The alveolar process () is the portion of
bone
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
containing the
tooth sockets on the
jaw bones (in humans, the
maxilla
In vertebrates, the maxilla (: maxillae ) is the upper fixed (not fixed in Neopterygii) bone of the jaw formed from the fusion of two maxillary bones. In humans, the upper jaw includes the hard palate in the front of the mouth. The two maxil ...
and the
mandible
In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla).
The jawbone i ...
). The alveolar process is covered by
gums
The gums or gingiva (: gingivae) consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.
Structure
The gums are part of the soft tissue lining of the ...
within the
mouth
A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...
, terminating roughly along the line of the
mandibular canal. Partially comprising
compact bone, it is penetrated by many small openings for
blood vessel
Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...
s and connective fibres.
The bone is of clinical,
phonetic
Phonetics is a branch of linguistics that studies how humans produce and perceive sounds or, in the case of sign languages, the equivalent aspects of sign. Linguists who specialize in studying the physical properties of speech are phoneticians ...
and forensic significance.
Terminology
The term ''alveolar'' () ('hollow') refers to the cavities of the tooth sockets, known as
dental alveoli. The alveolar process is also called the ''alveolar bone'' or ''alveolar ridge''.
In
phonetics
Phonetics is a branch of linguistics that studies how humans produce and perceive sounds or, in the case of sign languages, the equivalent aspects of sign. Linguists who specialize in studying the physical properties of speech are phoneticians ...
, the term refers more specifically to the ridges on the inside of the mouth which can be felt with the
tongue
The tongue is a Muscle, muscular organ (anatomy), organ in the mouth of a typical tetrapod. It manipulates food for chewing and swallowing as part of the digestive system, digestive process, and is the primary organ of taste. The tongue's upper s ...
, either on roof of the mouth between the upper
teeth
A tooth (: teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
and the
hard palate
The hard palate is a thin horizontal bony plate made up of two bones of the facial skeleton, located in the roof of the mouth. The bones are the palatine process of the maxilla and the horizontal plate of palatine bone. The hard palate spans ...
or on the bottom of the mouth behind the lower teeth.
The curved portion of the process is referred to as the alveolar arch. The alveolar bone proper, also called bundle bone, directly surrounds the teeth.
The terms ''alveolar border'', ''alveolar crest'', and ''alveolar margin'' describe the extreme rim of the bone nearest to the
crowns of the teeth.
The part of alveolar bone between two adjacent teeth is known as the interdental septum (or interdental bone).The connected, supporting area of the jaw (delineated by the apexes of the roots of the teeth) is known as the basal bone.
Structure
On the
maxilla
In vertebrates, the maxilla (: maxillae ) is the upper fixed (not fixed in Neopterygii) bone of the jaw formed from the fusion of two maxillary bones. In humans, the upper jaw includes the hard palate in the front of the mouth. The two maxil ...
, the alveolar process is a ridge on the inferior surface, making up the thickest part of the bone. On the
mandible
In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla).
The jawbone i ...
it is a ridge on the superior surface. The structures hold the teeth and are encased by
gums
The gums or gingiva (: gingivae) consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.
Structure
The gums are part of the soft tissue lining of the ...
as part of the
oral cavity
A mouth also referred to as the oral is the body orifice through which many animals ingest food and vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also the first part of the alime ...
.
The alveolar process comprises
cells and
periosteum
The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. (At the joints of long bones the bone's outer surface is lined with "articular cartila ...
, also encompassing
nerve
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the Electrochemistry, electrochemical nerv ...
s,
blood vessel
Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...
s, and
lymphatic vessel
The lymphatic vessels (or lymph vessels or lymphatics) are thin-walled vessels (tubes), structured like blood vessels, that carry lymph. As part of the lymphatic system, lymph vessels are complementary to the cardiovascular system. Lymph vessel ...
s.The alveolar crest terminates uniformly at about the
neck of the teeth (within about 1 to 2 millimetres in a healthy specimen), while the alveolar process terminates along the line of the
mandibular canal.
The alveolar process proper encases the tooth sockets, and contains a lining of
compact bone around the roots of the teeth, called the
lamina dura. This is attached by the
periodontal ligament
The periodontal ligament, commonly abbreviated as the PDL, are a group of specialized connective tissue fibers that essentially attach a tooth to the alveolar bone within which they sit. It inserts into root cementum on one side and onto alveo ...
(PDL) to the root
cementum
Cementum is a specialized calcified substance covering the root of a tooth. The cementum is the part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament.
Structure
The cells of cementum are ...
. Although the alveolar process is composed of compact bone, it may be called the
cribriform plate
In mammalian anatomy, the cribriform plate (Latin for lit. '' sieve-shaped''), horizontal lamina or lamina cribrosa is part of the ethmoid bone. It is received into the ethmoidal notch of the frontal bone and roofs in the nasal cavities. It s ...
because it contains numerous openings known as
Volkmann's canals, which allow blood vessels to pass between the alveolar bone and the PDL. The alveolar bone proper is also called bundle bone because
Sharpey fibers, part of the PDL, are inserted there. Sharpey fibers in alveolar bone proper are inserted at a right angle (just as with the cemental surface); they are fewer in number, but thicker in diameter than those found in cementum.
The supporting alveolar bone consists of both cortical (compact) bone and
trabecular bone. The cortical bone consists of plates on the facial and lingual surfaces of the alveolar bone. These cortical plates are usually about 1.5 to 3 mm thick over posterior teeth, but the thickness is highly variable around anterior teeth. The trabecular bone consists of
cancellous bone
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, an ...
that is located between the alveolar bone proper and the cortical plates.
The alveolar structure is a dynamic tissue which provides the jawbone with some degree of flexibility and resilience for the embedded teeth as they encounter numerous multi-directional forces.
Composition
Alveolar bone is 67% inorganic material, composed mainly of the minerals
calcium
Calcium is a chemical element; it has symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to it ...
and
phosphate
Phosphates are the naturally occurring form of the element phosphorus.
In chemistry, a phosphate is an anion, salt, functional group or ester derived from a phosphoric acid. It most commonly means orthophosphate, a derivative of orthop ...
. The
mineral salts it contains are mostly in the form of calcium
hydroxyapatite
Hydroxyapatite (International Mineralogical Association, IMA name: hydroxylapatite) (Hap, HAp, or HA) is a naturally occurring mineral form of calcium apatite with the Chemical formula, formula , often written to denote that the Crystal struc ...
crystals.
The remaining alveolar bone (33%) is
organic material, consisting of 28%
collagen
Collagen () is the main structural protein in the extracellular matrix of the connective tissues of many animals. It is the most abundant protein in mammals, making up 25% to 35% of protein content. Amino acids are bound together to form a trip ...
(mostly
type I) and 5% non-collagenous
protein
Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...
.
The cellular component of bone consists of
osteoblast
Osteoblasts (from the Greek combining forms for " bone", ὀστέο-, ''osteo-'' and βλαστάνω, ''blastanō'' "germinate") are cells with a single nucleus that synthesize bone. However, in the process of bone formation, osteoblasts fu ...
s,
osteocyte
An osteocyte, an oblate-shaped type of bone cell with dendritic processes, is the most commonly found cell in mature bone. It can live as long as the organism itself. The adult human body has about 42 billion of them. Osteocytes do not divide an ...
s and
osteoclast
An osteoclast () is a type of bone cell that breaks down bone tissue. This function is critical in the maintenance, repair, and bone remodeling, remodeling of bones of the vertebrate, vertebral skeleton. The osteoclast disassembles and digests th ...
s.
Clinical significance
Alveolar bone loss

Bone is lost through the process of resorption which involves osteoclasts breaking down the hard tissue of bone. A key indication of resorption is when scalloped erosion occurs. This is also known as Howship's lacuna. The resorption phase lasts as long as the lifespan of the osteoclast which is around 8 to 10 days. After this resorption phase, the osteoclast can continue resorbing surfaces in another cycle or carry out apoptosis. A repair phase follows the resorption phase which lasts over 3 months. In patients with periodontal disease, inflammation lasts longer and during the repair phase, resorption may override any bone formation. This results in a net loss of alveolar bone.
Alveolar bone loss is closely associated with periodontal disease. Periodontal disease involves the inflammation of the gingiva or gums or gingivitis. Studies in osteoimmunology have proposed 2 models for alveolar bone loss. One model states that inflammation is triggered by a periodontal pathogen which activates the acquired immune system to inhibit bone coupling by limiting new bone formation after resorption. Another model states that cytokinesis may inhibit the differentiation of osteoblasts from their precursors, therefore limiting bone formation. This results in a net loss of alveolar bone.
Developmental disturbances
The developmental disturbance of anodontia (or hypodontia, if only one tooth), in which tooth germs are congenitally absent, may affect the development of the alveolar processes. This occurrence can prevent the alveolar processes of either the maxillae or the mandible from developing. Proper development is impossible because the alveolar unit of each dental arch must form in response to the tooth germs in the area.
Pathology
After extraction of a tooth, the clot in the alveolus fills in with immature bone, which later is remodeled into mature secondary bone. Disturbance of the blood clot can cause
alveolar osteitis
Alveolar osteitis, also known as dry socket, is inflammation of the alveolar bone (i.e., the alveolar process of the maxilla or mandible). Classically, this occurs as a postoperative Complication (medicine), complication of tooth extraction.
Alve ...
, commonly referred to as "dry socket". With the partial or total loss of teeth, the alveolar process undergoes resorption. The underlying basal bone of the body of the maxilla or mandible remains less affected, however, because it does not need the presence of teeth to remain viable. The loss of alveolar bone, coupled with attrition of the teeth, causes a loss of height of the lower third of the vertical dimension of the face when the teeth are in maximum intercuspation. The extent of this loss is determined based on clinical judgment using the Golden Proportions.
The density of the alveolar bone in a given area also determines the route that dental infection takes with abscess formation, as well as the efficacy of local infiltration during the use of local anesthesia. In addition, the differences in alveolar process density determine the easiest and most convenient areas of bony fracture to be used, if needed during tooth extraction of impacted teeth. During chronic
periodontal disease that has affected the
periodontium
The periodontium () is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. Periodontics is the dental specialty that relates specifically to the care and maintenance of the ...
(periodontitis), localized bone tissue is also lost. The radiographic integrity of the lamina dura is important in detecting pathologic
lesion
A lesion is any damage or abnormal change in the tissue of an organism, usually caused by injury or diseases. The term ''Lesion'' is derived from the Latin meaning "injury". Lesions may occur in both plants and animals.
Types
There is no de ...
s. It appears uniformly
radiopaque (or lighter).
Alveolar bone grafting

Alveolar bone grafting in the mixed dentition is an essential part of the reconstructive journey for
cleft lip and cleft palate patients. The reconstruction of the alveolar cleft can provide both aesthetic and practical advantages to the patient. Alveolar bone grafting can also bring about the following benefits: stabilisation of the maxillary arch; aid of eruption of the canine and sometimes lateral incisor eruption; offering bony support to the teeth lying next to the cleft; elevate the alar base of the nose; aid sealing of oro-nasal fistula; permit insertion of a titanium fixture in the grafted region and achieve good periodontal conditions within and next to the cleft.
[ Material was copied from this source, which is available under a Creative Commons License.] The timing of the alveolar bone grafting takes into consideration both eruption of the canine and lateral incisor. The optimal time for bone grafting surgery is when a thin shell of bone still covers the soon erupting lateral incisor or canine tooth close to the cleft.
* Primary bone grafting: Primary bone grafting is believed to: eliminate bone deficiency, stabilize pre-maxilla, synthesize new bone matrix for eruption of teeth in the cleft area and augment the alar base. However, the early bone grafting procedure is abandoned in most cleft lip and palate centres around the world due to many disadvantages, including serious growth disturbances of the middle third of the facial skeleton. The operative technique that involves the vomero-premaxillary suture was found to inhibit maxillary growth.
* Secondary bone grafting: Secondary bone grafting, also referred to as bone grafting in the mixed dentition, became a well-established procedure after abandoning primary bone grafting. The prerequisites include precise timing, operating technique, and acceptably vascularized soft tissue. The advantages of primary bone grafting, which are allowing tooth eruption through the grafted bone, are retained. Furthermore, secondary bone grafting stabilizes the maxillary arch, thus enhancing the conditions for prosthodontic treatment such as crowns, bridges and implants. It also aids eruption of teeth, boosting the amount of bony tissue on the alveolar crest, permitting orthodontic treatment. Bony support to teeth adjacent to the cleft is a pre-requisite for orthodontic closure of the teeth in the cleft region. Hence, better hygienic conditions will be achieved which helps to lessen formation of caries and periodontal inflammation. Speech problems caused by irregular positioning of articulators, or leakage of air via the oronasal communication, may also be improved. Secondary bone grafting can also be used to augment the alar base of the nose to achieve symmetry with the non-cleft side, thereby enhancing facial appearance.
* Late secondary bone grafting: Bone grafting has a lower success rate when performed after canine has erupted as compared to before the eruption. It has been found that the possibility for orthodontic closure of the cleft in the dental arch is smaller in patients grafted before canine eruption than those after the canine eruption. The surgical procedure includes drilling of several small openings through the cortical layer into the cancellous layer, facilitating growth of blood vessels into the graft.
Congenital epulis
Congenital epulis is a rare,
benign
Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer.
A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...
mesenchymal tumour which usually presents at birth. It can be found growing on the alveolar ridge of newborns, presenting as non-ulcerated, pedunculated, reddish pink masses of varying sizes and numbers.
Congenital epulis can occur in either of the alveolar ridges, but they are found three times more frequently on the maxillary alveolar ridge than on the mandibular alveolar ridge. They also more commonly present in females compared to males.
Dentistry

The alveolar ridge is an area of particular interest in dentistry, as preservation of the ridges results in a higher success rate of therapeutic dental treatments.
Grafting materials
Grafting is an effective technique to reduce the inevitable changes in dimension of the alveolar ridge after tooth
extraction.
The type of grafting material is important as different materials are more effective than others in maintaining the alveolar ridge.
No biomaterial can prevent alveolar bone loss entirely after extraction, however, there are five grafting materials with the greatest efficacy in height resorption prevention; three of which are
xenograft materials (Gen-Os, Apatos, and MP3), one a
platelet
Platelets or thrombocytes () are a part of blood whose function (along with the coagulation#Coagulation factors, coagulation factors) is to react to bleeding from blood vessel injury by clumping to form a thrombus, blood clot. Platelets have no ...
concentrate (A-PRF) and one composed of A-PRF and the
allograft
Allotransplant (''allo-'' meaning "other" in Ancient Greek, Greek) is the Organ transplant, transplantation of cell (biology), cells, Biological tissue, tissues, or Organ (anatomy), organs to a recipient from a genetically non-identical donor of ...
material AlloOss combined.
For the best outcomes with respect to horizontal alveolar ridge preservation, application of a xenogenic (non-living bone material from another species) or allogenic grafting material (bone donated by another human) surrounded by a resorbable collagen membrane or sponge is ideal. These membranes promote wound healing,
osteogenesis
Osteoblasts (from the Greek language, Greek combining forms for "bone", ὀστέο-, ''osteo-'' and βλαστάνω, ''blastanō'' "germinate") are cell (biology), cells with a single Cell nucleus, nucleus that synthesize bone. However, in the p ...
and have a high
biocompatibility
Biocompatibility is related to the behavior of biomaterials in various contexts. The term refers to the ability of a material to perform with an appropriate host response in a specific situation. The ambiguity of the term reflects the ongoin ...
. Other reliable options for surgeons may include Bio-Oss and Bio-Oss Coll, primarily due to the strong scientific evidence behind their efficacy and recorded successful outcomes particularly in lateral ridge augmentation surgery.
is also preferred in many clinical situations because of its low cost of preparation.
Dental implants
As the rate of tooth loss in the population increases either due to early extraction, trauma, or other
systemic disease
A systemic disease is one that affects a number of Organ (anatomy), organs and Tissue (biology), tissues, or affects the Human body, body as a whole. It differs from a localized disease, which is a disease affecting only part of the body (e.g., ...
s, the use of implant therapy has increased as a form of tooth replacement therapy.
Dental implant
A dental implant (also known as an endosseous implant or fixture) is a prosthesis that interfaces with the bone of the jaw or skull to support a dental prosthesis such as a crown (dentistry), crown, bridge (dentistry), bridge, dentures, denture ...
s are a way to replace missing teeth, as they consist of a titanium surgical component that is placed in the alveolar ridge of the jawbone.
The implant then acts as a
prosthetic device that can hold either a
crown,
bridge
A bridge is a structure built to Span (engineering), span a physical obstacle (such as a body of water, valley, road, or railway) without blocking the path underneath. It is constructed for the purpose of providing passage over the obstacle, whi ...
, or
denture on its external surface.
For the implant placement to be successful, there needs to be enough alveolar bone to support and stabilize the dental implant.
It has been determined that many factors can contribute to the loss of both the vertical and horizontal height of the alveolar bone. These factors can include resorption of the bone after tooth removal (affecting the quality and quantity of the bone), the presence of
periodontal disease, the age and gender of the patient, smoking habits, the presence of other systemic diseases, and
oral hygiene
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and adopting good hygiene habits. It is important that oral hygiene be carr ...
habits. Although dental implants tend to have a high success rate, of about 99%, studies show that if an implant were to fail, it occurs more often in the front portion of the upper jaw.
More research is required to determine why this occurs, but it has been theorized that the alveolar bone in the upper jaw has a thinner cortical plate and lower bone density than that of the lower jaw.
As bone loss in the alveolar ridge becomes an increasing problem for the success of dental implants, research has been focused on the development of new surgical techniques and biomaterials that can be used to either maintain current bone levels, or to stimulate the growth of new alveolar bone through osteogenesis.
Articulation
Consonant
In articulatory phonetics, a consonant is a speech sound that is articulated with complete or partial closure of the vocal tract, except for the h sound, which is pronounced without any stricture in the vocal tract. Examples are and pronou ...
s whose constriction is made with the
tongue tip or
blade
A blade is the Sharpness (cutting), sharp, cutting portion of a tool, weapon, or machine, specifically designed to puncture, chop, slice, or scrape surfaces or materials. Blades are typically made from materials that are harder than those they a ...
touching or reaching for the alveolar ridge are called
alveolar consonant
Alveolar consonants (; UK also ) are articulated with the tongue against or close to the superior alveolar ridge, which is called that because it contains the alveoli (the sockets) of the upper teeth. Alveolar consonants may be articulated wi ...
s. Examples of alveolar consonants in English are, for instance, , , , , , like in the words ''tight, dawn, silly, zoo, nasty'' and ''lurid''. There are exceptions to this however, such as speakers of the
New York accent
The phonology, sound system of New York City English is popularly known as a New York accent. The accent (sociolinguistics), accent of the New York metropolitan area is one of the most recognizable in the United States, largely due to its p ...
who pronounce
and
at the back of their top teeth (
dental stops). When pronouncing these sounds the tongue touches (
, or nearly touches (
the upper alveolar ridge, which can also be referred to as gum ridge. In many other languages, consonants transcribed with these letters are articulated slightly differently, and are often described as
dental consonant
A dental consonant is a consonant articulated with the tongue against the upper teeth, such as , . In some languages, dentals are distinguished from other groups, such as alveolar consonants, in which the tongue contacts the gum ridge. Denta ...
s. In many languages consonants are articulated with the tongue touching or close to the upper alveolar ridge. The former are called alveolar
plosives
In phonetics, a plosive, also known as an occlusive or simply a stop, is a pulmonic consonant in which the vocal tract is blocked so that all airflow ceases.
The occlusion may be made with the tongue tip or blade (, ), tongue body (, ), lip ...
(such as and ), and the latter alveolar
fricatives
A fricative is a consonant produced by forcing air through a narrow channel made by placing two articulators close together. These may be the lower lip against the upper teeth, in the case of ; the back of the tongue against the soft palate in t ...
(such as and ) or (such as and ).
In culture
Other than a maxillar bridge made of gold, part of a mandible with teeth—which had been burned and broken around the alveolar process—was the only physical evidence used to confirm
Adolf Hitler
Adolf Hitler (20 April 1889 – 30 April 1945) was an Austrian-born German politician who was the dictator of Nazi Germany from 1933 until Death of Adolf Hitler, his suicide in 1945. Adolf Hitler's rise to power, He rose to power as the lea ...
's
death
Death is the end of life; the irreversible cessation of all biological functions that sustain a living organism. Death eventually and inevitably occurs in all organisms. The remains of a former organism normally begin to decompose sh ...
in 1945. Historians such as
Anton Joachimsthaler assert that the remainder of the body was burnt to near-ashes, but this is scientifically doubtful. Additionally, according to a
purported Soviet autopsy report, the alveolar process was missing from the charred maxilla of the body presumed to belong to
Eva Braun.
Gallery
Sobo 1906 326.png, In the oral cavity, the alveolar processes are covered by gums.
Blausen 0863 ToothAnatomy 02.png, How the roots of the teeth, gums, and alveolar bone are related
Teeth - animation 01.gif, 3D animation showing placement of teeth in human skull
Hitler's remains - diagram.jpg, Hitler's mandibular remains were sundered at the alveolar process.
Mandibel from Mauer.JPG, Eroded alveolar process of the archaic human ''Homo heidelbergensis
''Homo heidelbergensis'' is a species of archaic human from the Middle Pleistocene of Europe and Africa, as well as potentially Asia depending on the taxonomic convention used. The species-level classification of ''Homo'' during the Middle Pleis ...
''
References
Sources
*
External links
*
Photo of model at Waynesburg College skeleton/alveolarprocess'
*
{{Authority control
Bones of the head and neck
Dental anatomy
Mouth