PHYSIOLOGY OF BONE

PRESENTED BY
Dr.Archana. Naik
1. Introduction
2. Physiology: Function of Bone.
3. Evolution of Bone Terminology
4. Composition of Bone.
5. Types of Bones.
6. Anatomy of Bone.
7. Histology of Bone.
8. Physiology of Bone formation (ossification).
9. Physiology of Bone growth.
10.Bone Turnover.
11.Growth Factors.
12.Exercise and Bone.
13.Aging and Bone Tissues.
14.Developmental Anatomy of Bone.
15.Alveolar Bone.
16.Bone Disorders.
 Introduction

• Bone is a specialized mineralized

connective tissue that forms most of the
Skeletal framework that supports and
protects our organs and allows us to
move.
• The framework of bone and cartilage that
protects organs and allows movement is
called the Skeletal System.
 Bone tissue and the Skeletal system perform
several basic functions

1. Support—Bone provides a framework for the body by supporting

soft tissues.It provides points of attachment for many skeletal
muscles.
2. Protection—Bone protects many internal organs from injury. For
eg. Cranial bones protect the brain, Vertebrae surround the spinal
cord, the rib cage encloses the heart and lungs, the hip bones
guard internal reproductive organs.
3. Movement—When the muscles contract, they pull the bones and
together produce movement.
4. Mineral Homeostasis— Bone tissue stores several minerals,
especially ca++ and P, which are important in muscle contraction
and nerve activity. On demand, bone releases minerals into the
blood to maintain the critical balances.
5. Site of blood cell production —It is Hemopoietic in function. The
bone contains red bone marrow which produces red blood cells,
white blood cells and platelets.
6. Storage of energy —The bone has yellow bone marrow which
primarily contains adipose cells where lipids are stored and act as
a source of energy
 Anatomy: Structure of Bone

The structure of bone may be analyzed by first considering

the parts of a long bone. A typical long bone consists
of
1. Diaphysis -- ( dia= through; physis= growth). It is the
shaft or long, main portion of the bone.
2. Epiphysis-- (epi= above; physis= growth) The
extremities or ends of the long bone.
3. Articular Cartilage— A thin layer of hyaline cartilage
covering the epiphysis where the bone forms a joint
with another bone. The cartilage reduces friction and
absorbs shock at the joint
Anatomy Of Bone
4. Periosteum--The periosteum (peri = around; osteo=
bone) is a membrane around the surface of the bone
not covered by articular cartilage. It consists of two
layers.
The outer fibrous layer is composed of dense, irregular
C.T. containing blood vessels, lymphatic vessels and
nerves that pass into the bone.
The inner layer is the Osteogenic layer contains elastic
fibre, blood vessels, osteoprogenitor cells and
osteoblasts.
5. Medullary or marrow cavity--This is the space within the
diaphysis that contains the fatty yellow marrow in
adults
• 6.Endosteum--Lining the medullary cavity is the
endosteum, a membrane that contains
osteoprogenitor cells.
• Characterstically all bones have a dense outer sheet
of compact bone and a central medullary cavity.
Compact bone provides protection and support and
helps the long bones to resist the weight placed on
them.
• 7.The medullary cavity is filled with either red or
yellow bone marrow. The medullary (or marrow)
cavity is interrupted, particularly at the ends of long
bones, by a network of bone trabeculae called the
cancellous or spongy bone. These internal trabeculae
support the outer thick compact bone.The main
difference between compact and spongy bone is that
adult bone has a concentric ring structure, whereas
spongy bone appears as an irregular lattice work. (of
thin plates of bone called trabecular).
 Evolution of Bone Terminology

• Classification is by the order of magnification used

• i) With the naked eye, two types of bones are recognized
Compact bone(Cortical bone)
Spongy ( Trabecular) bone.
• ii) With a medium powered lens, it can be described as
having—
Haversian Canal
Interstitial matrix
circumferential lamellae
iii) With high powered lens collagenous matrix can be seen
and distinction can be done between
-Coarse fibered woven bone
-fine fibered lamellar bone.
 Composition of Bone

• o
 Types of Bones

Almost all the bones of the body may be

classified into 4 principal types on the
basis of shape.
1. Long bones
2. Short bones
3. Flat bones
4. Irregular bones
1. Long bones- have a greater length than width
and consists of a shaft and epiphyses at their
extremities. They are slightly curved for
strength. A curved bone absorbs the stress at
different points so that the stress is evenly
distributed. Long bones consist mostly of
compact bone at the ends. eg. Of long bones
are (femur) thigh, leg (fibia and fibula), toes
(phalanges), arm humerus, forearm (ulnar
and radius), and fingers (phalanges).
2. Short bones —are somewhat cube
shaped and the length and width are
nearly equal. They are mainly spongy
bone expect at the surface, where there
is a thin layer of compact bone. Eg. Of
short bones are the wrist ( carpal) and
ankles( tarsal) bone.
3.Flat bones —are generally thin and
composed of two nearly parallel plates of
compact bone enclosing a layer of
spongy bone. Flat bones provide
considerable protection and provide
extensive areas for muscle attachment.
Flat bones include the cranial bones,
sternum and ribs and the shoulder blades
( scapula
4. Irregular bones —have complex shapes
and cannot be grouped into any of the
three categories described above. The
amount of compact bone and spongy
bone varies in different bones. Eg. The
vertebrae and the facial bones.
There are two additional types of bones.
• Sutural or Wormian bones—are small
bones located between the sutures of
certain cranial bones.
• Sesamoid bones—are small bones
wrapped in tendons where considerable
pressure develops. These are present
one in the wrist, as a patellae one in
each knee.
HISTOLOGY OF BONE
 Structure of Compact Bone

It forms a typical Haversian System, the mature adult

bone consists of microscopic layers or lamellae. These
distinct types of layers are recognized.

1. Circumferential lamellae
2. Concentric
3. Interstitial
Compact Bone
 Spongy Bone Tissue
• The spongy bone tissue also histologically identical to
compact bone consisting of lamellae, lacunae. But in
contrast to compact bone, spongy bone does not contain
true osteons. It consists of trabeculae arranged in an
irregular latticework. The spaces between the trabeculae
of some bones are filled with red bone marrow which
produces blood cells.

• Within the trabeculae are the concentric lamellae that are

traversed by lacunae containing osteocyte.

• Canaliculi, containing the processes of osteocyte, radiate

from the lacunae. Blood vessels from the periosteum
penetrate through to the spongy bone. Therefore osteons
are not necessary in the spongy bone because
osteocytes are not deeply buried ( as in compact bone)
and have access to nutrients directly from the blood.
• SPONGY BONE tissue makes up the bone tissue of
short ,Flat and Irregular shaped bones and also the
epiphysis of long bones.

• SPONGY BONE tissue in the hip bones ,ribs,

breastbone(sternum), backbones (vertrbrae),skull and
ends of long bones are the only site of red bone marrow
storage and thus hemopoietic in adult .
 Bone Cells

There are 4 types of cells in bone tissue.

1. Osteoprogenitor ( osteogenic) cells.
2. Osteoblasts– which form the bone.
3. Osteocytes– which maintain the bone.
4. Osteoclasts– which resorb the bone.
1.Osteoprogenitor Cells– are the stem cells of
mesenchymal origin that can proliferate and ( they
undergo mitosis) convert themselves into osteoblasts
whenever there is need for bone formation. These
resemble fibroblasts in appearance.
In fetus such cells are found in plenty at sites where
bone formation is to take place.
In the adult, osteoprogenitor cells are present in the
periosteal and endosteal surfaces.
2. Osteoblasts– are uninucleated cells that synthesize
both collagenous and non-collagenous bone proteins (
the organic matrix, osteoid), but they have lost the
ability to divide by mitosis. They constitute a cellular
layer over the forming bone surface and is supposed to
form a bone membrane that controls the influx into and
out of the bone.
• Osteoblasts secrets type 1and type V collagen and
small amount of non collagenous proteins like the
phosphoproteins proteoglycons and glycoproteins, also
variety of cytokines, growth factors help in regulating
cell metabolism. When bone is no longer forming, the
surface osteoblasts become inactive and are termed
“lining” cells
• 2.Osteocyte—are mature bone cells that are
derived from osteoblasts. They are the principal
cells of the bone tissue like osteoblasts, they
have no mitotic potential. The osteoblasts when
they secrete the bone matrix, some of them
become entrapped in lacunae and they are
called osteocytes. In contrast to osteoblasts,
osteocytes have osinophilic cytoplasm with
small amount of RER indicating that these cells
have negligible secretory activity.
• The cells are of varied shape like oval, triangular or cuboidal.
It is suggested that gap junctions exists between the adjacent
cells; osteoblasts to osteoblasts, osteoblasts to osteocytes
and osteocytes to osteocytes.
• When bone is no longer forming, the surface osteoblasts
become inactive and are termed lining cells. The nucleus of
an osteoblast is ovoid and euchromatic. The cytoplasm is
basophilic because of presence of abundant rough
endoplasmic reticulum. Also there well developed golgi
bodies which signifies that the cell is engaged in
considerable synthetic activity.
• The preosteoblasts and osteoblasts exibit high levels of
alkaline PO4 are on the outer surface of plasma membranes.
This enzyme is used experimentally a a cytochemical marker,
helps in distinguishing the osteoblast from the fibroblast.
• 3.Osteoclast—The osteoclasts are multinucleated and
larger of all the cells. They are generally seen in cluster
rather than singly. These osteoclasts are found against
the bone surface, occupying shallow depressions called
Howship’s Lacunae. These shallow trough maintains
both the activity and the mobility of osteoclasts during
active resorption. The ultrastructure of an osteoclast
shows classic features of ruffled border, numerous
mitochondria, multinucleation and tightly arranged golgi
saccules.
 Divisions of the Skeletal
System

• The adult human skeleton consists of

206 named bones grouped into two
principal divisions
• The axial skeleton
• The appendicular skeleton
 Axial Skeleton (80 bones)

Skull (28) Facial Bones (14)

• Cranial Bones (8) •Maxilla (2)
• Parietal (2) •Zygomatic (2)
•Mandible (1)
• Temporal (2) •Nasal (2)
• Frontal (1) •Platine (2)
• Occipital (1) •Inferior nasal concha (2)
• Ethmoid (1) •Lacrimal (2)
• Sphenoid (1) •Vomer (1)
• Auditory Ossicles (6)
• Malleus (2)
• Incus (2)
• Stapes (2)
• Hyoid (1)
• Vetebral Column (26)
• Cervical vertebrae (7)
• Thoracic vertebrae (12)
• Lumbar vertebrae (5)
• Sacrum (1)
• Coccyx (1)
Thoracic Cage (View the illustration)
• Sternum (1)
• Ribs (24)
 Appendicular Skeleton (126 bones)
Pectoral girdles (View the illustration)
• Clavicle (2)
• Scapula (2)
Upper Extremity (View the illustration)
• Humerus (2)
• Radius (2)
• Ulna (2)
• Carpals (16)
• Metacarpals (10)
• Phalanges (28)
Pelvic Girdle (View the illustration)
• Coxal, innominate, or hip bones (2)
Lower Extremity (View the illustration)
• Femur (2)
• Tibia (2)
• Fibula (2)
• Patella (2)
• Tarsals (14)
• Metatarsals (10)
• Phalanges (28)
•
 Physiology of Bone
Formation

• The process by which the bone forms is called ossification.

• Ossification begins around the sixth or seventh week of
embryonic life and continues throughout adulthood.
• Occurs by three mechanisms.
1. Endochondral bone formation
2. Intramembranous ossification
3. Sutural bone formation
 Endochondral bone formation

• Occurs at the ends of all long bones,

vertebrae,ribs,base of the skull and at the head of the
mandible.
Proceeds in the following way:
• Development of a cartilage model
• Growth of the cartilage model
• Development of the primary ossification centre
• Development of diaphysis and epiphysis
 Intramembranous bone
formation
• Occurs in the flat bones of the skull,maxilla,body of the
mandible and midshaft of the long bones.
• Development of a centre of ossification
• As the bone matrix forms, it develops into trabeculae in
various osification centers
• On the outside of the bone,vascularised mesenchyme
develops into periosteum
Sutural bone formation
 Physiology of Bone Growth

• Bone grows because of the activity of epiphyseal

plate.
The epiphyseal plate consists of 4 zones
• The zone of resting cartilage
• The zone of proliferarting cartilage
• The zone of hypertrophic or maturing cartilage
• The zone of calcified cartilage
• The epiphyseal plateallows the diaphysis of the bone to
increase in length until early childhood.
• Shapes the articular surfaces.
• The rate of growth is controlled by hormones
• As the child grows, cartilage cells are produced by
mitosis on the epiphyseal side of the plate .But the
cartilage is replaced by bone on the diaphyseal side of
the plate. In this way, the thickness of the epiphyseal
side of the plate remains constant.but the bone on the
diaphyseal side increases in length.
• Growth in diameter occurs along with growth in length
• Here, the bone lining the medullary cavity is destroyed
by osteoclasts so that the cavity increases in
diameter.At the same time ,osteoblasts from the
periosteumadd new bone tissue to the outer surface.
• Initially the new bone formed at the diaphyseal and
epiphyseal end is spongy bone.Later the outer region of
spongy bone is reorganized into compact bone.
BONE TURNOVER

O
 BONE HOMEOSTASIS

• Bone remodelling
• Minerals needed for bone remodelling
• Vitamins needed for bone remodelling
• Hormonal regulation of bone growth and remodeling
BONE’S ROLE IN CALCIUM
HOMEOSTASIS
 Fracture and repair of Bone

• A fracture is any break in the bone.

• It is classified into
1. Partial fracture
2. Complete fracture
3. Closed (simple) fracture
4. Open (compound) fracture
5. Comminuted fracture
6. Green stick fracture
7. Pathologic fracture
 Reduction of a fracture

• Closed reduction
• Open reduction
 Repair of fracture
• Although bone has a generous blood supply healing
sometimes takes months
• In a fractured bon blood supply is decreased and
hence healing is difficult in an infected bone.
• The following steps occur in the repair of a bone #
1. Fracture hematoma
2. Procallus formation
3. Hard callus formation
4. Remodelling of the callus
 Growth factors

• Osteoblasts secrete several members of bone

morphogenetic protein(BMP) superfamily including
BMP2,BMP7 and Transforming growth factor-b.
• Also secretes insulin like growth factor (IGF I, IGFII),platelet
derived growth factor (PDGF-AA) and fibroblast growth
factor B(FGF-B).
• Although the timing of secretion and the comples
interactions of these growth factors are unclear, the
combinations IGF1, TGFBeta and PDGF-BB remarkably
increase the rapidity of bone formation and bone repair.
• All these factors are important in our future dental therapy.
For example, these combinations may be used to
accelerate wound healing and in bone growth following
periodontal surgery.
• Can also be used to prevent periodontal disease by early
treatment of periodontal pockets
 Exercise and Bone
• Bone has the ability to alter its strength in
response to mechanical stress
• When placed under stress bone tissue
becomes stronger through increased deposition
of mineral salts and production of collagen
fibers.
• Without mechanical stress, bone does not
remodel normally
• Bones of athletes which are repetitively and
highly stressed, become thicker than those of
non-athletes
 Aging and Bone Tissue
There are two principal effects of aging on bone tissue
1. There is loss of calcium and other minerals
(Demineralization)
2. There is decrease in the rate of bone synthesis. This
results in decreased ability to produce the organic
portion of bone matrix, mainly collagen, which gives
bone its tensile strength. As a result, the proportion of
inorganic minerals become more in the bone matrix.
The loss of tensile strength causes the bone to become
brittle and susceptible to fracture.
In some elderly people protein synthesis slows partly
due to diminished production of human growth
hormone.
 Alveolar Bone (Process)

• The Alveolar process is that bone of the

jaws containing the sockets (alveoli) for
the teeth.
• It forms when the tooth errupts
• It disappears gradually after the teeth are
lost
 Remodeling of Alveolar
Bone
• Remodeling takes place by means of
Resorption and Formation which are
regulated by local and systemic
influences.
• Local influences
1. Include functional requirements on the
tooth
2. Age related changes in bone cells
• Remodeling of Alveolar bone affects its
height, contour and density and is
manifested in the following 3 areas
1. Adjacent to the PDL
2. In relation to the periosteum of the facial
and the lingual plates
3. Along the endosteal surface of the marrow
surfaces
Developmental Anatomy of bone and
the skeletal system
 Development of Alveolar Bone

• Develops around each tooth follicle during

odontogenesis. When the deciduous tooth is
shed, its alveolar bone is resolved.
• The succedaneous permanent tooth moves into
place developing its own alveolar bone from its
own dental follicle.
• Although alveolar bone and basal bone have
different intermediate origins, both are
ultimately derived from neural crest
ectomesenchyme
 Bone Disorders

• Osteoporosis – means literally a

condition of porous bones.
Characterized by decreased bone mass
and increased susceptibility to fractures.
Here the bone resorption outpaces bone
formation
• Etiology
1. lack of adequate bone matrix
2. negative calcium balance
Risk factors for developing Osteoporosis
1. Body build
2. Weight
3. Smoking
4. Calcium deficiency and malabsorption
5. Vitamin D deficiency
6. Lack of exercise
7. Drugs like alcohol, diuretics, cortisone and
tetracycline
8. Premature menopause
9. Family history of osteoporosis
 Paget’s Disease

• Characterized by accelerated remodeling

process where there is increased
osteclastic resorption and new bone
formation
• As a result there is irregular thickening
and softening of the skull, pelvis and
extremities
• Complication – Osteosarcoma
 Osteoarthritis

• Most common type of arthritis where

there is degeneration of the cartilage
allowing the bony ends to touch against
the opposing bone
• Associated with aging process
• Weight bearing joints are the first ones to
involve
• TMJ involvement is also seen
 Osteosarcoma

• Is a Primary malignant neoplasm of the bone

• Can be of 2 forms
– Osteoblastic or Sclerosing type
– Osteolytic type
• Clinical features
– Pain and swelling of the involved bone is an early
feature
– In jaws, facial deformity and pain followed by loosening
of teeth parasthesia, tooth ache, bleeding, nasal
obstruction
• Histologic feature : proliferation of both atypical
osteoblast and their precursor.
– There is new tumor osteoid and bone formation in an
irregular pattern
 Skeletal Fluorosis

• Skeletal fluorosis is a bone disease caused by

excessive consumption of fluoride
• Common causes of fluorosis include: inhalation
of fluoride dusts/fumes by workers in industry,
use of coal as an indoor fuel source and
consumption of fluoride from drinking water.
• Early stages are marked by symptoms (stiff and
painful joints) which are frequently difficult to
differentiate from various types of arthritis