the cementoenamel junction (CEJ) by about 1.5-2 mm. The alveolar crests of the adjacent teeth are also uniform in height along the jaw when they are healthy.

The supporting alveolar bone structure consists of both cortical and trabecular bone. The cortical bone, also known as cortical plates, consist of plates of compact bone found on the facial and lingual surfaces of the alveolar bone. These cortical plates are typically about 1.5-3 mm thick compared to the posterior teeth. However, the thickness varies drastically around the anterior teeth. The trabecular bone contains cancellous bone, which is located between the alveolar bone proper in addition to the plates of cortical bone. The alveolar bone is located between two neighboring teeth is the interdental septum.

Composition

Inorganic matrix

The alveolar bone is composed of 67% inorganic material based on its weight. The inorganic material is composed primarily of calcium and phosphate. The mineral content is mainly found in the form of calcium hydroxyapatite crystals.

Organic matrix

The remaining alveolar bone is made up of 33% organic material. The organic material consists of both collagen and non-collagenous materials. The cellular components of the bone consists of osteoblasts, osteocytes and osteoclasts.

Osteoblasts are usually cuboidal and slightly elongated in their shape. They synthesize both collagenous and non-collagenous bone proteins. These cells contain a high level of alkaline phosphatase on the outer surface of their plasma membrane. The functions of osteoblasts include the formation of bone by synthesizing the organic matrix of bone, cell to cell communication and maintenance of bone matrix.

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