Seminar

Alveolar
bone
Shashi Kant Chaudhary
JRII
Dept of Periodntology & Oral Implantology
 Content

Introduction
Development
Gross histology
Cellular components
Regulation of bone metabolism
Alveolar process
Alveolar bone modeling and remodeling
Conclusion
References
 Introduction

Bone is a complex organ composed of multiple specialized

tissues (osseous, periosteum/endosteum, and bone
marrow) that act synergistically and serve multiple
functions

Bone is a living tissue, which makes up the body skeleton

and is one of the hardest structures of the animal body.

A specialized connective tissue composed of organic and

inorganic elements that mineralizes
Classification
Based on shape :

Irregu
Long Short Flat lar
bones
Based on development

Endochondral
bones

Intramembranous
bones.
Based on microscopic structure

Mature Immatu
bone re bone.

compact
bone

cancellous
bone
 Development

During embryogenesis, the skeleton forms by

either a direct or indirect ossification process
Although histologically one bone is no different
from another, bone formation occurs by three
main mechanisms:
Intramembranous
Endochondral and
Sutural
Intramembranous bone
formation

Intramembranous bone formation occurs directly

within mesenchyme

Eg. mandible, maxilla, skull, clavicle

Mesenchymal progenitor cells condensate and

undergo direct differentiation into osteoblasts, a
process known as intramembranous osteogenesis.
1. Formation of bone matrix in
fibrous membrane

2. Formation of woven bone

3. Appositional growth mechanism

and formation of compact bone

4. Formation of osteon
ENDOCHONDRAL BONE FORMATION

The mandibular condyle, the long bones and

vertebrae form initially through a cartilage template,
which serves as an anlage that is gradually replaced
by bone.

The cartilagedependent bone formation and growth

process is known as endochondral osteogenesis
(Ranly 2000)
Sutural bone growth

Bone forms along suture margins

Found in skull
Fibrous joints between bones
Allow only limited movement
Helps skull and face to accommodate
growing organs like eyes and brain
COMPOSITION OF BONE

Bone is a connective tissue composed of cells,

fibers and ground substance.
 Inorganic components

The inorganic part is made of bone minerals

Hydrated calcium and phosphate in the form of
hydroxyapatite crystals [3Ca3(PO4)2(OH)2] are
the principal inorganic constituent
Ions present are calcium phosphate, hydroxyl and
carbonate.
Citrate, magnesium, sodium, potassium, fluoride,
iron, zinc, copper, aluminum, lead, strontium,
silicon and boron are present in small quantities
 Organic components

The organic matrix is known as osteoid

Made collagen(90%) and noncollagenous proteins
Type I collagen (> 95%) is the principal collagen,
type V collagen (< 5%)
Alveolar bone :- type I, type V, type III and type
XII collagen, (Type XII expressed under mechanical
strain)
Sharpeys fibers:- type III with type I collagen.
 Noncollagenous proteins

10% of the total organic content of bone matrix

Most are endogenous proteins produced by

bone cells, while some like albumin are derived
from other sources such as blood
Noncollagenous Proteins are
Osteocalcin
first noncollagenous protein to be recognized
(less than 15% of the noncollagenous bone
protein)
Also known as bone Gla protein as it contains
the amino acid -carboxy glutamic acid.
Is a glycoprotein secreted by osteoblasts and
regulated by vitamin D3 and parathyroid
hormone.
Carboxy terminal acts as a chemoattractant to
osteoclast precursors, suggesting a role in
bone resorption
Involved in bone calcification as it is a calcium
binding protein
Osteopontin & Bone
sialoprotein
Previously termed as bone sialoproteins I and
II
Heavily glycosylated and phosphorylated with
high levels of acidic amino acids.
Glutamic acid is predominant in bone
sialoprotein
Aspartate is predominant in osteopontin.
Bone sialoprotein-function in the initiation of
mineral crystal formation& transcription is
suppressed by vitamin D3
osteopontin is a potent inhibitor of
hydroxyapatite crystal growth & transcription is
strongly upregulated by vitamin D3,
TGF- family members and glucocorticoids-
stimulate expression of both protein
Osteonectin
25% of noncollagenous proteins
Bound to collagen and hydroxyapatite crystals
Secreted calcium binding glycoprotein,
that interacts with extracellular matrix
molecules.
May play a role in the regulation of cell
adhesion, proliferation and modulation of
cytokine activity, and in initiating
hydroxyapatite crystal formation.
Proteoglycans

A large chondroitin sulfate proteoglycan, two small

proteoglycans, biglycan and decorin (chondroitin
sulfate proteoglycan I and II respectively)
Decorin and biglycan comprise < 10% & decreases with
maturation of bone.

Biglycan

More prominent in developing bone and has been

mineralized to pericellular areas.
The precise function unknown, but similar to decorin, it can
bind TGF- and extracellular matrix macromolecules,
including collagen, and thereby regulate fibrillogenesis.

Decorin

Binds mainly within the gap region of collagen fibrils and

decorates the fibril surface.
Lysyl oxidase & tyrosine rich
acidic matrix proteins
(TRAMP)
Components of demineralized bone and
dentin matrix.
Regulate the cellular response to TGF-

Lysyl oxidase

A critical enzyme for collagen crosslinking.

TRAMP

Also known as dermatopontin, binds

decorin and TGF-,
 Matrix Gla protein and 2Hs
glycoproteins
Not secreted by osteoblasts but regulate
mineralization.
Matrix Gla protein is a mineral binding ECM protein
secreted by vascular smooth muscle cells and
chondrocytes that prevent mineralization in vascular
tissues and cartilage.
The absence of 2HS glycoprotein, which is produced
by the liver, compromises the inhibition of apatite
formation by serum.
Procollagen peptides, thrombospondin, fibronectin, vitronectin
and alkaline phosphatase are the other proteins found in bone.

Also contains proteases, protease inhibitors and a variety of

cytokines secreted by osteoblasts, that regulate cell
metabolism.

These cells secrete several members of bone morphogenetic

proteins (BMP) superfamily, including BMP-2, BMP-7,
TGF-, insulin like growth factors (IGF-I and IGF-II), platelet
derived growth factor (PDGF) and fibroblast growth factor
(FGF). IGF-I, PDGF and TGF- increase the rapidity of bone
formation and bone repair.
 BONE HISTOLOGY

All mature bones have a dense

outer sheet of compact bone and
a central medullary cavity

The cavity is filled with red or

yellow bone marrow

Cavity shows a network of bone

trabeculae. (Trabecular, spongy
or cancellous bone are the terms
used to describe this network)
 Compact bone

The outer aspect of compact bone is surrounded

by a condensed fibrocollagen layer, the
periosteum
Two layers:
An outer layer which is a dense, irregular
connective tissue termed fibrous layer

An inner osteogenic layer, next to the bone

surface consisting of bone cells, their
precursors and a rich vascular supply
 The inner surface of compact and
cancellous bone are covered by a
thin cellular layer called
endosteum.

Quiescent osteoblasts and

osteoprogenitor cells are present on
the endosteal surfaces.

Act as reservoir of new bone forming

cells for remodeling or repair
 Mature or adult bones, whether compact or
trabecular, are histologically identical in that
they consist of microscopic layers or lamellae

Three distinct types of layering are

recognized:

Circumferential Concentric Interstitial

 Circumferential lamellae

At the periosteal and endosteal

surfaces, the lamellae are
arranged in parallel layers
surrounding the bony surface and
are called circumferential
lamellae

Circumferential lamellae enclose

the entire adult bone, forming its
outer and inner perimeters
Concentric lamellae

Deep to the circumferential lamellae, the lamellae

are arranged as small concentric layers around a
central vascular canal.
Haversian (vascular) canal (about 50 in
diameter) and the concentric lamellae together is
known as the osteon or haversian system
Concentric lamellae make up the bulk of compact
bone and form the basic metabolic unit of bone, the
osteon
up to 20 concentric lamellae within each osteon
 The osteon is a cylinder of
bone, generally oriented
parallel to the long axis of
the bone.

Adjacent haversian canals

are interconnected by
Volkmann canals; these
channels, like haversian
canals, contain blood
vessels, thus creating a rich
vascular network throughout
compact bone
 Interstitial lamellae

Interspersed between adjacent

concentric lamellae and fill the
spaces between them

Are actually fragments of

preexisting concentric lamellae
from osteons created during
remodeling that can take a
multitude of shapes
 Spongy bone

Spongy bone and compact bone have the same

cells and intercellular matrix, but differ in the
arrangement of components.
Looks like a poorly organized tissue
Consists of large slender spicules called
trabeculae. (up to 50 m thick)
The trabeculae are oriented along lines of stress to
withstand the forces applied to bone
The trabeculae surround the marrow spaces from
where they derive their nutrition through diffusion
 Bone marrow

The bone marrow consists of hematopoietic tissue

islands, stromal cells, and adipose cells
surrounded by vascular sinuses interspersed
within a meshwork of trabecular bone
Two Types
Red marrow:- consists mainly of hematopoetic tissue
Yellow marrow:-mainly made up of adipocytes.
At birth, all bone marrow is red with age it is
converted to the yellow type
Bone cells

Two cell lineages are present in bone, each with

specific functions:

Osteogenic
Osteoclasts
cells
Osteoprogenitors
Preosteoblasts
Osteoblasts
Osteocytes
Bone lining cells
 Osteoprogenitor cells

They are long, thin stem cell population

Derived from mesenchyme
Unspecialized stem cells
Undergo mitosis and develop into osteoblasts
Found on inner surface of periosteum and
endosteum
 Osteoblast

Mononucleated cells, basophilic, plump cuboidal or

slightly flattened cells
Found on surfaces of growing or remodeling bone
Abundant and well developed protein synthetic
organelles (rough endoplasmic reticulum)
Are fully differentiated cells and lack the capacity
for migration and proliferation
Produce the organic matrix of bone (Osteoid)
 Formation
Derived from undifferentiated pluripotent mesenchymal stem cells

Divided into Inducible

Determined osteogenic precursor two types osteogenic precursor cells
cells (DOPCs) and (IOPCs)

DOPCs are present in the bone marrow, endosteum and periosteum and
differentiate into osteoblasts

The IOPCs represent mesenchymal cells present in other organs and tissues
that may differentiate into bone forming cells when stimulated

Mesenchymal progenitor cells, driven by the expression of a gene known as

Indian hedgehog (Ihh)

Osteoprogenitor cells express transcription factors cbfa1/Runx-2 and

osterix which are essential for osteoblast differentiation
 Functions
Formation of new bone

Regulation of bone remodeling and mineral metabolism

Mineralization of osteoid

Secrete small amounts of type V collagen, osteonectin,

osteopontin, RANKL, osteoprotegerin, proteoglycans, latent
proteases and growth factors including BMPs

Exhibit high levels of alkaline phosphatase used as a

cytochemical marker to distinguish preosteoblasts from
fibroblasts

Express receptors for hormones involved in the regulation of

osteoblast differentiation
Fate of osteoblasts

At the end of bone forming phase, osteoblasts can

have one of four different fates
1. Become embedded in the bone as osteocytes
2. Transform into inactive osteoblasts and become
bone lining cells
3. Undergo apoptosis
4. Transdifferentiate into cells that deposit
chondroid or chondroid bone.
 Bone lining cells

Once osteoblasts have completed their function,

they are either entrapped in the bone matrix and
become osteocytes or remain on the surface as
lining cells
These cells cover most, but not all quiescent bone
surfaces in the adult skeleton.
Together with osteocytes, bone forming cells and
their connecting cell processes appear to form an
extensive homeostatic network of cells capable of
regulating plasma calcium concentration.
 Osteocytes

As osteoblasts form bone, some become trapped in

the matrix they secrete, whether mineralized or
unmineralized; these cells then are called
osteocytes
The number of osteoblasts that become osteocytes
varies depending on the rapidity of bone formation;
Embryonic (woven) bone and repair bone have
more osteocytes than does lamellar bone
Osteocytes are stellateshaped cells that are
embedded within the mineralized bone matrix in
spaces known as osteoctic lacunae
 Osteocyte cytoplasmic projections (known as
dendrites)extend through cylindrical encased
compartments referred as canaliculi
Osteocytes maintain contact with adjacent
osteocytes, osteoblasts or lining cells on the bone
surfaces
The osteocyte network is therefore an extracellular
and intracellular communication channel that is
sensitive to shear stress as the result of mechanical
stimuli and bone deformation
 Osteocytes translate mechanical signals into
biochemical mediators that will assist with the
orchestration of anabolic and catabolic events within
bone
Canalicularlacunar system arrangement allows
osteocytes to
1. Participate in the regulation of blood calcium
homeostasis and
2. Sense mechanical loading and transmit this
information to other cells within the bone to further
orchestrate osteoblast and osteoclast function
(Burger et al. 1995; Marotti 2000).
 Failure of any part of this interconnecting system
results in hypermineralization (sclerosis) and death
of the bone.
Later may be resorbed and replaced during the
process of bone turnover
Four schemes have been proposed to explain how an osteoblast
could get trapped within bone matrix

Osteoblasts are unpolarized and lay down bone in

all directions, i.e. the cells become trapped in
their own secretions.

Individual osteoblasts are polarized, but those within

same generation are polarized differently to those in
adjacent layers. As a result, bone is deposited in all
directions &osteoblasts become trapped.

Osteoblasts of each generation are polarized in

the same direction. One generation buries the
preceding one in bone matrix.

Within one generation, some osteoblasts slow

down rate of bone deposition or stop laying down
bone, so that they become trapped by the
secretion of their neighboring cells.
 Osteoclast

Greek words for bone and broken.

Specialized multinucleated cells(approx 40100
m in diameter with 15 to 20 nuclei)
Lie in resorption bays called Howships lacunae
Variable in shape due to their motility
Tartrate resistant acid phosphatase within its
cytoplasmic vesicles and vacuoles which
distinguishes it from multinucleated giant cells.
Adjacent to the tissue surface cell membrane of
the osteoclast form ruffled border
 At the periphery of this border, the plasma
membrane is apposed closely to the bone surface,
and the adjacent cytoplasm, devoid of cell
organelles, is enriched in actin, vinculin, and talin
This is clear or sealing zone
 Formation of osteoclast

Derived from hemopoietic cells of monocyte

macrophage lineage.
The differentiation into osteoclasts - involving cell
cell interaction with osteoblast stromal cells
Formation of osteoclast requires the presence of
RANK ligand (receptor activator of nuclear
factor B) and M-CSF (macrophage colony
stimulating factor).- produced by stromal cells
and osteoblasts direct contact of these cells and
osteoclast precursors.
 M-CSF act on receptor on osteoclast precursors c-
Fms (colony stimulating factor 1 receptor) and
provides signals for proliferation
RANKL binds to RANK on surface of M-CSF
triggered osteoclast precursors into multinucleated
giant cells, their differentiation into mature
osteoclasts, their attachment to bone surface and
their activation to resorb bone.
 Osteoprotegerin (OPG) recognizes RANKL, and
blocks the interaction between RANK and RANKL,
leading to an inhibition of osteoclast differentiation
and activation
Cbfa1 contributes to the expression of OPG
Regulation of osteoblast

Role of parathormone (PTH)

PTH is secreted in response to a hypocalcemic signal in

order to regulate calcium homeostasis by promoting bone
resorption,

Vitamin D3

Stimulates synthesis of osteocalcin and osteopontin by

osteoblasts and suppresses collagen production
Bone resorption at high concentrations (pharmacological)
and support bone formation at low (physiologic)
concentrations.

Growth hormone

Required for attaining normal bone mass mediated by IGF-

Insulin

Targets osteoblast & stimulates bone formation &

mineralization
Bone morphogenetic proteins

A subgroup of the TGF- superfamily.

Initiate osteoblastogenesis from uncommitted progenitor cells.
BMPs 2, 4 and 6 direct the pluripotent cells to commit to an
osteoblastic pathway

Glucocorticoids

Promote differentiation of osteoblasts & bone matrix

formation
Prolonged treatment with glucocorticoids results in bone loss
PDGF (platelet derived growth factor)

Promoting osteogenesis.
It acts as a potent mitogen for all cells of mesenchymal origin
TGF-

Early stage to recruit & stimulate osteoprogenitor

cells to proliferate, providing a pool of early
osteoblasts
Later stages of osteoblast blocks differentiation and
mineralization.
IGF I and II (insulin like growth
factors)
Increase proliferation and stimulating mature
osteoblast function

FGF (fibroblast growth factors)

Play a critical role in angiogenesis and mesenchymal

cell mitogenesis FGF-2 is expressed by osteoblasts-
bone formation
 Regulation of osteoclast

Estrogen

Suppresses the production of bone resorbing cytokines including IL-1 &

IL-6
Estrogen deficiency results bone resorption by increasing osteoclast
activity
Vitamin D3 and parathyroid hormone (PTH)

Vitamin D3 promotes the differentiation of osteoclasts from monocyte

macrophage stem cell precursors - enhanced osteoclastic bone
resorption
PTH binds to osteoblasts and induces the production of M-CSF and
RANKL-- stimulate the maturation and action of osteoclasts.
Calcitonin

Inhibits proliferation and differentiation of osteoclast precursors.

Reduces the dimension of ruffled border & dissociation into monocytic
cells.
Bisphosphonates

Suppress bone resorption via injury to osteoclasts when they

solubilize bisphosphonate contaminated bone without consistent
reduction in osteoclast numbers

PGE2 (Prostaglandins of E series)

Mediators of bone resorption and can also influence bone formation

Induce osteoclast formation through increased expression of RANKL
on the surface of immature osteoblasts and stromal cells

TNF

Stimulates differentiation of osteoclast progenitors into osteoclasts

OCIL (osteoclast inhibitory lectin)

An inhibitor of osteoclast formation

TGF- and interferon-

Inhibit proliferation and differentiation of committed precursors into

mature osteoclasts.
Structural lines in bones

Reversal The site of change from bone

resorption to bone formation is
line or represented by a scalloped
outline
cementing Rich in sialoproteiin &
line osteopontin

Resting Rythmic deposition of bone with

periods of relative quiescence
line seen as parallel vertical lines
 ALVEOLAR BONE

The alveolar process is defined as that part of the

maxilla and the mandible that forms and supports the
sockets of the teeth. Orbans

The alveolar bone is constituted strictly of the

ALVEOLAR PROCESS which is firmly attached to the
basal bone of the jaws Tencate

The alveolar process is the portion of the maxilla and

mandible that forms and supports the tooth sockets
(alveoli). Carranza
 Functions of alveolar
bone

Houses the roots of teeth

Anchors the roots of teeth to the alveoli, achieved by
the insertion of Sharpeys fibers into the alveolar
bone proper.
Helps to move the teeth for better occlusion
Helps to absorb & distribute occlusal forces
Supplies vessels to periodontal ligament.
Houses & protects developing permanent teeth, while
supporting primary teeth.
Organizes eruption of primary and permanent teeth.
DEVELOPMENT OF ALVEOLAR
PROCESS

At the end of 2nd month of fetal

life, the maxilla as well as
mandible forms a groove that
open to surface of oral cavity
Tooth germs contained in these
groove (alveolar vessels & nerve)
Alveolar process consists of bone
which is formed both by cells from
the dental follicle (alveolar bone
proper) & cells which are
independent of tooth development
Alveolar process develops from the dental follicle during eruption of tooth
size of the alveolus is dependent upon the size of the growing tooth
germ.

Resorption - inner wall of the alveolus/ Deposition -outer wall.

The developing teeth lie in a trough of bone -Tooth Crypt.

Teeth separated from each other by the development of interdental

septa.

With the onset of root formation - interradicular bone develops in

multirooted teeth.

When a deciduous tooth is shed, its alveolar bone is resorbed. Alveolar

process gradually incorporated into maxillary or mandibular body.

Permanent tooth moves into place, developing its own alveolar bone from
its own follicle
STRUCTURE OF THE ALVEOLAR
BONE

Anatomically, no distinct boundary

exists between the body of the
maxilla or the mandible and
alveolar processes.
As a result of its adaptation to
function, two parts of the alveolar
process can be distinguished,
The alveolar bone proper and
The supporting alveolar bone
 Cortical plate

Supporting
alveolar bone

Alveolar bone Spongy bone

Alveolar bone
proper
 Alveolar bone proper

Consists partly of lamellated & partly of bundle

bone

About 0.10.4 mm thick.

Surrounds the root of the tooth and gives

attachment to principal fibers of the periodontal
ligament
 Lamellated bone

Contains osteons each of which has a

blood Vessel in a haversian canal.
Blood vessel is surrounded by
concentric Lamellae to form osteon.
Some lamellae of the lamellated Bone
are arranged roughly parallel to the
surface of the Adjacent marrow
spaces, whereas others form
haversian systems.
 Bundle bone

Bone in which the principal fibers of the

periodontal ligament are anchored
The term bundle because, the bundles of the
principal fibers continue into the bone as
Sharpeys fibers
Characterized by the scarcity of the fibrils in the
intercellular substance and arranged at right
angles to Sharpeys fibers
Contains fewer fibrils than does lamellated bone
 Sharpeys fibers are
mineralized at the periphery
and have a larger diameter.

These fibers are less

numerous than the
corresponding fiber bundles
in the cementum
 Radiographically, it is also
referred to as the lamina dura,
because, of increased
radiopacity, which is due to the
presence of thick bone without
trabeculations
 The alveolar bone proper, which forms the inner
wall of the socket is perforated by many openings
that carry branches of the interalveolar nerves
and blood vessels into the periodontal ligament,
and it is therefore called the cribriform plate
 Bone between the teeth is called interdental
septum
Composed entirely of cribriform plate.
The interdental and interradicular septa contain the
perforating canals of Zuckerkandl and Hirschfeld
(nutrient canals) which house the interdental and
interradicular arteries, veins, lymph vessels and
nerves
 Supporting alveolar bone

Consists of
two parts

Cortica Spongy
l plates bone
 Cortical plates

Consist of compact bone and form the outer and

inner plates of the alveolar processes
Continuous with the compact layers of the
maxillary and mandibular body
Thinner in the maxilla, than in the mandible
Thickest in the premolar and molar region on
buccal side of the lower jaw
The supporting bone usually very thin in anterior
teeth region of both jaws no spongy bone
 Histologically, the cortical plates consist of
longitudinal lamellae and haversian systems.
In the lower jaw, circumferential or basic lamellae
reach from the body of the mandible into the
cortical plates
 Spongy bone

Spongy bone fills the area between the cortical

plates and the alveolar bone proper
Contains trabeculae of lamellar bone- surrounded
by marrow that is rich in adipocytes and
pluripotent mesenchymal cells
The trabeculae contain osteocytes in the interior
and osteoblasts or osteoclasts on the surface
Trabeculae buttress the functional forces to which
alveolar bone proper is exposed
Classification of the spongiosa
(radiographically )

Type I the interdental and

interradicular trabeculae are regular
and horizontal in a ladder like
arrangement - most often in the
mandible

Type II shows irregularly arranged,

numerous, delicate interdental and
interradicular trabeculae more
common in the maxilla
 lnterdental Septum

The interdental septum consists of

cancellous bone and cortical plates

If the interdental space is narrow,

the septum may consist of only
lamina dura (between mandibular
2ndpremolars and 1stmolars
consists of only lamina dura in 15%
cases)

If roots are too close together, an

irregular "window" can appear in the
bone between adjacent roots
 The mesiodistal angulation of
the crest of the interdental
septum usually parallels a line
drawn between the cemento-
enamel junctions of the
approximating teeth

The distance between the crest

of the alveolar bone and the
CEJ in young adults varies
between 0.75 and 1.49 mm
(average, 1.08 mm)

This distance increases with

age to an average of 2.81 mm
Osseous topography

Normally conforms to the

prominence of the roots

The height and thickness of

the facial and lingual bony
plates are affected by the
alignment of the teeth, by the
angulation of the root to the
bone, and by occlusal forces
Fenestrations and Dehiscences

Isolated areas in which the root is denuded of bone

and the root surface is covered only by periosteum
and overlying gingiva are termed as fenestrations
In these instances the marginal bone is intact
When the denuded areas extend through the
marginal bone, the defect is called a dehiscence
Fenestration and dehiscence are important, because
they may complicate the outcome of periodontal
surgery.
dehiscence fenestration
 They occur more often on the facial bone than
on the lingual, are more common on anterior
teeth than on posterior teeth, and are frequently
bilateral.
Prominent root contours, malposition, and labial
protrusion of the root combined with a thin bony
plate are predisposing factors.(Elliot
JR,Bowers GM)
 Bone formation

The osteo progenitor cells express transcription

factors cbfa1/Runx2. cbfa1(osteoblast specific
transcription factors) Osterix and b- catenin
(maturation)
Osteoblast contains high level of alkaline
phosphatase-liberated phosphate - initiation and
progressive growth of bone mineral crystals
Cytoplasm is intensely basophilic, abundant and
well developed protein synthetic organelles such
as rough endoplasmic reticulum
 Procollagen and other organic proteins
synthesized and transported to golgi complex by
transfer vesicle
Golgi complex form secretory vesicles and secret
extracellularly along the bone forming surface to
form osteoid(prebone)
Osteoblasts produces Collagen type I, collagen
type V and non collagenous protein such as bone
sialoprotein and osteopontin- where they
participate in regulating mineral deposition
BONE RESORPTION
Sequence of events in resorptive
process

Attachment of osteoclasts to mineralized surface of bone

Creation of a sealed acidic environment through action of the proton

pump which demineralizes bone and expose organic matrix

Degradation of the exposed organic matrix to its constituents amino

acids by action of released enzymes such as acid phosphatase and
cathepsin

Sequestering of mineral ions and amino acids within the osteoclast

Ten Cate AR
 Role of TRAP in bone
resorption( tartarate resistant acid
phosphatase)

latent inactive proenzyme-cysteine proteinases

convert it into an active form
Extracellular role:
Regulate osteoclast adhesion to the bone
Degrades the phosphoprotein- degradation of the
bone matrix
Liberate pyrophosphate (inhibitor)osteoclast
migration
Intracellular role:
Endocytosed vesicle & TRAP containing vesicle
 Extra cellular fate:
TRAP taken up into circulation from interstitial
space
Bind with 2 macroglobulin
Loses binuclear iron centre and recycled
Free enzymes metabolized in liver & excreted
through urine
Various bone resorbing
factors

A. Systemic factors:
(a) Parathyroid hormone
(b) Parathyroid related peptide
(c) Vitamin D3
(d) Thyroid hormone
C. Growth factors:
B. Local factors: (a) EGF

(a) Prostanoids (b) TGF

(c) TGF

(b) Lipoxygenase metabolites (d) PDGF

(c) Cytokines: IL 1, IL 4, TNF
, TNF , IL 6
D. Bacterial factors:
(a) Lipopolysaccharides
(b) Capsular material
(c) Peptidoglycans
(d) Lipoteichoic acids.
 Bone modeling

Bone modeling is defined as a change in the shape

and architecture of the bone
It extends from embryonic bone development to
the pre-adult period of human growth, which is
continuous and covers a large surface
The ability of bone to adapt to mechanical loads is
brought about by continuous bone resorption and
bone formation
If these processes occur at different locations, the
bone morphology is altered, Frost defined this as
modeling (Frost, 1990a)
 Bone remodeling

Bone remodeling is defined as a change without

concomitant change in the shape and architecture of
the bone
In a homeostatic equilibrium resorption and
formation are balanced In that case old bone is
continuously replaced by new tissue
This ensures that the mechanical integrity of the
bone is maintained but it causes no global changes
in morphology, Frost defined this as remodeling
(Frost, 1990b)
 In a healthy individual, this turnover is in a steady
state; that is, the amount of bone lost is balanced
by bone formed.
Remodeling occurs in discrete, focal areas
involving groups of cells called bone remodeling
or basic multicellular units.
The bone remodeling
cycle

Activation

Resting Resorption

Formation Reversal
 As osteoclasts move through compact bone, they
create a resorption channel. The leading edge of
resorption is termed the cutting cone and is
characterized by a scalloped array of resorption
lacunae (Howships lacunae), each housing an
osteoclast
Behind the cutting cone is a migration of
mononucleated cells (macrophages and/or
preosteoblasts) differentiate into osteoblasts, The
entire area of the osteon where active bone formation
occurs is termed the filling cone
When formation is complete, the haversian canal
contains a central blood vessel and a layer of inactive
osteoblasts, the lining cells that communicate by
means of cell processes with the embedded
osteocytes.
 Remodeling of alveolar bone

Major pathway of bony changes in shape,

resistance to forces, repair of wounds and calcium-
phosphate homeostasis

Involves the co-ordination of activities of cells from

two distinct lineages, the osteoblasts and the
osteoclasts

A complex process involving hormone and local

factors acting in autocrine and paracrine manner
on generation and activity of differentiated bone
cells
 Coupling

It is interdependency of osteoblasts and osteoclasts

in remodeling of the bone.Releases osteogenic substrates
Multinucleated
Parathyroid OSTEOCLASTS Bound to collagen
hormone
(Resorb bone)

Stimulates Migrates into bone and coalasces Stimulates differentiation of

OSTEOBLASTS
OSTEOBLASTS Monocytes
(Deposits bone)

Release Stimulates
Releases
Interleukin 1 and leukemia
6 inhibiting factor
(LIF)
 Age changes

Inolder individuals:
Alveolar sockets appear jagged and uneven.
The marrow spaces have fatty infiltration
The alveolar process in edentulous jaws decreases in size.
Loss of maxillary bone is accompanied by increase in size
of the maxillary sinus.
Internal trabecular arrangement is more open, which
indicates bone loss.
The distance between the crest of the alveolar bone and
CEJ increases with ageapproximately by 2.81 mm.
 Conclusion

Bone is a mineralized connective tissue with a

relatively flexible character and compressive
strength
The property of plasticity allows it to be remodeled
according to the functional demands placed on it.
In order to maintain stability and integrity of bone,
it constantly undergoes remodeling.
About 10% of bone material is renewed each year.
This process is brought about by osteoclasts and
osteoblasts.
References

Newman ,Takei , Klokkevold , Carranza ; Carranza's Clinical

Periodontology ,10thedition,
Newman ,Takei , Klokkevold , Carranza; Carranza's Clinical
Periodontology , 12th Edition.
Niklaus P. Lang , Jan Lindhe , Clinical Periodontology And
Implant Dentistry ,6thedition
Orban's Oral Histology And Embryology , 13th Edition ,
Antonio Nancy, Ten Cate Oral Histology Development ,
Structure And Function , 8th edition
Thank you