Alveolar process of the maxilla

Anatomical and histological structure

The alveolar process of the maxilla is a curved bone structure with vestibular and palatal surfaces. Its margin contains 8 alveoli (sockets).

• Histomorphology: The tissue of the process consists of spongy bone enclosed within compact bone plates.
• Clinically significant feature: The outer compact plate is thinner than the inner one. This thickness difference is especially pronounced in the anterior teeth area.

Topography and adjacent structures

The alveolar process serves as a topographical landmark and is related to the following structures:

• Maxillary sinus (sinus maxillaris): The process forms its inferior wall. The portion of the maxilla between the alveolar process and the infraorbital margin forms the anterior wall of the sinus.
• Infraorbital region (regio infraorbitalis): The alveolar process is the lower boundary of this region (bounded superiorly by the infraorbital margin, medially by the lateral nasal wall, and laterally by the zygomaticomaxillary suture).

Clinical significance in traumatology

Isolated fractures of the alveolar process occur due to bending or shifting at the site of force application. According to K.S. Yadrova's classification, the following types of fractures are distinguished:

• Partial: The fracture line passes only through the outer part: the outer compact plate within the sockets of several teeth and a part of the interdental septa are damaged. There is no fragment displacement.
• Incomplete: Appears as a fissure passing through the entire thickness of the process (both compact plates and spongy bone). There is no fragment displacement.
• Complete: Two vertical fracture lines are joined by one horizontal line, passing through the entire thickness of the alveolar process.
• Comminuted: Multiple fracture lines intersect in several directions.
• With bone defect: Accompanied by a complete detachment of the fractured part of the alveolar process.

The alveolar process of the maxilla, along with the hard palate, serves as support for the supra-gingival Vankevich splint, which is used for fixation and prevention of lateral and rotational displacement of mandibular fragments, especially in significant defects.

Significance in prosthetic dentistry

The degree of prominence and atrophy of the alveolar process is taken into account when designing removable partial laminar dentures:

• Preparation of wax rims: The outer edge of a low wax rim (3–5 mm) should lie on the line passing along the crest of the alveolar process.
• Selection of artificial teeth: When the process is well-developed, teeth with a small cervical curvature are used. In case of significant atrophy, teeth with a more pronounced curvature are used.
• Methods of tooth arrangement:
• Ground-in arrangement: Artificial teeth are ground directly to the edentulous alveolar process; the inner surface of the artificial tooth is subject to grinding. Indicated for a well- or moderately developed process in the anterior region and a shortened upper lip.
• On an artificial gingiva: Teeth are set on the denture base. Indicated for a moderately developed process or severe atrophy, as well as a long upper lip. In the posterior regions, teeth are set on the artificial gingiva strictly in the middle of the alveolar part.

Class and exam questions

What else to study on this topic

• Maxillary Sinus (Sinus maxillaris)
• Infraorbital region (Regio infraorbitalis)
• Vankevich splint and Vankevich-Stepanov splint
• Classification of alveolar process fractures

Other topics in the "Anatomical Structures" section

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