Radhi Types of Bone Intramembranous Endochondral epiphyseal bone Intramembranous Small bones Immediately from Mesynchymal cells Mesynchymal cells change into bone immediately ID: 919079
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Slide1
Bone Diseases 1
Dr. Hani Al Sheikh
Radhi
Slide2Types of Bone
Intramembranous
Endochondral
(epiphyseal
bone)
Slide3Intramembranous
Small bones
Immediately from
Mesynchymal
cells
(
Mesynchymal
cells change into bone immediately (
osteocytes)).
Slide4Endochondral
(epiphyseal)
Long bones
Intermediate cartilage formation
Slide5Slide6Achondroplasia
(Dwarfism)
Defect in the Endochondral bone formation.
Mutation in FGFR3 gene.
Mid- face forms by epiphyseal while the rest is
intermembranous
.
Defect in fibroblast growth factor which will affect cartilage.
Slide7Slide8Posterior cross bite.
Anterior open bite.
Class III malocclusion
Slide9Associated features
Macroglossia and tongue thrust.
Increase caries rate
No disturbance in eruption dates
Backache due to spine stenosis in some patients form late childhood until early adolescence
Slide10Slide11Slide12Management
Psychological therapy
Lower dental chair with the need of steps sometimes
Back and head pillow for children to reduce discomfort associated with backache
Slide13Bone Remodeling
Slide14Slide15Factors affecting bone remodeling
PTH
Vit
. D
Collagenases
Lysosome
Cytokines
Prostaglandins
BMP
Slide16Inhibitors of Bone remodeling
Calcitonin
Interferon
Bisphosphontae
Cortisol
Slide17Brown Tumor of Hyperparathyroidism
Increased
PTH
conc. Can increase the activity of osteoclasts a which will increase bone resorption.
Slide18Giant cell granuloma
CGCG
GCG
due to action of osteoclasts, not related to
PTH
Although histologically identical to brown’s tumor differentiated by investigations of
PTH
conc. And alkaline phosphatase.
The World Health Organization
has defined
CGCG
as an
intraosseous
lesion consisting of cellular fibrous tissue containing multiple foci of hemorrhage, aggregations of multinucleated giant
cells and, occasionally, trabeculae of woven bone.
Can be mild and asymptomatic or it can be aggressive and painful and it can perforate the cortical plates.
Slide19Slide20Treatment and Prognosis
For central lesions:
Conservative but complete surgical resection is the preferred treatment.
Recurrence rates vary and reported from 11% to near 50%
Radiation treatment generally not indicated
Slide21Treatment and Prognosis
For peripheral lesions:
Conservative but complete surgical resection to
include the entire depth of the lesion with curettage of subjacent bone.
May recur in a small percentage of cases (approximately 10%)
Slide22Bisphosphonate Induced
Osteochemonecrosis
Bisphosphonate
used to
be commonly administered to control bone resorption conditions caused due to over activity of osteoclasts
Slide23Osteoradionecrosis
Slide24Osteopetrosis
Alber
-Schonberg Disease
Slide25Osteopetrosis
Osteoclasts malfunction.
Normal osteoblasts.
2 types:
Infantile:
at birth. Severe cranial nerve problems, almost all bones, anemia (bone marrow), osteomyelitis, delayed eruption and
ankylosis
.
Adult (Benign
osteopetrosis
) long bone rarely affected, less problems 40% discovered by routine examination
Slide26Slide27Difficult to distinguish roots from bone.
ankylosis
delayed eruption of teeth.
risk of osteomyelitis with extraction due to poor blood supply of bone
Slide28Management
2 PROBLEMS (bone marrow failure, and increased bone density)
Osteomyelitis management is difficult.
Bone marrow transplantation to improve cellularity.