1. Alveolar bone forms the sockets that house the roots of teeth and anchors them in place. It is composed of living cells embedded in a mineralized matrix.
2. Osteoblasts lay down and mineralize the organic bone matrix to form osteoid. Some osteoblasts become trapped in the bone matrix and transform into osteocytes.
3. Osteoclasts are large multinucleated cells that resorb bone tissue. They are formed from precursor cells under the influence of RANKL and M-CSF secreted by osteoblasts. RANKL binds to RANK on osteoclast precursors and promotes their differentiation.
Definition of periodontal pocket, classification, Histopathology of periodontal pocket, microflora involved, pathogenesis, periodontal pocket as a healing lesion, microtopography of root surface, treatment of periodontal pocket
Periodontal pockets can form when the gingival sulcus deepens through movement of the gingival margin or displacement of the gingival attachment. Pockets are classified based on their morphology, relationship to crestal bone, number of tooth surfaces involved, and nature of the soft tissue wall. The pathogenesis of pockets involves inflammatory changes that lead to degradation of collagen fibers and destruction of connective tissue and bone. Clinically, pockets present with signs like bleeding and suppuration. Microscopic examination reveals areas of bacterial accumulation, leukocyte emergence and interaction, and epithelial desquamation. Pockets contain debris, microorganisms, and inflammatory products. Probing is used to detect and measure pocket depth.
This document provides an overview of guided tissue regeneration (GTR). It begins with definitions of periodontal regeneration and GTR. It then discusses the history and development of GTR from the 1970s onwards. The core concept of GTR is explained, which is based on Melcher's hypothesis that only periodontal ligament cells can regenerate the periodontal attachment apparatus. Indications, contraindications, design criteria and objectives of GTR barriers are covered. The document classifies and compares advantages and disadvantages of absorbable versus non-absorbable membranes. Key factors affecting GTR outcomes are discussed. Surgical techniques and the healing of GTR-treated defects are described. The document concludes with additional considerations like complications and the
This document discusses various surgical techniques for preserving the interdental papilla during periodontal regeneration procedures. It describes the conventional papilla preservation flap technique introduced by Takei in 1985, as well as several modifications including the modified papilla preservation flap, simplified papilla preservation flap, interproximal tissue maintenance technique, and whale's tail technique. The advantages and disadvantages of each technique are summarized. A novel entire papilla preservation technique introduced in 2015 is also outlined, which aims to completely preserve the interdental papilla.
Width of attached gingiva and its significance Hudson Jonathan
This document discusses the width of attached gingiva and its significance. It begins by defining the different parts of the gingiva and describing the microscopic and macroscopic features of attached gingiva. It then discusses the normal width of attached gingiva in different regions of the mouth, how it is measured, and what constitutes an inadequate width. The document also covers the indications for increasing the width of attached gingiva, its significance around implants, and methods for measuring and augmenting the width.
This document provides an overview of cementum, the mineralized tissue that covers tooth roots. It defines cementum and discusses its development, physical and chemical characteristics, classification, cells, functions, and involvement in periodontal disease. Cementum is composed of collagen fibers embedded in mineralized matrix. It provides attachment for periodontal ligament fibers and aids in tooth function and repair. The document also examines cementum at the microscopic level and various proteins and cells involved in its formation and remodeling.
Definition of periodontal pocket, classification, Histopathology of periodontal pocket, microflora involved, pathogenesis, periodontal pocket as a healing lesion, microtopography of root surface, treatment of periodontal pocket
Periodontal pockets can form when the gingival sulcus deepens through movement of the gingival margin or displacement of the gingival attachment. Pockets are classified based on their morphology, relationship to crestal bone, number of tooth surfaces involved, and nature of the soft tissue wall. The pathogenesis of pockets involves inflammatory changes that lead to degradation of collagen fibers and destruction of connective tissue and bone. Clinically, pockets present with signs like bleeding and suppuration. Microscopic examination reveals areas of bacterial accumulation, leukocyte emergence and interaction, and epithelial desquamation. Pockets contain debris, microorganisms, and inflammatory products. Probing is used to detect and measure pocket depth.
This document provides an overview of guided tissue regeneration (GTR). It begins with definitions of periodontal regeneration and GTR. It then discusses the history and development of GTR from the 1970s onwards. The core concept of GTR is explained, which is based on Melcher's hypothesis that only periodontal ligament cells can regenerate the periodontal attachment apparatus. Indications, contraindications, design criteria and objectives of GTR barriers are covered. The document classifies and compares advantages and disadvantages of absorbable versus non-absorbable membranes. Key factors affecting GTR outcomes are discussed. Surgical techniques and the healing of GTR-treated defects are described. The document concludes with additional considerations like complications and the
This document discusses various surgical techniques for preserving the interdental papilla during periodontal regeneration procedures. It describes the conventional papilla preservation flap technique introduced by Takei in 1985, as well as several modifications including the modified papilla preservation flap, simplified papilla preservation flap, interproximal tissue maintenance technique, and whale's tail technique. The advantages and disadvantages of each technique are summarized. A novel entire papilla preservation technique introduced in 2015 is also outlined, which aims to completely preserve the interdental papilla.
Width of attached gingiva and its significance Hudson Jonathan
This document discusses the width of attached gingiva and its significance. It begins by defining the different parts of the gingiva and describing the microscopic and macroscopic features of attached gingiva. It then discusses the normal width of attached gingiva in different regions of the mouth, how it is measured, and what constitutes an inadequate width. The document also covers the indications for increasing the width of attached gingiva, its significance around implants, and methods for measuring and augmenting the width.
This document provides an overview of cementum, the mineralized tissue that covers tooth roots. It defines cementum and discusses its development, physical and chemical characteristics, classification, cells, functions, and involvement in periodontal disease. Cementum is composed of collagen fibers embedded in mineralized matrix. It provides attachment for periodontal ligament fibers and aids in tooth function and repair. The document also examines cementum at the microscopic level and various proteins and cells involved in its formation and remodeling.
This document discusses root surface biomodification for periodontitis treatment. It begins with an introduction to root surface changes from periodontitis, including structural, chemical, and cytotoxic changes. It then discusses the historical background of root biomodification and defines important terms. The document outlines various methods of root biomodification, including mechanical, chemical, and physical approaches. It provides details on specific chemical agents used like citric acid and their proposed mechanisms of action in facilitating periodontal regeneration.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
The document discusses the biologic width, which refers to the dimensions of the soft tissue attached to the tooth coronal to the alveolar bone crest. It consists of the junctional epithelium, connective tissue attachment, and the sulcular depth, totaling approximately 2-3 mm. Violation of the biologic width by placing restorative margins too far subgingivally can lead to bone resorption, gingival recession, or hyperplasia. The document outlines techniques for assessing biologic width dimensions and various surgical or orthodontic procedures to correct violations. Maintaining at least 3 mm of distance from the restorative margin to alveolar bone is important for periodontal health.
Periodontitis is a chronic infectious inflammatory disease caused by microbes; however the presence of microbes is not enough for the cause of its complex nature of disease. Inflammation is the prime cause of periodontal disease. It commences with the aggregation of pathogenic microbes that induce the host to stimulate a cascade of inflammatory response reactions which in-turn leads to the destruction of the host tissues itself. There is a complex interplay of innate and adaptive immune responses which fights against the pathogens by direct interaction or by release of certain molecules including cytokines.
Cytokines are cell signalling molecules that aid cell to cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. Cytokine biology reveals that there are some subsets of cytokines which are pro-inflammatory cytokines which stimulate the inflammatory responses and cause tissue destruction.
A periodontist is expected to have a sound basis of the cytokine profile to understand the pathogenesis of periodontitis and also to discover the new treatment modality of anti-cytokine therapy.
Alveolar bone forms tooth sockets and provides attachment for the periodontal ligament. It is composed of outer cortical and inner cancellous bone. Osteoblasts form bone matrix containing collagen fibers and hydroxyapatite crystals. Osteoclasts resorb bone. Bone is remodeled through the balanced actions of osteoblasts and osteoclasts, regulated by hormones and growth factors.
The document summarizes key aspects of alveolar bone anatomy and physiology:
1. The alveolar process forms tooth sockets and provides osseous attachment to the periodontal ligament. It is made up of cortical plates and cancellous bone containing osteons and lamellae.
2. Alveolar bone remodeling is regulated by hormones like PTH and involves balanced bone resorption by osteoclasts and formation by osteoblasts.
3. The alveolar bone proper surrounds tooth roots and gives attachment to periodontal fibers, while supporting bone surrounds it. Disorders like fenestrations and dehiscences can result in root surface denudation.
This document provides an overview of pathologic tooth migration (PTM). It defines PTM as tooth displacement resulting from a disruption of forces that maintain normal tooth position due to periodontal disease. The document discusses several potential etiologic factors for PTM, including the destruction of periodontal tissues, occlusal factors, soft tissue pressures, periodontal inflammation, extrusive forces, habits, missing teeth, and malocclusions. It provides examples from studies on the role of bone loss, bite collapse, arch integrity, occlusal interferences, and oral habits in contributing to PTM. The document concludes by noting that the duration of forces is important in tooth movement.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
This document discusses the anatomy, measurement, and clinical significance of the attached gingiva. It notes that the attached gingiva extends from the base of the gingival sulcus to the mucogingival junction. The normal width is 3-4.5mm in the maxillary anterior region but narrower in other areas. Inadequate width can facilitate subgingival plaque formation. Methods to measure width and increase width through surgery are described. The importance of keratinized, attached tissue for resisting mechanical irritation and stabilizing the gingival margin is emphasized.
Periodontal medicine is the study of the relationship between periodontal health and systemic health. Periodontal disease can influence systemic health through direct effects of bacteria or indirect host-mediated inflammatory responses. Periodontitis has been linked to increased risk of cardiovascular disease, diabetes, and preterm low birth weight. Treatment of periodontal infection may help improve glycemic control in diabetic patients and reduce systemic inflammation.
The document discusses the effects of hormones from various endocrine glands on the periodontium. It describes how hormones from the hypothalamus and pituitary gland regulate other endocrine glands. It then examines the specific effects of hormones from the adrenal, thyroid, parathyroid, gonads and pancreas on periodontal tissues and the mechanisms by which they may influence periodontal health and disease. It also discusses how gender, age and hormone supplements can impact the effects of sex hormones on the periodontium.
This document provides an overview of gingival epithelium, including its microscopic features, structural characteristics, defense mechanisms, and renewal process. It defines gingiva as the part of oral mucosa that covers the alveolar process and surrounds tooth necks. Gingiva consists of three types: marginal, attached, and interdental gingiva. The gingival epithelium contains keratinocytes and melanocytes. Keratinocytes form the bulk of the epithelium and undergo continuous renewal, while melanocytes transfer melanin to keratinocytes. The degree of keratinization varies between oral mucosal sites.
This document discusses the development of the periodontium, which includes the cementum, periodontal ligament, alveolar bone, and gingiva. It describes how the tooth germ develops from the enamel organ and dental papilla through stages of growth. Root formation is induced by Hertwig's epithelial root sheath, which regulates the development of cementum, periodontal ligament, and alveolar bone through cellular differentiation and protein signaling. The periodontium develops through reciprocal interactions between the enamel organ and dental follicle mesenchyme.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
The document defines a periodontal pocket as a pathological deepening of the gingival sulcus bounded by the tooth surface and soft tissue wall. Pockets are classified as supracrestal or infrabony and simple, compound, or complex. Supracrestal pockets have a coronal base while infrabony pockets have an apical base below the alveolar crest. Histopathology shows the soft tissue wall is edematous and infiltrated with plasma cells, lymphocytes, and PMNs. Bacteria can invade the epithelium and connective tissue. Clinical features include red, swollen gingiva while histology reveals increased vascularity and thinning/degeneration of the epithelium. Pocket depth does not
Pathologic tooth migration (PTM) refers to tooth displacement resulting from a disturbance in factors that maintain normal tooth position. PTM is common in periodontal patients, with prevalence studies finding rates of 30-55%. The primary factor in PTM is periodontal bone loss resulting from periodontal disease. Other factors include occlusal changes from tooth loss, soft tissue pressures, oral habits, and periapical or gingival inflammation. Treatment involves periodontal therapy, sometimes with adjunctive orthodontics or prosthodontics, while prevention focuses on periodontal disease control and management of predisposing occlusal and habit factors.
This document discusses local drug delivery (LDD) for the treatment of periodontal disease. It begins with an introduction to LDD and its advantages over systemic antibiotics. It describes the goal of LDD as achieving therapeutic drug levels in the periodontal pocket for effective treatment. The document discusses various LDD methods including non-sustained and sustained release delivery systems. It covers indications, contraindications, advantages and disadvantages of LDD. Various classifications of LDD systems and commonly used drugs are also summarized.
Basic to recent advances in local drug delivery also covering the effects of GCF flow on local drugs as well as use of local drugs used in periimplantitis.
INTRODUCTION
DEFINITION
TYPES OF TRAUMA FROM OCCLUSION
GLICKMAN CONCEPT
WAERHAUG CONCEPT
STAGES OF TISSUE RESPONSE TO INJURY
CLINICAL AND RADIOGRAPHIC FEATURES OF TFO
CLINICAL DIAGNOSIS OF TFO
TFO AND IMPLANTS
TREATMENT OF TFO
CONCLUSION
REFRENCES
Dental plaque is a biofilm that forms on teeth. It progresses from an initial bacterial coating to a mature biofilm with complex microbial communities. Early plaque is predominantly gram-positive cocci while mature plaque contains more gram-negative rods and anaerobes. Plaque composition changes with periodontal disease, shifting from gram-positive to gram-negative and non-motile to motile organisms. Plaque initiates periodontal diseases through its noxious metabolic byproducts and through stimulating the host immune response, ultimately leading to tissue destruction if left unchecked.
The periodontal ligament is composed of complex vascular and highly cellular connective tissue that surrounds the tooth root and connects it to the inner wall of alveolar bone. It develops from the dental follicle and is composed of fibroblasts, osteoblasts, cementoblasts and other cells embedded in collagen fibers and ground substance. The principal fiber groups help resist various forces on the tooth. The periodontal ligament plays an important role in maintaining homeostasis and provides shock absorption for teeth.
This document discusses protein structure and function. It begins by defining proteins and explaining their primary, secondary, tertiary, and quaternary levels of structure. It then describes protein denaturation and various protein functions like enzymes, antibodies, and structural roles. The document concludes by discussing protein deficiency, its symptoms, and two associated syndromes - kwashiorkor and marasmus.
This document discusses root surface biomodification for periodontitis treatment. It begins with an introduction to root surface changes from periodontitis, including structural, chemical, and cytotoxic changes. It then discusses the historical background of root biomodification and defines important terms. The document outlines various methods of root biomodification, including mechanical, chemical, and physical approaches. It provides details on specific chemical agents used like citric acid and their proposed mechanisms of action in facilitating periodontal regeneration.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
The document discusses the biologic width, which refers to the dimensions of the soft tissue attached to the tooth coronal to the alveolar bone crest. It consists of the junctional epithelium, connective tissue attachment, and the sulcular depth, totaling approximately 2-3 mm. Violation of the biologic width by placing restorative margins too far subgingivally can lead to bone resorption, gingival recession, or hyperplasia. The document outlines techniques for assessing biologic width dimensions and various surgical or orthodontic procedures to correct violations. Maintaining at least 3 mm of distance from the restorative margin to alveolar bone is important for periodontal health.
Periodontitis is a chronic infectious inflammatory disease caused by microbes; however the presence of microbes is not enough for the cause of its complex nature of disease. Inflammation is the prime cause of periodontal disease. It commences with the aggregation of pathogenic microbes that induce the host to stimulate a cascade of inflammatory response reactions which in-turn leads to the destruction of the host tissues itself. There is a complex interplay of innate and adaptive immune responses which fights against the pathogens by direct interaction or by release of certain molecules including cytokines.
Cytokines are cell signalling molecules that aid cell to cell communication in immune responses and stimulate the movement of cells towards sites of inflammation, infection and trauma. Cytokine biology reveals that there are some subsets of cytokines which are pro-inflammatory cytokines which stimulate the inflammatory responses and cause tissue destruction.
A periodontist is expected to have a sound basis of the cytokine profile to understand the pathogenesis of periodontitis and also to discover the new treatment modality of anti-cytokine therapy.
Alveolar bone forms tooth sockets and provides attachment for the periodontal ligament. It is composed of outer cortical and inner cancellous bone. Osteoblasts form bone matrix containing collagen fibers and hydroxyapatite crystals. Osteoclasts resorb bone. Bone is remodeled through the balanced actions of osteoblasts and osteoclasts, regulated by hormones and growth factors.
The document summarizes key aspects of alveolar bone anatomy and physiology:
1. The alveolar process forms tooth sockets and provides osseous attachment to the periodontal ligament. It is made up of cortical plates and cancellous bone containing osteons and lamellae.
2. Alveolar bone remodeling is regulated by hormones like PTH and involves balanced bone resorption by osteoclasts and formation by osteoblasts.
3. The alveolar bone proper surrounds tooth roots and gives attachment to periodontal fibers, while supporting bone surrounds it. Disorders like fenestrations and dehiscences can result in root surface denudation.
This document provides an overview of pathologic tooth migration (PTM). It defines PTM as tooth displacement resulting from a disruption of forces that maintain normal tooth position due to periodontal disease. The document discusses several potential etiologic factors for PTM, including the destruction of periodontal tissues, occlusal factors, soft tissue pressures, periodontal inflammation, extrusive forces, habits, missing teeth, and malocclusions. It provides examples from studies on the role of bone loss, bite collapse, arch integrity, occlusal interferences, and oral habits in contributing to PTM. The document concludes by noting that the duration of forces is important in tooth movement.
The periodontal dressing is a physical barrier that is placed in the surgical site to protect the healing tissues from the forces produced during mastication, for comfort and close adaptation.
This document discusses the anatomy, measurement, and clinical significance of the attached gingiva. It notes that the attached gingiva extends from the base of the gingival sulcus to the mucogingival junction. The normal width is 3-4.5mm in the maxillary anterior region but narrower in other areas. Inadequate width can facilitate subgingival plaque formation. Methods to measure width and increase width through surgery are described. The importance of keratinized, attached tissue for resisting mechanical irritation and stabilizing the gingival margin is emphasized.
Periodontal medicine is the study of the relationship between periodontal health and systemic health. Periodontal disease can influence systemic health through direct effects of bacteria or indirect host-mediated inflammatory responses. Periodontitis has been linked to increased risk of cardiovascular disease, diabetes, and preterm low birth weight. Treatment of periodontal infection may help improve glycemic control in diabetic patients and reduce systemic inflammation.
The document discusses the effects of hormones from various endocrine glands on the periodontium. It describes how hormones from the hypothalamus and pituitary gland regulate other endocrine glands. It then examines the specific effects of hormones from the adrenal, thyroid, parathyroid, gonads and pancreas on periodontal tissues and the mechanisms by which they may influence periodontal health and disease. It also discusses how gender, age and hormone supplements can impact the effects of sex hormones on the periodontium.
This document provides an overview of gingival epithelium, including its microscopic features, structural characteristics, defense mechanisms, and renewal process. It defines gingiva as the part of oral mucosa that covers the alveolar process and surrounds tooth necks. Gingiva consists of three types: marginal, attached, and interdental gingiva. The gingival epithelium contains keratinocytes and melanocytes. Keratinocytes form the bulk of the epithelium and undergo continuous renewal, while melanocytes transfer melanin to keratinocytes. The degree of keratinization varies between oral mucosal sites.
This document discusses the development of the periodontium, which includes the cementum, periodontal ligament, alveolar bone, and gingiva. It describes how the tooth germ develops from the enamel organ and dental papilla through stages of growth. Root formation is induced by Hertwig's epithelial root sheath, which regulates the development of cementum, periodontal ligament, and alveolar bone through cellular differentiation and protein signaling. The periodontium develops through reciprocal interactions between the enamel organ and dental follicle mesenchyme.
2017 classification of periodontal and periimplant diseasesDr. Bibina George
The document summarizes the key changes in the 2017 classification of periodontal and peri-implant diseases compared to the 1999 classification. The 2017 classification introduces staging and grading systems for periodontitis to indicate disease severity and risk of progression. It also includes classifications for peri-implant health, mucositis, and implantitis, as well as mucogingival deformities. The document reviews these changes and provides references for the revised classification system.
The document defines a periodontal pocket as a pathological deepening of the gingival sulcus bounded by the tooth surface and soft tissue wall. Pockets are classified as supracrestal or infrabony and simple, compound, or complex. Supracrestal pockets have a coronal base while infrabony pockets have an apical base below the alveolar crest. Histopathology shows the soft tissue wall is edematous and infiltrated with plasma cells, lymphocytes, and PMNs. Bacteria can invade the epithelium and connective tissue. Clinical features include red, swollen gingiva while histology reveals increased vascularity and thinning/degeneration of the epithelium. Pocket depth does not
Pathologic tooth migration (PTM) refers to tooth displacement resulting from a disturbance in factors that maintain normal tooth position. PTM is common in periodontal patients, with prevalence studies finding rates of 30-55%. The primary factor in PTM is periodontal bone loss resulting from periodontal disease. Other factors include occlusal changes from tooth loss, soft tissue pressures, oral habits, and periapical or gingival inflammation. Treatment involves periodontal therapy, sometimes with adjunctive orthodontics or prosthodontics, while prevention focuses on periodontal disease control and management of predisposing occlusal and habit factors.
This document discusses local drug delivery (LDD) for the treatment of periodontal disease. It begins with an introduction to LDD and its advantages over systemic antibiotics. It describes the goal of LDD as achieving therapeutic drug levels in the periodontal pocket for effective treatment. The document discusses various LDD methods including non-sustained and sustained release delivery systems. It covers indications, contraindications, advantages and disadvantages of LDD. Various classifications of LDD systems and commonly used drugs are also summarized.
Basic to recent advances in local drug delivery also covering the effects of GCF flow on local drugs as well as use of local drugs used in periimplantitis.
INTRODUCTION
DEFINITION
TYPES OF TRAUMA FROM OCCLUSION
GLICKMAN CONCEPT
WAERHAUG CONCEPT
STAGES OF TISSUE RESPONSE TO INJURY
CLINICAL AND RADIOGRAPHIC FEATURES OF TFO
CLINICAL DIAGNOSIS OF TFO
TFO AND IMPLANTS
TREATMENT OF TFO
CONCLUSION
REFRENCES
Dental plaque is a biofilm that forms on teeth. It progresses from an initial bacterial coating to a mature biofilm with complex microbial communities. Early plaque is predominantly gram-positive cocci while mature plaque contains more gram-negative rods and anaerobes. Plaque composition changes with periodontal disease, shifting from gram-positive to gram-negative and non-motile to motile organisms. Plaque initiates periodontal diseases through its noxious metabolic byproducts and through stimulating the host immune response, ultimately leading to tissue destruction if left unchecked.
The periodontal ligament is composed of complex vascular and highly cellular connective tissue that surrounds the tooth root and connects it to the inner wall of alveolar bone. It develops from the dental follicle and is composed of fibroblasts, osteoblasts, cementoblasts and other cells embedded in collagen fibers and ground substance. The principal fiber groups help resist various forces on the tooth. The periodontal ligament plays an important role in maintaining homeostasis and provides shock absorption for teeth.
This document discusses protein structure and function. It begins by defining proteins and explaining their primary, secondary, tertiary, and quaternary levels of structure. It then describes protein denaturation and various protein functions like enzymes, antibodies, and structural roles. The document concludes by discussing protein deficiency, its symptoms, and two associated syndromes - kwashiorkor and marasmus.
Molecular cell biology presented by sai prasad .ksaiprasad279
Cell adhesion plays a crucial role in the formation of multicellular organisms and tissues. There are several major mechanisms of cell-cell adhesion, including cadherins and selectins. Cadherins form adherens junctions between cells by binding to other cadherins on adjacent cells. Selectins mediate the initial tethering and rolling of leukocytes along vascular endothelium through binding carbohydrate ligands. Both cadherins and selectins undergo conformational changes to regulate their binding affinity in response to mechanical forces like shear stress.
Bones are composed of both organic and inorganic components. The inorganic component is mainly calcium and phosphorus in the form of hydroxyapatite crystals. The organic component includes collagen fibers and cells. There are four main cell types in bone: osteoblasts which form new bone, osteocytes embedded in the bone matrix, osteoclasts which resorb bone, and osteoprogenitor cells which differentiate into osteoblasts. Bones develop through either intramembranous or endochondral ossification, which involve the differentiation of mesenchymal stem cells into osteoblasts and the deposition of bone matrix. Growth plates located near the ends of long bones facilitate bone growth and consist of columns of chondrocytes at
This document provides an overview of alveolar bone structure and function. It begins with introductions to bone composition, development, and cell types. Key bone cells include osteoblasts, which form bone, and osteoclasts, which resorb bone. The document then discusses alveolar bone morphology, blood supply, and functions. Importantly, alveolar bone is in a constant state of flux, undergoing remodeling as bone is broken down and rebuilt through the coupled actions of osteoblasts and osteoclasts. Healing of alveolar bone after tooth extraction and age-related changes are also covered.
6. alveolar bone in health part b dr-ibrahim_shaikhDrIbrahim Shaikh
This document discusses the cells and components that make up healthy alveolar bone. It describes the main cell types, including osteoprogenitor cells that develop into osteoblasts or osteoclasts. Osteoblasts secrete osteoid and regulate mineralization, while osteoclasts are responsible for bone resorption. The bone matrix contains collagen fibers and hydroxyapatite crystals, along with noncollagenous proteins. Alveolar bone undergoes physiological remodeling through the coordinated actions of osteoblasts and osteoclasts, allowing adaptation to tooth movement and replacement over time.
This document summarizes bone physiology and calcium metabolism. It describes the organic and inorganic constituents of bone, including collagen, calcium hydroxyapatite, and other minerals. It outlines the cells involved in bone remodeling including osteoprogenitor cells, osteoblasts, osteocytes, and osteoclasts. It also discusses the roles of vitamin D, parathyroid hormone, and calcitonin in regulating calcium levels in the body and maintaining bone health. Key bone diseases like osteoporosis, Paget's disease, and renal osteodystrophy are also summarized.
PDL is complex vascular structure which surround tooth root and connect it to the alveolar bone. In this we discuss development, macroscopic and microscopic features, functions and it’s supply and clinical consideration.
Meat : Structure, Composition and Characteristics.Umesh Maskare
Meat - General introduction about meat, production and consumption in all over the World, its Complete structure and Composition with data and Characteristic Properties.
The periodontal ligament is a complex connective tissue that connects teeth to the alveolar bone. It contains fibroblasts, cementoblasts, osteoblasts, osteoclasts and epithelial rests of Malassez. The fibroblasts are the predominant cells and produce collagen fibers that develop into principal fiber bundles. The periodontal ligament allows for adaptation during function by remodeling its collagen fibers and allows movement within the periodontal space. It develops from the dental follicle prior to tooth eruption and contains stem cells that can differentiate into cementoblasts, osteoblasts or fibroblasts.
Bone is a specialized connective tissue composed of cells and an organic/inorganic matrix. It contains osteogenic stem cells that differentiate into osteoblasts which form bone matrix and osteocytes that reside in the bone tissue. Osteoclasts are large multinucleated cells that resorb bone. The matrix contains collagen fibers, proteoglycans and glycoproteins. Mineral salts such as calcium phosphate crystallize within the matrix. Bones develop through two processes - intramembranous where bone forms within connective tissue and endochondral where cartilage is replaced by bone.
The oral epithelium acts as a protective barrier for the oral mucosa. It is composed of keratinocytes that undergo proliferation and maturation as they move from the basal layer to the surface. Keratinocytes express different cytokeratins as they mature and differentiate. The oral epithelium can be keratinized or non-keratinized depending on its location. A basement membrane anchors the epithelium. Various cellular disorders can affect the oral epithelium. Non-keratinocytes including melanocytes, Langerhans cells, and lymphocytes are also present in small numbers.
This document provides an overview of the structure of dentin. It discusses the formation of dentin through odontoblast activity and mineralization. It describes the composition and structural components of dentin, including dentinal tubules, peritubular dentin, intertubular dentin, and different types of dentin such as primary, secondary, and tertiary dentin. The document also covers topics like patterns of mineralization, vascular and nerve supply of dentin, physical and chemical properties, and age-related changes in dentin structure.
2.an insight into the regulatory mechanisms of cells by dr ibrahi mDr Ibrahim
This document provides an overview of the regulatory mechanisms involved in the resorption of dental hard tissues. It discusses the key cells involved, including osteoclasts, odontoclasts, and cementoclasts. The resorption process is regulated by the RANK/RANKL/OPG system and other factors such as cytokines and hormones that modulate the expression of these proteins. Understanding these regulatory mechanisms could enable delaying or inhibiting the natural exfoliation of primary teeth and development of drugs for pathological resorption conditions.
The document discusses the periodontal ligament, including its definition, composition, functions, development, and involvement in various diseases and clinical considerations. Specifically, it notes that the periodontal ligament is a specialized connective tissue that anchors the tooth to the alveolar bone and transmits occlusal forces. It consists of collagen fibers embedded in a ground substance containing proteoglycans and glycoproteins. The periodontal ligament serves important supportive, nutritive, sensory and remodeling functions for the tooth.
The document discusses fibrous proteins and collagen. It provides details on:
1) Fibrous proteins are usually insoluble and found in skin, connective tissue, blood vessels and other structures. They have high alpha-helix or beta-sheet content and examples include collagen, elastin, keratin and fibroin.
2) Collagen is the most abundant fibrous protein, making up 25-35% of the body's protein. It provides structure and strength, and there are at least 19 types designated by Roman numerals.
3) Collagen has a characteristic amino acid sequence of glycine-X-Y where X is often proline and Y can be hydroxyproline or hydroxy
Robert Hooke first discovered cells in 1665 while observing a thin slice of cork under his homemade microscope. He saw compartments resembling the structure of a honeycomb and coined the term "cell" to describe these structures. Later scientists like Leeuwenhoek, Brown, Purkinje, Schwann, Schleiden, and Virchow contributed to the development of the cell theory, which states that the cell is the fundamental unit of life, all living things are composed of cells, and new cells are produced from existing cells.
Similar to Alveolar bone by Dr yamini Unni pg periodontics. amrita institute of medical science (20)
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
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5. OVERVIEW OF BONES :
WHAT & WHY WE NEED THEM?
Bone is a dynamic biological tissue,
composed of various metabolically
active cells that are integrated into a
rigid framework
Enable
Mobility
SUPPORT &
PROTECT
ENDOCRINE
REGULATION
STORE
MINERALS
6. The ALVEOLAR process of bone is defined as that part of the maxilla
and the mandible that forms and supports the sockets of the teeth
10. HOUSES ROOTS OF THE TEETH
ANCHORS ROOTS OF THE TEETH TO THE ALVEOLI –
INSERTION OF SHARPEY’S FIBRE INTO THE ALVEOLAR BONE PROPER
HELPS TO MOVE THE TEETH FOR BETTER OCCLUSION
HELPS TO ABSORB AND DISTRIBUTE OCCLUSAL FORCES GENERATED DURING
TEETH CONTACT
SUPPLIES VESSELS TO PERIODONTAL LIGAMENT
HOUSES AND PROTECTS DEVELOPING PERMANENT TEETH WHILE SUPPORTING
PRIMARY TEETH
ORGANISES ERUPTION OF PRIMARY AND PERMANENT TEETH
11. GROSS BONE MORPHOLOGY
• DENSE OUTER SHEET-
COMPACT BONE
• CENTRAL-MEDULLARY
CAVITY
CHARACTERISTIC
• IN LIVING BONE
CAVITY FILLED WITH
• RED AND YELLOW
BONE MARROW
FILLING
• EXTREMITIES OF LONG
BONES
• NETWORK OF BONY
TRABECULAE
INTERRUPTION
14. CIRCUMFERENTIAL
CONCENTRIC
INTERSTITIAL
• ENCLOSE ENTIRE ADULT BONE
• FORMS INNER AND OUTER PERIMETER
• BULK OF COMPACT BONE
• FORM BASIC METABOLIC UNIT OF BONE-
OSTEON [HAVERSIAN SYSTEM]
• INTERSPERSED BETWEEN ADJACENT CONCENTRIC
LAMELLAE
• FILL SPACES BETWEEN THEM
• THEY ARE FRAGMENTS OF PREEXISTING CONCENTRIC
LAMELLAE
• FORMED FROM OSTEONS- REMODELLING
15.
16. CONCENTRIC LAMELLAE
CYLINDER OF BONE
ORIENTED
PARALLEL TO THE
LONG AXIS OF THE
BONE
OSTEON
-CANAL LOCATED IN
CENTER OF EACH
BONE
-EACH CANAL HAS
CAPILLARIES
-LINED BY SINGLE
LAYER OF BONE CELLS
THAT COVER THE
BONE SURFACE
HAVERSIAN
CANAL
-INTERCONNECTION
OF HAVERSIAN CANAL
-HAVERSIAN CANAL
HAS THIS VASCULAR
CONNECTIONS
VOLKMANN
CANAL
17.
18. CONNECTIVE TISSUE OF BONE
CONTENTS
TWO LAYERS
MEMBRANE COVERING
OUTER ASPECT OF BONE
PERIOSTEUM
OUTER
LAYER
FIBROUS
LAYER
DENSE
IRREGULAR
CONNECTIVE
INNER
LAYER/
CAMBIUM
LAYER
BONE CELLS-
PRECURSORS-
RICH BLOOD
RICH
MICROVASCULAR
SUPPLY
19.
20. ENDOSTEUM
COVERS INTERNAL SURFACE OF COMPACT AND CANCELLOUS BONE
LOOSE CONNECTIVE TISSUE
OSTEOGENIC CELLS SEPERATES BONE AND MARROW WITHIN
21.
22. HEMATOPOIETIC TISSUE IN BONE
• YOUNG BONE
• FOUND IN CAVITIES OF LONG BONE AND DIPLOE OF FLAT BONES
• STEM CELLS OF BOTH FIBROBLAST/MESENCHYMAL TYPE AND BLOOD CELL
RED
MARROW
• OLD BONE
• SEEN IN EPIPHYSIS OF LONG LONE
• LOSS OF HEMOPOETIC POTENTIAL
• INCREASED ACCUMULATION OF FAT CELLS- YELLOW
• YELLOW REVERT TO RED: ANEMIC AND NEEDS INCREASED RED CELL
PRODUCTION
YELLOW
MARROW
31. COLLAGEN
• FORMS HETEROTYPIC FIBER BUNDLES- PROVIDES BASIC
STRUCTURAL INTEGRITY OF CONNECTIVE TISSUE
• ELASTICITY OF COLLAGEN IMPARTS RESILIENCY TO TISSUE
AND RESIST FRACTURE
MAJOR ORGANIC
COMPONENT-
TYPE I COLLAGEN 95%
TYPE V COLLAGEN <5%
• SHARPEY’S FIBRE- TYPE III & TYPE I
• TYPE XII- UNDER MECHANICAL STRAIN
• TYPE III AND XII PRODUCED BY FIBROBLAST DURING PDL
FORMATION
• TYPE I , V , XII – BY OSTEOBLAST
ALVEOLAR BONE –
TYPE I , TYPE V,
TYPE III AND TYPE XII
40. PROTEOGLYCANS
LARGE
• CHONDROITIN SULFATE PROTEOGLYCAN
• NON MINERALIZED BONE MATRIX
SMALL
• BIGLYCAN(CHONDROITIN SULPHATE PROTEOGLYCAN I)
• DECORIN(CHONDROITIN SULPHATE PROTEOGLYCAN II)
• THIRD SMALL PROTEOGLYCAN FOUND IN MINERAL CRYSTALS
41. BIGLYCAN
• PROMINENT IN DEVELOPING BONE AND MINERAIZES TO PERICELLULAR AREA
• IT CAN BIND TO TGF-β AND EXTRA CELLULAR MATRIX MACROMOLECULES INCLUDING
COLLAGEN
• REGULATE FIBRILLOGENESIS
DECORIN
• BINDS MAINLY WITHIN THE GAP REGION OF COLLAGEN FIBRILLS AND DECORATES FIBRIL
SURFACE
• PRIMARY CALCIFICATION IN BONES- REMOVAL OF DECORIN AND FUSION OF COLLAGEN
FIBRILS
42. TRAMP AND LYSYL OXIDASE
• TYROSINE RICH ACIDIC MATRIX PROTEINS
• DEMINERALIZED BONE + DENTIN MATRIX
• TGF- β AND DECORIN BINDING
• TOGETHER THESE PROTEINS REGULATE THECELLULAR RESPONSE TO
TGF-β
‘TRAMP’
DERMATOPONTI
• ‘CRITICAL ENZYME’
• COLLAGEN CROSS LINKING
• SAME ACTION OF ‘TRAMP’
• PROCOLLAGEN PEPTIDES,THROMBOSPONDIN,FIBRONECTIN,VITRONECTIN,
ALKALINE PHOSPHATASE – OTHER ENZYMES FOUND IN BONE
LYSYL OXIDASE
55. SECRETORY GRANULES
THESE GRANULES RELEASE CONTENTS ALONG THE SURFACE OF CELL- OPPOSED TO FORMING BONE-
ASSEMBLE EXTRACELLULARLY AS FIBRILS TO FORM OSTEOID
GOLGI COMPLEX- PALE JUXTANUCLEAR AREA (SITE)
PROCOLLAGEN + ORGANIC CONSTITUENTS OF BONE ENTER ITS LUMEN
TRANSFERRED AND ASSEMBLED IN GOLGI COMPLEX INSIDE SECRETORY GRANULES
ABUNDANT,WELL DEVELOPED SYNTHETIC ORGANELLES
INTENSE CYTOPLASMIC BASOPHILIA- ↑ ROUGH ENDOPLASMIC RETICULUM
56. ARRANGEMENT
THIS CONNECTION PROVIDES INTERCELLULAR
ADHESION &CELL TO CELL COMMUNICATION
ENSURES THE OSTEOBLAST LAYER COMPLETELY COVERS
OSTEOID SURFACE AND FUNCTIONS IN COORDINATED
CANALICULI FORMATION-
ORGANIC MATRIX DEPOSITED AROUND CELL BODIES AND CYTOPLASMIC PROCESS
CELL CONTACT EACH OTHER BY GAP JUNCTIONS
AND ADHERENS
FUNCTIONALLY CONNECTED TO MICROFILAMENTS AND
ENZYMES THROUGH SECONDARY MESSENGER SYSTEM
NUCLEUS SITUATED ECCENTRICALLY-
AWAY FROM ADJACENT BONE SURFACE
NON COLLAGENOUS PROTEIN
RELEASED AND DIFFUSED ALONG OSTEOBLAST
SURFACE
PARTICIPATE IN REGULATING MINERAL
DEPOSITION
61. DETERMINED OSTEOGENIC PRECURSOR CELLS (DOPC’S)
PRESENT IN BONE MARROW, ENDOSTEUM,PERIOSTEUM
DIFFERENCIATED WITH HELP OF SYTEMIC AND BONE DERIVED
GROWTH FACTORS
OSTEOBLAST
INDUCIBLE OSTEOGENIC PRECURSOR CELLS (IOPC’S)
REPRESENT MESENCHYMAL CELLS PRESENT IN OTHER
ORGANS/TISSUES
STIMULATED
OSTEOBLAST
62. FUNCTIONS
• NEW BONE FORMATION
• VIA SYNTHESIS OF PROTEINS AND
POLYSACCHARIDES
MAIN
FUNCTION
• REGULATION OF BONE
REMODELLING
• MINERAL METABOLISM
OTHER
FUNCTIONS
63. MINERALIZATION OF OSTEOID
OSTEOBLAST SECRETE TYPE 1
COLLAGEN
WIDELY DISTRIBUTED
SECRETION
TYPE V COLLAGEN OSTEONECTIN
OSTEOPONTIN
RANKL, OSTEOPROTEGERIN
PROTEOGLYCANS GROWTH
FACTOR(BMP)
HORMONES
PTH, VIT D3 ESTROGEN
GLUCOCORTICOIDS
OSTEOBLAST DIFFERENCIATION
RECOGNISE RESORPTIVE SIGNALS –
TRANSMIT TO OSTEOCLAST
64.
65.
66. FOURSCHEMES
OSTEOBLAST ARE UNPOLARIZED, LAY DOWN BONE IN ALL
DIRECTIONS
SAME GENERATION ARE POLARIZED:
OSTEOBLASTS ARE POLARIZED IN THE SAME DIRECTION. ONE GENERATION
BURIES PRECEDING ONE IN BONE MATRIX
WITHIN ONE GENERATION:
SOME OSTEOBLAST SLOW DOWN RATE OF DEPOSITION/STOP LAYING DOWN
BONE
HOW OSTEOBLAST GETS TRAPPED
67.
68. OSTEOBLAST
HAS 4 FATES
EMBEDDED
IN BONE -
OSTEOCYTE
INACTIVE
OSTEOBLAST
-BONE
LINING
UNDERGO
APOPTOSIS
CELLS THAT
DEPOSIT
CHONDROID
AND
CHONDROID
BONE
69. BONE LINING CELLS
REMAIN ON SURFACE-
LINING CELLS
ENTRAPPED IN BONE
MATRIX- OSTEOCYTES
REMOVES MINERALIZED
MATRIX OF BONE
REMOVES BONE TISSUE
“BONE AND BROKEN”
OSTEOCYTES
OSTEOCLAST
70.
71. OSTEOCYTES
• Microscopically osteocytes are lost
• Cavties are filled with debris
Woven and repair bone has
↑ osteocytes than lamellar
bone
• In bone matrix osteocyte reduce in size creating space
around it.
• Narrow extentions of lacunae form channels called
canaliculi.
OSTEOCYTIC LACUNA
72.
73. Old osteocytes retract their process from
canaliculi and when dead the lacunae and
canaliculi get plugged with debris
Death of osteocytes leads to
resorptionof the matrix of osteoclasts
Osteocytes secrete few
matrix protein
80. RANKL
RECEPTOR ACTIVATOR OF NUCLEAR FACTOR Κ B- ligand
Member of the tumor necrosis factor (TNF) cytokine family
It binds to RANK on cells of myeloid lineage
It functions as a key factor for osteoclast differenciation and activation
RANKL may also bind to OPG
RANKL helps in dendritic cell function
81. OSTEOPROTEGRIN- OPG
• Osteoprotegerin (OPG) is secreted by
osteoblasts and osteogenic stromal stem cells
and protects the skeleton from excessive bone
resorption by binding to RANKL and preventing
it from interacting with RANK.
82. FORMATION
CFU-GM (GRANULOCYTE
MACROPHAGE COLONY
FORMING UNIT
COMMITTED PRECURSOR
CELLS
PRE-OSTEOCLASTS(Immature
multinucleated giant cell)
RANK on the surface
Stromal cells/osteoblasts secrete
• RANK-L (ODF-osteoclast
differenciation factor)
• M-CS F(Macrophage colony
stimulating factor)
OPG expressed by osteoblasts
inhibits RANK-RANKL Interaction
INHIBITION OF OSTEOCLAST
DIFFERENCIATION &ACTIVITY
INTERACTION OF
RANK & RANKL
FULLY FUNCTIONAL OSTEOCLAST
83. Regulation of osteoclast formation in cortical (A)
and trabecular (B) bone.
At the periosteal site of cortical bone [(A), left],
ATRA stimulates RANKL production in osteoblasts
and/or osteocytes which leads to stimulation of
differentiation of mature osteoclasts from osteoclast
progenitors.
In bone marrow or at endosteal site [(A), right],
ATRA does not stimulate RANKL formation but
inhibits differentiation of osteoclast progenitors to
mature osteoclasts.
The role of ATRA for osteoclast formation on the
endosteal surfaces of trabecular bone
84. FACTORS FAVOURING FORMATION
TRANSCRIPTION FACTORS
LOCAL AND SYSTEMIC FACTORS
a. Hematopoeitic factors
b. Cytokines
c. Hormones
Vit d3 , pth , PGE2 , GLUCOCORTICOIDS
FACTORS LIMITING FORMATION
DIFFERENCIATION : OPG , OCIL
LOCAL AND SYSTEMIC FACTORS
a. Growth hormones-TGFβ IGF-1 IGF11
b.hormones;glucocorticoids,pth,PGE2,
calcitonin , estrogen
c.cytokines: IL-4,10,12,13,18
d. pharmacological:bis phosphonates
FACTORS REGULATING OSTEOCLAST FORMATION
85. The ruffled border is composed of many tightly
packed microvilli adjacent to the bone surface,
providing a large surface area for the resorptive
process.
Cathepsin containing vescicles and
vacuoles are present closed to ruffled
border indicating resorptive activity of
Rich in acid phosphatase and other lysozyme.
synthesized in RER transported to golgi
and moved to the ruffled border in transport
vesicles , they release their content into the
bone surface.
86. SEALING/CLEAR ZONE
At the periphery of the ruffled border, the
plasma membrane is smooth and closely
apposed to the bone surface.
The adjacent cytoplasm, devoid of cell
organelles contains contractile actin
microfilaments.
This region is called CLEAR/SEALING ZONE.
This zone, thus creates an isolated
microenvironment in which resorption can
take place.
87. Osteoclasts lie in resorption bays called Howship’s
lacunae
Cutting Cone
88. Several osteoclasts excavating
a large area on bone which is the
leading edge of resorption is
termed as the Cutting cone.
Released cytokines (BMP &
IGF) stimulate stem cells to
differentiate into osteoblasts.
THESE OSTEOBLASTS
OSTEOID KNOWN AS FILLING
CONE
89. BONE FORMATION
1. INTRAMEMBRANOUS OSSIFICATION
2. INTRACARTILAGENOUS OSSIFICATION (ENDOCHONDRAL)
3. IMMATURE VS MATURE/WOVEN VS LAMELLAR
103. BONE RESORPTION
• Complex process
• Appearence: Eroded bone surface(Howship’s lacunae) large multinucleated cells(osteoclast)
• Osteoclast:
• origination: hematopoietic tissue.
• formation: fusion of mononuclear cells of asynchronous population.
• Appearance: Ruffled border(elaborately developed)
• Secretion: hydrolytic enzymes(digest organic portion of bone)
• Regulation: activity and morphology regulated by enzymes
(PTH and calcitonin-receptors on osteoclast membrane.)
104.
105. TENCATE’S SEQUENCE
• Attachment of osteoclast to the mineralized surface of bone.
• Creation of a sealed acidic environment through action of the proton pump ,
which demineralises bone and exposes organic matrix.
• Degradation of the exposed organic matrix to its constituent amino acids-by
the action of released enzymes-phosphatase and cathepsin.
• Sequestering of mineral ions and amino acids within the osteoclast.
110. EXTERNAL PLATE OF CORTICAL BONE
Haversian bone +compact bone lamellae
ALVEOLAR BONE PROPER/CRIBRIFORM PLATE/LAMINA DURA
CANCELLOUS TRABECULAE/TRABECULAR BONE
INTERDENTAL SEPTA
INTERRADICULAR SEPTA
BASAL BONE
111.
112.
113. ALVEOLAR BONE PROPER
ALVEOLAR BONE PROPER
A THIN LAMELLAE OF BONE THAT SURROUNDS THE ROOTS OF THE TOOTH
AND GIVES ATTACHMENT TO PRINCIPAL FIBERS OF THE PERIODONTAL
LIGAMENT-
LAMELLATED BONE- SOME LAMELLAE OF BONE ARE ARRANGED
PARALLEL TO THE SURFACE OF ADJACENT MARROW SPACES.OTHERS FORM
HAVERSIAN SYSTEM
BUNDLE BONE: THE PRINCIPAL FIBERS OF PERIODONTAL LIGAMENT
ARE ANCHORED INTO THE BONE.
114. ALVEOLAR BONE PROPER
ZUCKERKANDL AND HIRSCHFELD CANALS (nutrient canals)
Nutrient canals are anatomic structures of the alveolar bone through which neurovascular elements transit to supply teeth and
CRIBRIFORM PLATE
A SERIES OF OPENINGS THROUGH WHICH NEUROVASCULAR BUNDLES LINK THE PERIODONTAL LIGAMENT WITH CENTRAL
COMPONENT OF BONE- CANCELLOUS BONE
Alveolar bone proper is a part of alveolar bone that form the inner thin wall of the socket facing the
In radiographs seen as LAMINA DURA HISTOLOGICALLY KNOWN AS CRIBRIFORM PLATE
115.
116. BLOOD SUPPLY-ALVEOLAR BONE PROPER
ALVEOLAR BONE
PROPER
FORMS THE INNER WALL OF
SOCKET
PERFORATED BY BRANCHES
OF INTERALVEOLAR NERVES
AND BLOOD VESSELS
CRIBRIFORM PLATE
BLOOD VESSELS ARE
PERFORATED INTO
PERIODONTAL LIGAMENT
HENCE KNOWN AS CRIBRIFORM
PLATEINTERDENTAL SEPTUM IS THE
BONE BETWEEN TEETH AND
COMPOSED OF CRIBRIFORM
PLATE
NUTRIENT CANALS
INTER DENTAL AND INTER
RADICULAR SEPTA CONTAIN
PERFORATING CANALS-
ZUCKERKANDL AND HIRSCHFELD
THEY HOUSE THE BLOOD
AND LYMPHATIC SUPPLY
117. LAMELLAR BONE
Consist of osteons
• Concentric lamellae with
central blood vessel
CONTINUES WITH
SUPPORTING
ALVEOLAR BONE
• MATURE
BONE
Plywood like
layers
• Arrange
in sheets
123. SPONGY BONE
TYPE II
INTERDENTAL AND INTERRADICULAR TRABECULAE ARE
IRREGULARLY ARRANGED AND DELICATE
LACKS DISTINCT TRAJECTORY PATTERN-SEEN IN MAXILLA
FATTY MARROW SPACES PRESENT
TYPE I
INTERDENTAL AND INTERRADICULAR TRABECULAE ARE
REGULAR AND HORIZONTAL
LADDER LIKE APPEARANCE
SEEN IN MANDIBLE – TRAJECTORY PATTERN
FILLS AREA BETWEEN CORTICAL PLATE AND ALVEOLAR BONE PROPER
TYPE 1 TYPE II
124.
125. ALVEOLAR CREST
SHAPE DEPENDS ON
THE POSITION OF
ADJACENT TEETH
IN HEALTHY- CEJ AND
FREE BORDER OF
ALVEOLAR BONE
PROPER IS CONSTANT
NEIGHBOURING
TEETH INCLINED-
ALVEOLAR CREST IS
OBLIQUE
CORTICALAND
ALVEOLAR BONE
MEET AT ALVEOLR
CREST AT 1.5 -2MM
BELOW LEVEL OF CEJ
126.
127. SOCKET WALL
• DENSE
• LAMELLATED BONE
• BUNDLE BONE
• Bone adjacent to the periodontal ligament
• Large number of sharpey’s fibres.
• Thin lamellae arranged in layers parallel to the
root,with intervening appositional lines.
• Localized within alveolar bone proper.
128. INTERDENTAL SEPTUM
Consists of-
• Cancellous bone bordered by socket wall cribriform
plates (lamina dura/alveolar bone proper)
• Approximates teeth , facial and lingual cortical
plates.
• Narrow interdental space- septum has only one
cribriform plate.
• If roots are too close together an irregular
“window” appear in bone between adjacent roots.
130. DETERMINING ROOT PROXIMITY-
RADIOGRAPHICALLY
• Mesiodistal angulation of the crest of the interdental
septum usually parallels a line drawn between the CEJ of
approximating teeth.
• Distance between crest of alveolar bone and CEJ in young
adults-
0.75 - 1.49(average 1.08)
• Distance increases with age (average2.81).
136. BASED ON DEVELOPMENT
ENDOCHONDRAL
BONE
FORMED BY
REPLACEMENT OF
HYALINE CARTILAGE
WITH BONY TISSUE
OSSIFICATION OCCURS
IN TRUNK AND
EXTREMITIES
INTRAMEMBRANOUS
BONE
FORMED BY REPLACEMENT OF
SHEET LIKE CONNECTIVE TISSUE
MEMBRANE WITH BONY TISSUE
OSSIFICATION OCCURS IN
THE CRANIAL AND FACIAL
FLAT BONES OF SKULL ,
MANDIBLE AND CLAVICLE
142. RADIOGRAPHIC APPEARENCE
TYPE 1
REGULAR INTERRADICULAR AND INTERDENTAL
TRABECULAE
HORIZONTAL AND LADDER LIKE ARRANGEMENT
COMMON IN MANDIBLE
TYPE 11
IRREGULARLY ARRANGED NUMEROUS DELICATE
INTERDENTAL AND INTERRADICULAR TRABECULAE
COMMON IN MAXILLA
146. LINLOW IN 1970
CLASS I BONE
STRUCTURE
EVENLY SPACED
TRABECULAE
WITH SMALL
CANCELLATED
SPACES
CLASS II BONE
STRUCTURE
SLIGHTLY LARGER
CANCELLATED
SPACES
LESS
UNIFORMITY OF
THE OSSEOUS
PATTERN
CLASS III
BONE
STRUCTURE
LARGE MARROW
FILLED SPACES
BETWEEN BONE
AND
TRABECULAE
147.
148. LEKHOLM AND ZARB IN 1985
QUALITY I
HOMOGENOUS
COMPACT BONE
QUALITY II
THICK LAYER OF
COMPACT BONE
SURROUNDING
DENSE TRABECULAR
BONE
QUALITY III
THIN LAYER CORTICAL
BONE SURROUNDING
DENSE TRABECULAR
BONE (FAVOURABLE
STRENGTH)
QUALITY IV
THIN LAYER OF
CORTICAL BONE
SURROUNDING LOW
DENSITY
BONE
155. Both jaw bones start as small centers of endochondral ossification around
stomodaeum
Later, the teeth become separated from each other by the development of interdental
septa.
156.
157. With the onset of root formation, inter radicular bone develops in multi rooted teeth.
When a deciduous tooth is shed, its alveolar bone is resorbed.
The size of the alveolus is dependent upon the size of the growing tooth
germ.
Resorption occurs on the inner wall of the alveolus while deposition occurs on the
outer wall.
The developing teeth therefore come to lie in a trough of bone called the Tooth Crypt.
158.
159.
160. The succedaneous permanent tooth moves into place developing from its own alveolar
bone from its own follicle
Mandibular basal bones begins mineralization at the exit of the mental
nerve of the mental foramen
Maxillary basal bone begins mineralization at the exit of the infraorbital nerve from the
infraorbital foramen
172. HORMONES
• PRODUCED IN RESPONSE TO HYPOCALCEMIA-STIMULATING BONE RESORPTION
• “DUAL EFFECT” OF RESORPTION & FORMATION
• BONE RESORPTION STIMULATED BY PTH (CONTINOUS SUPPLY) SYNTHESIS OF RANKL
• INTERMITTENT DOSE: STIMULATE FORMATION OF BONE BY INCREASE IN GROWTH
FACTORS AND DECREASE ISN APOPTOSIS OF OSTEOBLASTS
PARATHYROID
HORMONE
173. • SECRETED WHEN THE BLOOD CALCIUM LEVEL RISE
• INHIBITS BONE RESORPTION- PROMOTE CALCIUM SALT CALCIUM LEVELS
• AS BLOOD CALCIUM FALLS: CALCITONIN RELEASE WANES
• REDUCE ACTIVITY OFOSTEOCLASTS
CALCITONIN
174. COUPLING
• The interdependency of osteoblasts and osteoclasts in
remodelling is called COUPLING
• The bone matrix laid down by the osteoblast is non-
mineralized OSTEOID.
• While new osteoid is being deposited the older
osteoid located below the surface becomes
mineralized as the mineralization front advances.
177. MARKERS OF BONE
TURNOVER
SERUM MARKERS
(BONE FORMATION)
ALK PHOSPHATASE
OSTEOCALCIN
PROCOLLAGEN I
EXTENSION PEPTIDE
URINARY MARKERS
(BONE RESORPTION)
URINE CALCIUM, URINARY
HYDROXY PROLINE URINE
N,C TELOPEPTIDE URINE
PYRIDINOLINE
178. BONE LOSS IN VARIOUS CONDITIONS
• Bone destruction caused by extension of gingival inflammation.
• Bone destruction caused by trauma from occlusion.
• Bone destruction caused by systemic disorders-
• Osteitis fibrosa cystica
• Paget’s disease
• Fibrous dysplasia
• Osteopetrosis
• Osteoporosis
• Scleroderma
• Malignancy
187. FACTORS DETERMINING BONE MORPHOLOGY
• The thickness, width and crestal angulation of the interdental septa.
• The thickness of the facial and lingual alveolar plates.
• The presence of fenestrations and dehiscence.
• The alignment of the teeth.
• Root and root trunk anatomy.
• Root position within the alveolar process.
• Proximity with another tooth surface.
188.
189. EXOSTOSIS
• These are outgrowths of bone of varied size and shape.
• They can occur as small nodules, large
• nodules, sharp ridges, spike-like projections or
• any combination of these.
• In rare cases, found to develop after the
• placement of free gingival grafts.
190.
191. TRAUMA FROM OCCLUSION
• May cause a thickening of the cervical margin of alveolar bone or a change in the
morphology of bone (eg. angular defects, buttressing bone) on which inflammatory
changes will later be superimposed.
192. BUTTRESSING BONE FORMATION (LIPPING)
• Bone formation sometimes occurs in an attempt to buttress bony trabaculae
weakened by resorption.
• When it occurs within the jaw, termed Central buttressing bone formation.
• When it occurs on the external surface, termed Peripheral buttressing bone
formation.
• The latter may cause bulging of the bone contour, termed as Lipping, which
sometimes accompanies the production of osseous craters and angular defects.
194. FOOD IMPACTION
• Interdental bone defects often occur where proximal contact is abnormal or absent.
• Pressure and irritation from food impaction contribute to the inverted bone
architecture.
• Poor proximal relationship may result from a shift in tooth position because of
extensive bone destruction preceding food impaction.
195.
196. AGGRESSIVE PERIODONTITIS
• Vertical or angular pattern of alveolar bone
• destruction is found around the first molars.
• The cause of the localized bone destruction is unknown.
197.
198. FENESTRATION AND DEHISCENCE
• Fenestrations - isolated areas in which the tooth is denuded of bone and the root surface is
covered only by periosteum and overlying gingiva.
Dehiscence - When the denuded areas extend through the marginal bone.
• Occurance - on approximately 20% of the teeth.
• Occur more often on the facial bone than on
• the lingual bone.
• More common on anterior teeth than on
• posterior teeth, and are frequently bilateral.
• Important because they complicate the outcome of periodontal surgery.
199.
200. BONE DESTRUCTION PATTERNS IN PERIODONTAL DISEASE
• Periodontal disease alters the morphologic features of the bone, in addition to reducing bone height.
• An understanding of its nature and pathogenesis is essential for effective diagnosis and treatment.
• Horizontal bone loss
• Bone deformities
• Vertical or angular defects
• Osseous craters
• Bulbous bone contours
• Reversed architecture
• Ledges
• Furcation involvement
201. BONE DEFORMITIES
(OSSEOUS DEFECTS)
• Different types of bone deformities seen in periodontal disease.
• Presence may be suggested on radiographs.
• Careful probing and surgical exposure of the areas required to determine their exact
nature.
202. HORIZONTAL BONE LOSS
Most common pattern of bone loss in periodontal disease.
Bone is reduced in height.
Bone margin remains approximately perpendicular to the tooth surface.
The interdental septa and facial and lingual plates are affected, but not necessarily to
an equal degree around the same tooth.
203.
204. VERTICAL OR ANGULAR DEFECTS
• Occur in an oblique direction, leaving a hollowed-out trough in the bone along side the root;
the base of the defect is located apical to the surrounding bone.
• Angular defects are classified on the basis of the number of osseous walls, into one, two or
three walls.
• The number of walls in the apical portion of the defect may be greater than that in its occlusal
portion, termed as Combined osseous defect.
• Vertical defects occurring interdentally can generally be seen on the radiograph, although
thick, bony plates sometimes may obscure them.
• Angular defects can also appear on facial and lingual or palatal surfaces but are not seen on
radiographs.
208. • Surgical exposure is the only way to determine the presence and configuration of vertical osseous
defect.
• Vertical defects increase with age.
• Vertical defects detected radiographically - most often appear on the distal and mesial surfaces.
• Three wall defects are more frequently found on the mesial surfaces of upper and lower molars.
• Originally called an Intrabony defect.
• Appears most frequently on the mesial aspects of second and third maxillary and mandibular molars.
• The one wall vertical defect is also called a Hemiseptum.
209. OSSEOUS CRATERS
• Concavities in the crest of the interdental bone confined within the facial and the
lingual walls.
• Found to make up about one third (35.2%) of all defects and about two thirds (62%)
of all mandibular defects.
• Occur twice as often in posterior segments than in anterior segments.
210.
211. • Reasons for the high frequency of interdental craters are-
• Interdental area collects plaque and is difficult to clean.
• The normal flat or even concave faciolingual shape of the interdental septum in
lower molars may favor formation.
• Vascular patterns from the gingiva to the center of the crest may provide a pathway
for inflammation.
212. BULBOUS BONE CONTOURS
• Bony enlargements caused by exostoses , adaptation to function or buttressing
bone formation.
• Found more frequently in the maxilla than in the mandible.
213.
214. REVERSED ARCHITECTURE
• Loss of interdental bone, including the facial and lingual plates, without
concomitant loss of radicular bone, thereby reversing the normal architecture.
• More common in the maxilla.
217. FURCATION INVOLVEMENT
• Invasion of the bifurcation and trifurcation of multirooted teeth by periodontal disease.
• The number of furcation involvements increases with age.
• Classified as grades I, II, III and IV, according to the amount of tissue destruction.
• Grade I is incipient bone loss.
• Grade II is partial bone loss (cul-de-sac).
• Grade III is total bone loss with through and through opening of the furcation.
• Grade IV is similar to Grade III, but with gingival recession exposing the furcation to view.
• The diagnosis is made by clinical examination and careful probing with a specially designed
probe.
218.
219.
220. THERAPEUTIC CONSIDERATIONS
• Many osseous grafting materials are currently available.
• Has been used in periodontal surgery since the 1970’s.
• Involves a surgical procedure to place bone or bone substitute material into a
bone defect with the objective of producing new bone and possibly the
regeneration of periodontal ligament and cementum.
221.
222. AUTOGRAFTS
• Utilizes the patient’s bone, obtained from intraoral or extraoral sites.
• Best materials for bone grafting.
• Very well accepted by the body and may produce the fastest rate of bone growth.
• Potential risk of additional discomfort and a secondary procedure.
• Patient is assured of protection from disease transmission and/or immune reaction.
223.
224. ALLOGRAFTS
• Available either demineralized or non-demineralized.
• Includes growth factors which are osteoinductive.
• Induces bone growth and provide an environment that increases the body’s
regenerative process.
225.
226. XENOGRAFTS
• Obtained from animal sources; usually cows and/or pigs.
• Include processed animal bone or growth proteins.
• Risk of disease transmission and/or rejection is reduced by processing.
227.
228. SYNTHETIC BONE GRAFTING MATERIALS
• Examples - Natural and synthetic hydroxyapatites, Ceramics, Calcium carbonate
(natural coral), Silicon-containing glasses and Synthetic polymers.
• No risk of disease transmission or immune system rejection.
• Creates an environment that facilitates the body’s regenerative process.
229.
230. BIOLOGICALLY MEDIATED STRATEGIES
• Include materials, such as enamel matrix proteins, that can be premixed with vehicle
solution.
• Intended as an adjunct to periodontal surgery for topical application onto exposed
root surfaces or bone.
• Leaves only a resorbable protein matrix on the root surface, which makes bone
more likely to regenerate.
• Initiates a cascade of events leading to the differentiation of progenitor cells into
phenotypes involved in periodontal regeneration.
231. NEW DEVELOPMENTS
Alveolar distraction
• Alveolar bone distraction recently was introduced as an alternative to bone grafting for ridge augmentation of
traumatically induced, limited alveolar defects.
Micro-osteoperforation
• Bone remodeling allows greater movement of the teeth. The previous highly invasive technique can be
replaced with small, shallow micro-osteoperforations in the alveolar bone without the need for soft tissue
flaps, bone grafting or suturing.
232.
233.
234. CONCLUSION
• The alveolar processes develop and undergo remodeling with the tooth formation
and eruption- Tooth dependent bony structure.
• Although its constantly changing its internal organization, it retains the same form
from childhood through adult life.
• The coupling of bone resorption with bone formation constitutes one of the
fundamental principles by which bone is remodeled throughout its life.
A bone Is a rigid organ that constitutes part of the vertebrate skeleton. They are lightweight yet strong and hard, and serve multiple functions
. Bone is a dynamic biological tissue, composed of various metabolically active cells that are integrated into a rigid framework
Houses roots of teeth anchors roots of teeth helps to move teeth for better occlusion
Helps to absorb forces and distributes equally
Supplies vessels to pdl houses and supports developing permanent teeth and hold primary teeth
Organises eruption of permanent teeth
Dense outer sheet- compact bone central medullary cavity filling- red and yellow marrow extremities network of bone lamellae
Concentric- bulk of compact bone osteon- form basic metabolic unit
Interstitial- interspersed between adjacent concentric lamellae -fills space-fragments of pre-existing concentric lamellae-
Formed by osteons remodelling
Osteon-cylinder of bone oriented parallel to long axis of bone.madeof lamellar bone
Haversian canal- located in center of bone- they have capillaries.lamellar bone surrounds longitudinally oriented vascular channels of haversian canal.
Volmann- interconnection of haversian- vascular connections present- horizontally oriented.
Together makes a 3 d structure..
Vascularized fibrous sheath coversexternal surface of most bones. Except articular surface,tendon insertions. Periosteum contains osteogenic cells-regulate outer shape. Outer fibrous has 2 layers:superficial and deep. Superf: collagenous matrix and less elastic fibers/vascularised and provide nutrients supply.
Inner layer called cambium. Highly cellular. Direct contact with bone. It is a thick layer.
Covers internal surface of all bones(compact and cancellous)
Red- young bone yellow –old (increased accumulation of fat)
1/3rd organic matrix 2/3rd inorganic matter
Cytokines are a large group of proteins, peptides or glycoproteins that are secreted by specific cells of immune system. Cytokines are a category of signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis.
Osteopontin and sialoprotein
Cytokines are a large group of proteins, peptides or glycoproteins that are secreted by specific cells of immune system. Cytokines are a category of signaling molecules that mediate and regulate immunity, inflammation and hematopoiesis.
It is a protein composed of AminoAcid.. Glycine ,proline, hydroxylysine,hydroxyproline.
The amount og collagen in a tissue determined by hydroxyproline. Main function of collagen is maintainance of framework and tone of tissue.
Collagen biosynthesis occurs inside fibroblast to form tropocollagen molecules. These aggregate into tropocollagen molecules. Tropocollagen aggregate into microfibril packed together to form fibril. Fibrils have transverse striations. Characteristic periodicity of 64nm. Striation is caused by overlapping arrangement of tropocollagen molecules.
Type 1 and 3- fibers type 1 form bundles
Basic structural integrity. Resiliance to issue-resist fracture ??why.. Due to elasticity
.(ACTS ON MINERAL PHASE AND HELPS IN INCORPORATION INTO BONE)..ACT AS NEGATIVE REGULATOR- OSTEOCALCIN BIND TO OSTEOPONTIN INTERACT TO OSTEOCLAST .. HELPS IN RECRUITING OSTEOCLAST TO SITES OF NEWLY FORMED BONE.
Mineral binding
Secreted protein acidic and rich in cysteine. Seen in high levels in morphogenesis ,remodelling and repair. Also known as culture shock glycoprotein.
Important role in wound healing.
Specifically expressed by osteoblast. Predominant matrix protein of hard tissue. Important role in osteoblast attachment to mineralized tissues.
Seen in reversal lines. Dentin formation and alveolar bone.
OSTEOPONTIN VITONECTINAND FIBRONECTIN- RGD CONTAINING PROTEINS
SPECIFIC SEQUENCE- ARG-GLY-ASP
Proteoglycans are proteins that are heavily glycosylated. Named after GLYCOSAMINOGLYCANS COVALENTLY BOND TO PROTEIN CORE.
This component allows connective tissues of the Extracellular Matrix (ECM) to be able to withstand compressional forces through hydration and swelling pressure to the tissue.
Dermatopontin is an extracellular matrix protein with possible functions in cell-matrix interactions and matrix assembly..
Before mineralization osteoblast produce matrix vescicles- contain enzyme(alk phosphatase)-which start nucleation of hydroxyapatitecrystals.
HOA grow and develop –form coalescing bone nodules. combination with fast growing nonoriented collagen fibers. --- substructure of woven bone.
Later by bone deposition ,remodelling and secretion of collagen fibers in sheets –mature lamellar bone is formed.
1st bone formed- alveolus..
HOA alligened with long axis parallel to collagen fibers. In mature bone hao gets deposited on and within collagen fibers.
In this way bone matrix is able to withstand heavy mechanical stresses.
OSTEOCYTES- ENTRAPED IN BONE METRIX , REMAIN ON SURFACE AS LINING CELLS
OSTEOCLAST- ‘BONE AND BROKEN’ , REMOVES BONE TISSUE, REMOVES MINERALIZED MATRIX
MESENCHYMAL ORIGIN. PERIOSTEUM SERVES AS RESERVOIR
Mononucleated cells
Golgi - secretion and intracellular transport.
Centrosome- contain cell microtubules it regulates cell division cycle.
Cytoplasm- The jelly-like fluid
ribosome: makes protein. functions- repairing damage chemical processes. floating inside cytoplasm/attached endoplasmic reticulum-help in production/storage of proteins/ rough- ribosome.
Mitochon-perform cellular respiration. Cytoske-maintain shape and internal organization,
vescicle-contain lipid/helps to move molecule
nucleolus-makes ribosomal subunits
nucleus-stores the cell's hereditary material /coordinates the cell's activities
Other name endoglin. – type 1 memb glycoprotein run x 2 – core binding factoer
OSTEOCALCIN AND CBFA 1 ARE SPECIFIC TO OSTEOBLAST LINEAGE.
Alk phosphatase- cytochemical marker to distinguish preosteoblasts from fibroblasts
In bone matrix
4 SCHEMES 1. CELLS GET TRAPPED IN THEIR OWN SECRETION 2. WITHIN SAME GENERATION ARE POLARIZED DIFFERENTLY TO THOSE IN ADJACENT LAYERS
4 SO THAT THEY GET TRAPPED BY SECRETION OF NEIGHBURING CELLS
It is also said that osteoblast are highly polarised- function as a unit to lay down bone.
All cells move away from osteogenic front as bone matrix deposited-resulting in acellular bone
OSTEOCYTES- ENTRAPED IN BONE METRIX , REMAIN ON SURFACE AS LINING CELLS
OSTEOCLAST- ‘BONE AND BROKEN’ , REMOVES BONE TISSUE, REMOVES MINERALIZED MATRIX
Osteoblast flattens-when bone is not forming and extends along the bone surface.
Missing osteoblast die by apoptosis- groth factors and cytokines promote this
Ynf promotes apoptosis.
Tnf-b and il-6 has antiapoptotic effects
Glucocorticoids and estrogen withdrawal promotes apoptosis in osteoblast and osteocyte
In transformation 3 cells are involved preosteoblast differenciate into osteoblast and osteoblast trapped into osteocyte.
Preosteoblast- less cuboidal, located away from bone,do not deposit bone, but can divide, produce collagen
RANK- receptor activator of nuclear factor kappa b.
THAT PART OF THE CELL LYING ADJACENT TO BONE WHERE RESORPTION IS OCCURING- STRIATED IN APPERARENCE
OSTEOCLAST WITH MORE NUCLEI RESORB BONE MORE THAN OSTEOCLAST WITH LESS NUCLEI
PRESENENCE OF ACID phosphatase distinguishes osteoclast from other multinucleated giant cell
Macrophage colony stimulating factor- secreted cytokine. Differenciate haematopoetic stem cell to macrophage.
C- fos is a protooncogene.
Cfu-gm is a colony forming unit. Pu 1 is a transcription factor.
Osteoprotegrin. a protein secreted mainly by cells of the osteoblast lineage which is a potent inhibitor of osteoclast formation by preventing binding of RANKL to RANK
Osteoprotegrin. a protein secreted mainly by cells of the osteoblast lineage which is a potent inhibitor of osteoclast formation by preventing binding of RANKL to RANK
Macrophage colony stimulating factor- secreted cytokine. Differenciate haematopoetic stem cell to macrophage.
C- fos is a protooncogene.
Cfu-gm is a colony forming unit. Pu 1 is a transcription factor.
All trance retinoic acid – vit A
THIS ARTICLE WAS TAKEN FROM FRONTIERS OF ENDOCRINOLOGY - Retinoid Receptors in Bone and Their Role in Bone Remodeling PUBLISHED ON MARCH 2015.
Microvilli provides large surface area- for resorptive process
Cathrpsin present
Tartarate rich acid phosphatase.
Several osteoclasts excavating a large area on bone which is the leading edge of resorption is termed as the Cutting cone.
HOWSHIPS LACUNAE- ERODED BONE SURFACE
Intramemb ossification: occurs by the inner periosteal osteogenic layer .bone synthesised without cartilage phase.skull maxilla and mand are formed.
Bone developing area- loose mesenchymal cells with interconnecting cytoplasmic process osteogenesis center is formed
CCALCIFICATION OCCURS-OSTEOCYTES OBTAIN NUTRIENTS AND OXYGEN BY DIFFUSION ALONG CANALICULI
IRREGULAR SPICULE: 1ST FORMED BONE MATRIX
IRREGULAR SPICULE: 1ST FORMED BONE MATRIX TRABECULAE EXTEND IN RADIAL PATTERN- SPONGY BONE
TRABECULAE ENCLOSE BLOOD VESSELS- EARLY MEMBRANE BONE- WOVEN BONE
IN VASCULAR AREA OSTEOGENIC CELLS GIVE RISE TO OSTEOBLAST- AREA WITH NO BLOOD VESSEL-CHONDROBLAST- FORM CARTILAGE
NEW LAYERS OF BONE DEPOSITED ON PRE-EXISTING BONE SURFACE
APPOSITIONAL GROWTH:OSTEOGENIC CELLS ON SURFACE OF TRABECULAE –SUPERFICIAL POSITION-REPEATING PROCESS AGAIN
BUILD UP OF BONE TISSUE –ONE LAYER AT A TIME , TRABECULAR SIZE INCREASE.
REMODELLING OF TRABECULAE- MAINTAIN SIZE AND SHAPE.
OSTEON FORMED
Forms within hyaline cartilage. At the site where bone develops. Condensation of mesenchymal cells in avascular condition
Chodroblast lay down cartilagenus matrix (perichondrium surrounding)Mineralization of matrix
Increase in length (interstitial growth) Increase in thickness( appositional growth)
Formation of periosteum:In the middle of diaphysis capillaries grow into the perichondrium PERICHONDRIUM is later referred to as periosteum
Cells in the inner layer of perichondrium(periosteum) Differenciate into osteoblast thin collar of bone matrix formedHappens around the mid region of model
Periosteal capillaries and osteogenic cells invade mid region of model– development of primary ossification center
Periosteal bud: Osteogenic cells in periosteal bud– differenciate into osteoblast Deposit bone matrix on residual calcified cartilage
calcification of matix- chondrocytes grow and secrete alk phosphatase calcification of matrix Blood supply cut off- no nutrient-death of chondrocytes-cavitation of cartilage matrix
Osteoclast break down newly formed spongy bone- formation of medullary cavity
2nd stage – 2 ends of developing bone- composed of cartilage(epiphysis)
Bone formation- no medullary cavity formation in epiphysis
Hyaline cartilage- 2 places: articular cartilage , junction of epiphysis and diaphysis(epiphyseal plate)
Alv bone has 3 types of bone woven ,cortical,cancellous. Woven- immature, formed during embryonic stage,fracture healing,pathological state.(pagets,hyperpara)
Cortical/compact/lamellar- maturation of woven bone. Well organised vascular structure.
Attachment of osteoclast to the mineralized surface of bone.
Creation of a sealed acidic environment through action of the proton pump , which demineralises bone and exposes organic matrix
Degradation of the exposed organic matrix to its constituent amino acids-by the action of released enzymes-phosphatase and cathepsin.
Sequestering of mineral ions and amino acids within the osteoclast.
Bone resorption to deposition –reversal
Resting – deposition of bone
ANT PART OF MAXILLA PALATINE PROCESS FUSES WITH ORAL PLATE OF ALVEOLAR PROCESS
IN POST PART OF MANDIBLE; OBLIQUE LINE IS SUPERIMPOSED LATERALLY ON THE BONE OF ALVEOLAR PROCESS
Lamellae of lamellated bone….
Radiographically known as lamina dura due to increased opacity
CORTICAL PLATE CONSIST OF COMPACT BONE- FORM OUTER AND INNER PLATES OF THE ALVEOLAR PROCESS- THINNER IN MAXILLA THAN IN MANDIBLE- THICKEST IN THE BUCCAL SIDE OF LOWER PREMOLAR AND MOLAR MAXILLARY OUTER CORTICAL PLATE IS PERFORATED BY MANY SMALL OPENINGS-BLOOD AND LYMPH VESSELS PASS THROUGH IT
BONE UNDERLYING GINGIVA-SPONGY BONE –ABSENT-CORTICAL PLATE FUSED WITH ALVEOLAR BONE PROPER-CRIBRIFORM AND CORTICAL PLATE IS COMPACT BONE
HISTOLOGICALLY: CONSIST OF LONGITUDINAL LAMELLAE AND HAVERSIAN SYSTEM
Spongy/cancellous/trabecular-honey comb like structure..haemopoetic tissue fillings seen within the bone..oriented perpendicular to provide structural support.
DIPLOE – SEPARATE INNER AND OUTER CORTICAL PLATES
Spongy/cancellous/trabecular-honey comb like structure..haemopoetic tissue fillings seen within the bone..oriented perpendicular to provide structural support.
Parallels cej of the teeth.
INCLINATION MORE PRONOUNCED IN THE PREMOLAR AND MOLAR REGION – TEETH TIPPED MESIALLY
D1 – dense cortical bone D2:DENSE TO POROUS CORTICAL BONE COARSE TRABECULAR BONE WITHIN
D3- THINNER POROUS CORTICAL CREST FINE TRABECULAR REGION D4- NO CRESTAL CORTICAL BONE. FINE TRABECULAR BONE PRESENT
Alveolar procees develops along with eruption of teeth.during 2nd month of fetal life , groove formed in max and mand. Opens toward the surface of oral cavity.
Major portion of alveolar process begins to form during root formation and eruption of the teeth.
MAX AND MAND-1ST BRANCHIAL ARCH TEETH BECOME SEPERATED FROM EACH OTHER BY INTERDENTAL SEPTA
IN ROOT fORMATION- INTERRADICULAR BONE DEVELOPS
Resorption occurs on the inner wall of the alveolus while deposition occurs on the outer wall.
The developing tooth lie in a trough of bone-bone crypt
FUNCTION OF REMODELLING: PREVENT ACCUMULATION OF DAMAGED AND FATIGUED BONE BY REGENERATING NEW BONE , ALLOW BONE TO RESPOND TO MECHANICAL FORCES , FACILITATE MINERAL HOMEOSTASIS
BMU:bone remodelling is done by clusters of bone resorbing osteoclast and bone forming osteoblast arranged within temporary anatomical structure called basic multicellular units.
ACTIVE BMU CONTAINS LEADING FRONT OF BONE RESORBING OSTEOCLAST
Traversing and encapsulating BMU(basic multicellular unit) is a canopy of cells –bone remodelling compartment(brc). REVERSAL CELLS FOLLOW OSTEOCLASTS- COVER NEWLY EXPOSED BONE SURFACE &PREPARE FOR DEPOSITION OF REPLACEMENT BONE
.
OSTEOBLAST OCCUPY TAIL PORTION – SECRETE AND DEPOSIT OSTEOID(UNMINERALIZED BONE MATRIX) AND FINALLY FORMS MATURE LAMELLAR BONE. A BALANCE BETWEEN BONE SYNTHESIS AND BONE BREAKDOWN OCCURS SIMULATEOUSLY- COUPLING OF BONE RESORPTION AND FORMATION
Activation..SIGNAL DETECTION DUE TO MECHANICAL STRAIN & HORMONAL ACTION , RECRUIT MONOCYTE MACROPHAGE OSTEOCLAST PRECURSOR…. INTERACTION OF PRECURSOR CELLS RANKL –OSTEOBLAST RANK –OSTEOCLAST DIFFERENCTIATION MIGRATION FUSION
OSTEOCLAST DISSOLVE MINERALS . RESORPTION TUNNEL / CUTTING CONE – SCALLOPED HOWSHIPS LACUNAE IS FORMED. MACROPHAGE REMOVE COLLAGEN REMANATS (MONONUCLEAR CELLS)
Reversal phase:RESORPTION CAVITIES CONTAIN PREOSTEOBLAST APOPTOSIS OF OSTEOCLAST NEW BONE FORMATION ON REVERSAL LINE
Formation: Once osteoblasts generate in the resorption site, they start producing alkaline phosphate, which helps in the formation of new bone matrix, known as osteoid. Then they materialize and form a completely new bone. The surface of the bone again returns to its resting phase (quiescence phase) and this completes the bone remodeling cycle.
PTH PRODUCED IN PARATHYROID GLAND
Osteitis fibrous cystica- (hyperparathyroidism), in which bone tissue becomes soft and deformed. The brown tumor is a bone lesion that arises in settings of excess osteoclast activity, such as hyperparathyroidism. decreased bone trabeculation giving it a ‘ground-glass’ or granular appearance. There is also a well-defined, multilocular radiolucent entity in the right/anterior mandible that is consistent with a brown tumor.
Histological picture of bone shows- fibrosis and intratrabecular tunnels of bone
PAGETS -Early stage – radioleucency and alteration of trabecular pattern late stage- patchy areas of sclerotic bone- cotton wool appearance
Fibrous dysplasia is a disorder where normal bone and marrow is replaced with fibrous tissue, resulting in formation of bone that is weak and prone to expansion.
Case report on unusual presentation of peripheral buttressing of bone in anterior maxilla. Published in contemporary clinical journal in 2012