Bone Pathology Flashcards
What are the main regulators of bone remodelling?
Mechanical stimuli
Hormones:
- Parathyroid hormone
- Vit D3
- Oestrogen
Cytokines
- Perio
- Inflammatory diseases
- Pathological processes
What special tests can be done to investigate bone pathology?
Serum calcium
Serum alkaline phosphatase (Osteoblastic activity)
Collagen in urine and blood (osteoclastic activity)
Parathyroid hormone levels
Vit D assays
What are the main types of developmental bone defect?
Tori
Osteogenisis imperfecta
Achondroplasia
Osteoporosis
Fiberous dysplasia
What is osteogenesis imperfecta?
Type 1 collagen defect
Inherited variance
Clinical features - weak bones, multiple fractures, sometimes associated with dentiogenisis imperfecta
What is achondroplasia?
Autosomal dominant abnormality, causing poor endochondral ossification (dwarfism)
What is osteopetrosis?
Lack of osteoclastic activity, failure of resorption, marrow obliteration.
What is fiberous dysplasia?
Gene defect
Slow growing asymptomatic bony swelling (bone is replaced by fiberous soft tissue)
Stops growing after active growth period
What is rarefying osteitis?
Localised loss of bone in response to inflammation
Always secondary to other pathology.
What is sclerosing osteitis?
Localised increase in bone density in response to low grade inflammation.
Most common around apex of tooth, poorly defined, and may lead to ERR if chronic.
What is idiopathic osteosclerosis?
A localised increase in bone density of unknown cause. Little effect on tooth structures.
How do you determine whether its idiopathic osteosclerosis or sclerosing osteitis?
Sensibility testing. Sclerosing will occur in response to pulpal necrosis.
What is osteomyelitis?
A rare endogenous infection, which can be acute or chronic.
Suppuration is rare, but can result in sequestrum, actinomycosis, or other complications.
Describe the aetiology of bone necrosis.
Osteomyelitis (acute or chronic)
Avascular necrosis (age related ischaemia or medication related)
Irradiation (ORN)
What are anti-resorbative medications used for?
Osteoporosis
Paget’s
Bone metastases
Describe the aetiology of osteoporosis?
Sex hormone imbalance
Age
Calcium status/physical activity
Secondary to:
- Hyperparathyroidism
- Cushing’s
- Thyrotoxicosis
- Diabetes mellitus