The document provides an overview of alveolar bone, including its classification, histology, composition, development, parts, functions, remodeling, blood and nerve supply, and age-related changes. Key points include that alveolar bone develops during tooth eruption, consists of alveolar bone proper and supporting alveolar bone (cortical plates and spongy bone), and its morphology is determined by the shape and location of teeth. Alveolar bone anchors teeth, distributes occlusal forces, and is remodeled through the coupling of bone resorption and formation.
alveolar bone in health with microscopic features and details about bone formation, resorption also includes bone remodelling and changes after extraction
alveolar bone in health with microscopic features and details about bone formation, resorption also includes bone remodelling and changes after extraction
Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Coronal and radicular pulp
Apical foramen
Accessory canal
Functions of dental pulp
Components of dental pulp
Functions of pulpal extracellular matrix
Organization of cells in the pulp
The principle cells of the pulp
The pathways of collagen synthesis
Matrix and ground substances
Vasculature and lymphatic supply
Innervation of Dentin- pulp complex
Disorders of the dental pulp
Advances in pulp vitality testing
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
this ppt depicts pattern of bone destruction. its a very good slide show showing the process of bone formation, bone destruction and their patterns in periodontal diseases.
Alveolar bone / /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Alveolar bone /certified fixed orthodontic courses by Indian dental academy Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
The bone of the skeleton is a mineralized vascular type of connective tissue with a solid matrix. The alveolar process is the bony extension of the mandible and maxilla that provides the necessary support for the teeth and serves as a site of attachment for the periodontal ligament fibers. By its resorption and deposition, it also compensates for tooth movement.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
4. •Thickness of Alveolar bone
•Periosteum
•Endosteum
•Functions of Alveolar bone
•Remodeling and Repair
•Blood supply
•Nerve supply
•Age Changes
•Clinical Considerations
•Conclusion
•References
5. INTRODUCTION
BONE is a specialized connective tissue that is mainly
characterized by its mineralized organic matrix.
The alveolar process is the portion of maxilla and
mandible that forms and support the tooth socket.
It forms when tooth erupts to provide the osseous
attachment to the forming periodontal ligament; it
disappears gradually after the tooth is lost.
6. These are tooth dependent bony structures therefore
the size, shape, location and function of the teeth
determines their morphology.
7. CLASSIFICATION
OF BONE
BASED ON DEVELOPMENT
•Endochondral bone
•Intramembranous bone
•Sutural bone
BASED ON THEIR MICROSCOPIC STRUCTURE
IMMATURE BONE OR WOVEN BONE
&
MATURE BONE
•Compact (cortical) bone
•Cancellous (spongy) bone
8. Bone formation is preceded by
formation of cartilage which is
later replaced by bone
(Horton,1990).
Occurs in extremities of all
long bones, in vertebrae, in ribs,
in articular extremities of the
mandible and the base of skull.
Endochondral bone
9.
10. •Bone develops directly within
the soft connective tissue.
•Occurs in Maxilla and Body of
mandible, cranial vault and
midshaft of long bones.
INTRA MEMBRANOUS /
DIRECT BONE FORMATION
11.
12. •Bone forms along suture margins
•Not seen in relation to alveolar
bone.
•Occurs in skull, fibrous joints.
•Helps skull and face to
accommodate growing organs like
brain.
SUTURAL BONE
GROWTH
13. Immature bone /Fibrous bone :
• These have more cells & fibers in them.
• These are first formed bone.
• In humans they are found only in fetus or in sockets
of alveolar bone, during fracture repair and sutures
of the skull.
• Also Known as Woven Bones.
Mature bone /Lamellar bone: The type of bone which
are composed of thin plates (lamellae) of bony
tissue.
•Compact (cortical) bone
•Cancellous (spongy) bone
14. COMPACT (CORTICAL) BONE
• Composed of dense and concentrically arranged bony
trabeculae or lamella.
• More solid with fewer cavities.
• Found external to spongy bone
• Presence of haversian system.
15. CANCELLOUS (SPONGY) BONE
•Composed of bone trabeculae or spicules.
•Has a simple and less organized architecture.
•Has a lattice-work pattern with numerous small cavities.
•Found internal to compact bone.
•Has no haversian system.
16. Bone
Outer compact bone Central medullary cavity
(Trabacular / Spongy /
Cancellous bone)
BONE HISTOLOGY
17. • Bone whether Compact or Trabecular are
deposited in layers, or lamellae, each lamella
being about 5µm thick.
Three distinct types of layering are recognised :
Circumferential lamellae encloses the entire
adult bone, forming its outer and inner perimeters.
Concentric lamellae forms the bulk of compact
bone & forms the basic metabolic unit of bone – The
Osteon.
Interstitial lamellae interspersed between adj.
concentric lamellae and fills the spaces between
them.
21. Alveolar process is that portion of the maxilla and
mandible that forms and supports the tooth sockets
(alveoli).
DEFINITION
Joseph P Fiorellini, David M Kim, Satashi O Ishikawa. The
Tooth Supporting Structures. In: Fermin A. Carranza, editor.
Clinical Periodontology, 10th edition, Noida: Elsevier; 2009.
p.68–92.
22. DEVELOPMENT OF
ALVEOLAR BONE
Near the end of 2nd month of fetal life, mandible
and maxilla form a groove that is opened toward the
surface of the oral cavity.
As tooth germ starts to develop, bony septa form
gradually.
The alveolar process starts developing strictly during
tooth eruption.
25. Inner socket
wall of thin
compact bone
called alveolar
bone proper.
Cancellous
trabaculae between
these two compact
layers.
An external
plate of
cortical bone
Alveolar process
consists of :
26. The parts of the alveolar bone
1. Alveolar bone proper
2. Supporting alveolar bone
o Cortical plates
o Spongy bone
27. ALVEOLAR BONE
PROPER
•Cribriform plate (anatomic term)
•Lamina dura (radiographic term)
•Bundle bone (histologic term, coined by Stein and
Weinmann, 1925)
•It is that bone in which the principal fibers of the
periodontal ligament are anchored. (Sharpey’s fibers).
•This type of bone contains several layers of bone
deposited in orientation parallel to the tooth socket
wall.
28.
29. It is characterized by the scarcity of the fibrils in
the intercellular substance.
It contains fewer fibrils than lamellated bone.
Since bundle bone contains more calcium salts per unit
area than other type of bone tissues, they appear as
dense radioopacities in roentgenograms.
30. SUPPORTING ALVEOLAR
BONE
Surrounds the alveolar bone proper and gives
additional support.
It consists of
o Cortical plates
o Spongiosa/ Cancellous
31. •It consists of compact bone and forms the outer and
inner plates of alveolar processes.
•It is found in mandible & maxilla although cortical bone
is more prominent in mandible.
•It makes upto 80% of the body of the mandible.
CORTICAL BONE
32. •It is formed by haversian bone and
compacted lamellae.
33. •Spongy bone (anatomic term)
•Trabecular bone (radiographic term)
•Cancellous bone (histologic term)
Presence of trabeculae enclosing irregular marrow
spaces lined with a layer of thin, flattened endosteal
cells.
Variation in trabeculae pattern depending upon occlusal
forces and genetically.
CANCELLOUS BONE
34. Matrix consists of irregularly arranged lamellae
separated by incremental and resorption line.
It makes upto 20% of the body of the mandible.
Cancellous bone is metabolically more active, thus
skeletal metabolism is equal between both cortical &
cancellous bone.
35. INTERDENTAL SEPTA
•The interdental septa are bony partitions that separate
adjacent alveoli.
•Coronally, the inner & outer cortical plates fuse 1mm apical to
the Cemento-enamel junction.
•The mesiodistal angulation of crest of the interdental septum
usually parallels a line drawn between the CEJ of the
approximating teeth.
36.
37. The mesiodistal and faciolingual dimensions and shape
of the interdental septum are governed by the size and
convexity of the crowns of the two approximating teeth,
as well as by the position of the teeth in the jaw and
their degree of eruption.
38. ALVEOLAR CREST
•The alveolar crest is normally rounded or beaded.
•However on the buccal aspect of incisor & canine, the
bone margins ends in a fine sharp edge.
39. •The contour of crestal margin varies with the shape of
root.
•When root surface is flat, the contour is straight or flat.
•When convex, the contour is scalloped.
•When concave, the bone margin arch coronally.
•Scalloping is accenuated when bone is thin & reduced when
thick.
40.
41. THICKNESS OF ALVEOLAR BONE-
MAXILLA
•The alveolar bone is thicker on
the palatal aspect than on the
buccal.
•The bone plate is thicker on
the posterior region than on
the anterior region.
42. THICKNESS OF ALVEOLAR
PROCESS IN MANDIBLE
•In the incisor & premolar region, bone plate is
thinner on the buccal aspect than on the lingual.
•In the molar region, Alveolar Process is thicker on
the buccal than on the lingual.
43. PERIOSTEUM &
ENDOSTEUM
The outer aspect of cortical bone is surrounded by a
connective tissue membrane which has two layers.
1. The outer fibrous layer – Periosteum
2. The inner cellular layer - Endosteum
44. PERIOSTEUM
•It consists of dense irregular connective tissue.
•It serves as a reservoir of osteoblasts.
•The periosteum is important during growth,
fracture repair and healing around implants.
•Usually at the periosteal surface, bone
formation exceeds bone resorption, creating a
net increase in outer diameter of bone with age.
45. PERIOSTEUM
Its functions are :
o Medium through which muscles, tendons and
ligaments are attached to bone.
o Nutritive function to the bone
o Osteoprogenitor cells – Important role during
development and repair after fracture
o Fibrous layer- acts as limiting membrane
(exostoses in cases of periosteal tear)
o Formation of tubercles at site of attachment of
tendons.
46. • Rich in blood vessels,
nerves.
• Contains collagen fibres
and fibroblasts.
Outer
layer(fibrous)
• Composed of osteoblasts
and osteoprogenitor cells
• Cellular periosteum
Inner layer
(osteogenic)
47. ENDOSTEUM
•The tissue lining the internal bone cavities is called
Endosteum.
•It is composed of a single layer of osteoblasts and a
small amount of connective tissue.
•It consists of:
An inner layer which is osteogenic layer
An outer layer which is fibrous layer.
•It consists of loose connective tissue containing
osteogenic cells, that physically seperates the bone
surface from marrow within.
48.
49. FUNCTIONS OF
ALVEOLAR BONE
1.Houses -root of teeth.
2. Anchors - root of teeth to Alveoli.
3. Helps to move teeth for better occlusion.
4.Helps to absorb and distribute occlusal forces
generated during tooth contact.
5. Supplies vessels to Periodontal ligament.
50. 6. Houses and protects developing permanent teeth,
while supporting primary teeth.
7. Organizes eruption of permanent and primary teeth.
8. Acts as a reservoir for ions.
9. Provide attachment to muscles.
52. BONE TURNOVER
(REMODELING)
Modelling -The process by which the overall size and
shape of bones is established.
Remodeling –
•The process by which there is constant resorption of bone
occuring on a particular bony surface, followed by a phase
of bone formation.
•It is the replacement of old bone by new bone.
•Bone turnover does not stop when adulthood is reached,
although its rate slows.
•It usually takes place at the periosteal & endosteal
surfaces leading to changes in shape of growing bone.
53. BONE REMODELLING
During remodeling, termination of bone
resorption by osteoclasts and the initiation of
bone formation by osteoblasts occurs through a
coupling mechanism.
The coupling process ensures that the amount of
bone removed is similar to the bone laid down
during the subsequent bone formation phase.
In certain diseases and with age, the resorption
exceeds formation.
54. SEQUENCE OF EVENTS IN BONE
REMODELLING
First, the Osteoclasts tunnel into the surface of bone
which lasts for 3 weeks
In Haversian canals, closest to the surface, osteoclasts
travel along a vessel, resorb the haversian lamellae and a
part of circumferential lamellae, and form a resorption
tunnel or CUTTING CONE.
55. After sometime the resorption ceases and osteoclasts
are replaced by osteoblasts.
These osteoblasts lay down a new set of haversian
lamellae , encircling a vessel upon a reversal line.
The entire area of osteon where active formation
occurs is termed as FILLING CONE.
56. BLOOD SUPPLY
It receive blood supply from inferior and superior
alveolar arteries for mandible and maxilla ,
respectively and reaches Periodontal ligaments from
three sources; apical vessels, penetrating vessels from
the alveolar bone and anastomosing vessels from
gingiva.
57. Nerve Supply
Labial aspect of maxillary incisors, canines & premolars
is innervated - superior labial branches from the
infraorbital nerve.
Buccal aspect of maxillary molar regions innervated -
branches from the posterior superior alveolar nerve.
Palatal aspect by greater palatine nerve, except for
incisor which is innervated by long sphenopalatine nerve.
58. • Lingual aspect in mandible -
lingual nerve
• Labial aspect of mandibular
incisors & canines - mental
nerve.
• Buccal aspect of the molars -
buccal nerve.
• The nerve enters the
periodontal ligament through
Volkmann's canal of alveolar
bone.
59. AGE CHANGES
• Similar to those occurring in remainder of skeletal system
• Osteoporosis with ageing
• Decreased vascularity
• Reduction in metabolic rate and healing capacity
• Bone resorption may increase or decrease
• More irregular periodontal surface
60. • Thinning of cortical plates
• Rarification of bone
• Reduction in no. of trabeculae
• Lacunar resorption more prominent
• Susceptibility to fracture
• Thickening of collagen fibers
• Decrease in water content
61. CLINICAL CONSIDERATIONS
• FENESTRATION
Isolated areas in which the root is denuded of bone and
root surface is covered only by periosteum and
overlying gingiva is termed as fenestration.
• DEHISCENCE
When denuded areas extend through the marginal
bone , defect is called dehiscence.
63. MANAGEMENT OF FENESTRATION AND
DEHISCENCE
Several treatment modalities includes:
• Root planning along with chlorhexidene mouth rinsing,
• Full thickness mucogingival flap with primary closure,
• Pedicle flap surgery,
• Free gingival grafting,
• Guided tissue regeneration and
• Combination of bone grafting and free mucosal graft.
64. Buttressing bone- adaptive mechanism against occlusal
force (thickened cervical portion of alveolar plate)
Buttressing bone
Management: Osteoplasty followed by gingivoplasty.
65. The bone l o ss i n periodontal disease occurs at
local sites, but i t i s reg ulated by both
syst emic and local fact ors .
Bone resorpt ion is probably t he m ost crit ical
factor i n periodont al att ac hm ent lo ss leading
t o event ual t oot h loss .
Safe guarding the integrity of the periodontal
lig ament and t he alveolar bone i s one of the
most import ant challeng e f o r t he clinician .
CONCLUSION
66. Joseph P Fiorellini, David M Kim, Satashi O Ishikawa. The Tooth
Supporting Structures. In: Fermin A. Carranza, editor. Clinical
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REFRENCES
Editor's Notes
Alveolar bone develops from the dental follicle
The ectomesenchymal cells of the dental follicle differentiate into osteoblasts and lay down the matrix called osteoid
Some osteoblasts become embedded in the matrix and are called osteocytes