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Craniofacial Bone Biology > Lecture 9 > Flashcards

Lecture 9 Flashcards

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1
Q

OSTEOPETROSIS

A

DEFECT IN THE FORMATION OF OSTEOCLASTS - BONES HARDEN AND BECOME MORE DENSE

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2
Q

OSTEOMALACIA

A

SOFTENING OF THE BONE CAUSED BY DEFECTIVE BONE MINERALIZATION SECONDARY TO INADEQUATE AMOUNTS OF AVAILABLE PHOSPHORUS AND CALCIUM

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3
Q

OSTEOPOROSIS

A

BONES BECOME FRAGILE AND MORE LIKELY TO FRACTURE
BONE LOSES DENSITY WHICH MEASURES THE AMOUNT OF CALCIUM AND MINERALS IN THE BONE
50% OF ALL WOMEN AND 25% OF ALL MEN AGES 50+ WILL FRACTURE A BONE B/C OF OSTEOPOROSIS (MAINLY SEEN IN CAUCASIAN AND ASIAN WOMEN)

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4
Q

RISK FACTORS OF OSTEOPOROSIS

A
  1. ) AGEING
  2. ) BEING SMALL AND THIN
  3. ) FAMILY HISTORY (GENETIC INVOLVEMENT)
  4. ) CERTAIN MEDICATIONS
  5. ) MOST COMMONLY IN OLDER WOMEN

**GWAMS

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5
Q

OSTEOPOROSIS TREATMENT

A

BISPHOSPHONATES
PROMOTE PRESERVATION OF BONE DENSITY BY INHIBITING RESORPTION BY OSTEOCLASTS
PRENYLATION - ADDITION OF A HYDROPHOBIC MOLECULE TO A PROTEIN NEEDED TO ACTIVATE OSTEOCLASTS - ACCOMPLISHED BY THE ENZYME FPP
OR… BISPHOSPHONATE FORMS A COMPLEX W/ HAP AND THIS IS A TOXIC SUBSTANCE IN ENDOCYTIZED BY THE OSTEOCLASTS

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6
Q

NITROGEN-CONTAINING BISPHOSPHONATES

A

INHIBIT FPP AND BLOCK INTRACELLULAR SIGNAL CONDUCTION
GTP BINDING PROTEINS - NECESSARY FOR OSTEOCLAST ACTIVATION AFTER BEING PRENYLATED
1.) RHO
2.) RAC
3.) CDC42

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7
Q

BISPHOSPHONATES USED FOR

A

ORAL ADMIN. - STABILIZING BONE LOSS BY OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN
IV ADMIN. - STABILIZING METASTATIC CANCER (BREAST/PROSTATE), TREATMENT OF BONE RESORPTION DEFECTS OF MULTIPLE MYELOMA AND SEVERE HYPERCALCEMIA

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8
Q

SIDE EFFECTS OF BISPHOSPHONATES

A

PAINFUL EXPOSURE OF MAX/MAN BONE (CORRELATION ESTABLISHED BETWEEN BISPHOSPHONATE USE AND OSTEONECROSIS OF THE JAW ->BRONJ OR MRONJ)

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9
Q

BRONJ/MRONJ RISK FACTORS

A
  1. ) DENTAL XO
  2. ) SX BONE MANIPULATION
  3. ) TRAUMA FROM DENTURES
  4. ) ORAL INFECTION
  5. ) POOR ORAL HEALTH

DSTOP

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10
Q

THEORIES FOR BRONJ/MRONJ

A
  1. ) CESSATION OF BONE REMODELING/TURNOVER - OSTEOCLAST/BLAST ACTIVITY IMBALANCE
  2. ) INHIBITION OF CAPILLARY NEOANGIOGENESIS => ENDOTHELIAL CELL PROLIFERATION INHIBITED IN THE JAW CAUSES A LOSS IN BLOOD VESSELS AND AVASCULAR CONDITION => NECROSIS
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11
Q

DENOSUMAB - MONOCLONAL ANTIBODY

A

ALTERNATIVE TREATMENT FOR OSTEOPOROSIS

BLOCKS RANKL AND PREVENTS OSTEOCLAST ACTIVATION => OSTEONECROSIS OF THE JAW

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12
Q

EARLY PREVENTATIVE MEASURES OF OSTEONECROSIS OF THE JAW

A 
DENTAL EVALUATION
XO OF TEETH
DENTAL TREATMENT PLAN
RESTORATIVE DENTISTRY
GOAL SETTING
PROPHYLAXIS
PERIODONTAL HEALTH STATUS
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13
Q

MANAGEMENT OF DENTAL CARE DURING OSTEONECROSIS OF THE JAW

A

ROUTINE RESTORATIVE CARE
AVOID DENTAL XO
EXTENSIVELY CARIOUS TEETH SHOULD BE CONSIDERED FOR ENDODONTIC THERAPY
ELIMINATE SHARP EDGES OF BONE THAT TRAUMATIZE SOFT TISSUE
SOFT VINYL APPLIANCES TO COVER EXPOSED NECROTIC BONE
REEVALUATE PROSTHETIC APPLIANCES
ATRAUMATIC SRP/PROPHYLAXIS
TREATMENT OF ODONTOGENIC INFECTIONS AGGRESIVELY

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14
Q

POST NATAL GROWTH

A

1.) APPOSITIONAL GROWTH/REMODELING - WIDENING
2.) INTERSTITIAL BONE GROWTH - LENGTHENING
3.) SUTURAL GROWTH - APPOSITIONAL GROWTH OCCURS HERE AND PERIOSTEAL ACTIVITY DUE TO THE PRESSURE OF THE GROWING BRAIN
4.) SURFACE APPOSITION/REMODELING RESORPTION
CRANIAL VAULT = IM GROWTH (COMPLETED @ 8 Y.O.)
CRANIAL BASE = EC GROWTH (COMPLETED = ANT @ 10 Y.O., POST. @ 20 Y.O.)

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15
Q

WOLFF’S LAW

A

BONE IN HEALTHY INDIVIDUALS ADAPTS TO LOADS UNDER WHICH THEY ARE PLACED
MECHANICAL STRESS APPLIED TO BONE INCREASES OSTEOBLAST ACTIVITY AND REMOVAL OF MECHANICAL STRESS DECREASES OSTEOBLAST ACTIVITY

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16
Q

BONE RESPONSES TO STRESS

A

MECHANOTRANSDUCTION - MEDIATES REMODELING OF BONE IN RESPONSE TO STRESS
STEPS = MECHANO- AND BIOCHEMICAL-COUPLING, SIGNAL TRANSMISSION, AND CELL RESPONSE
SPECIFIC EFFECTS DEPEND ON - DURATION, MAGNITUDE, AND RATE OF LOADING
DURING MECHANICAL LOADING - FLUID FLOWS AWAY FROM AREAS OF HIGH COMPRESSION
OSTEOCYTES = MOST ABUNDANT AND SENSITIVE TO FLUID FLOW (W/IN LACUNAE AND THERE ARE CHANNELS THAT ALLOW COMMUNICATION BETWEEN OSTEOCLASTS)
SIGNAL CELLS THROUGH HAVERSIAN CANNALS OR OTHER SIGNALS (INITIATE INITIAL STEPS IN RESPONSE TO PRESSURE)
OSTEOPROGENITOR CELLS = CAN DIFFERENTIATE INTO OSTEOCYTES/BLASTS DEPENDING ON LOADING CONDITION

17
Q

POST-NATAL GROWTH OF MAN/MAX

A

MAXILLA FOLLOWS NEURAL GROWTH PATTERNS

MANDIBLE FOLLOWS SOMATIC GROWTH PATTERNS

18
Q

GROWTH OF THE FACE

A

UPPER NASOMAXILLARY COMPLEX = COMPLETED @ 16-18 Y.O. (MAXILLA = IM GROWTH)
MANDIBLE = 20-25 Y.O. (MIXED IM EC)

19
Q

GROWTH CENTER

A

LOCATION OF INDIVIDUAL GROWTH (CONTROLS BONE GROWTH)

EPIPHYSEAL PLATES

20
Q

GROWTH SITES

A

SITE AT WHICH GROWTH OCCURS (MANDIBULAR CONDYLE AND MAXILLARY TUBEROSITY)

21
Q

CORTICAL DRIFT

A

COMBINATION OF PERIOSTEAL BONE DEPOSITION AND ENDOSTEAL RESORPTION - RESULTS IN GROWTH MOVEMENT TOWARDS DEPOSITION SURFACE

22
Q

DISPLACEMENT

A

MOVEMENT OF WHOLE BONE AS A UNIT AWAY FROM A CERTAIN POSITION/PLACE
1˚ DISPLACEMENT - OCCURS IN CONJUNCTION W/ BONE’S OWN GROWTH
*W/IN MAXILLA OCCURS IN MAXILLARY TUBEROSITY
*W/IN MANDIBLE THERE IS LARGE VARIABILITY IN GROWTH POST-NATALLY - GROWS ANTERIORLY AND INFERIORLY (EXPANDING V PRINCIPLE)
2˚ DISPLACEMENT - CAUSED BY AN ENLARGEMENT OF ADJACENT OR REMOTE BONES OR SOFT TISSUE BUT NOT OF BONE ITSELF

23
Q

MANDIBULAR GROWTH AT BIRTH

A

SHELL-LIKE BONE BODY - CONTAINS SOCKETS OF 2 INCISORS, CANINE, AND 2 DECIDUOUS TEETH
LARGE MANDIBULAR CANAL RUNE NEAR LOWER BORDER OF THE BONE (CONTAINS INFERIOR ALVEOLAR NERVE, ARTERY AND VEIN - CONTINUOUS W/ MENTAL FORAMEN AND MANDIBULAR FORAMEN)
MENTAL FORAMEN IS BELOW THE SOCKET OF THE 1ST DECIDUOUS MOLAR
ANGLE = OBTUSE 175˚
CONDYLOID PROCESS NEARLY IN LINE W/ BODY, CORONOID PROCESS = LARGE IN SIZE

24
Q

MANDIBULAR GROWTH AT CHILDHOOD

A

BONE SEGMENTS BECOME JOINED AT THE SYMPHASIS
BODY LENGTH - BECOMES ELONGATED BEHIND THE MENTAL FORAMEN (TO ACCOMODATE ADDITIONAL TEETH)
BODY DEPTH - INCREASES W/ INCREASED GROWTH OF ALVEOLAR PORTION - ENABLES THE JAW TO W/STAND MASTICATORY MUSCLE ONCTRACTIONS
ANGLE - 140˚ AT 4TH YEAR

25
Q

MANDIBULAR GROWTH AT ADULTHOOD

A

RAMUS ALMOST VERTICAL (110˚-120˚)
MOVES POSTERIORLY BY A COMBINATION OF RESORPTION AND DEPOSITION
RESORPTION ON ANTERIOR AND DEPOSITION ON POSTERIOR
CAUSES A DRIFT POSTERIORLY
DEPOSITION EXCEEDS RESORPTION
AFTER THIS STAGE- ANGLE INCREASES DUE TO OSTEONECROSIS

26
Q

CONTRIBUTION OF ALVEOLAR PROCESS

A

DEVELOPS IN RESPONSE TO PRESENCE OF TOOTH BUDS
AS TEETH ERUPT THE ALVEOLAR PROCESS DEVELOPS AND INCREASES IN HEIGHT
IF TEETH ABSENT IT WILL FAIL TO DEVELOP

27
Q

TOOTH DEVELOPMENT

A
  1. ) THICKENING (LAMINA PHASE) - 1ST SIGNS OF TOOTH DEVELOPMENT
  2. ) BUD - INVAGINATION OF THE EPITHELIUM INTO THE MESENCHYME
  3. ) CAP - MESENCHYME CONDENSATION
  4. ) BELL - AMELOBLASTS AND ODONTOBLASTS FORM BETWEEN EPITHELIUM AND MESENCHYME
  5. ) ERUPTED TOOTH - ~5 DAYS PAST-NATAL
28
Q

AGE CHANGES IN THE MANDIBLE

A

BONE REDUCED IN SIZE - TOOTH LOSS => ALVEOLAR PROCESS RESORPTION
RAMUS @ 140˚ W/ NECK OF CONDYLE BENT BACKWARDS

29
Q

CHANGES IN MENTAL FORAMEN LOCATION

A

BIRTH - @ LOWER BORDER
ADULT - MIDWAY
ELDERLY - NEAR THE UPPER BORDER

30
Q

BONE DEPOSITION RESULTS

A

EXTERIOR SURFACE OF MANDIBLE
POSTERIOR BORDER OF RAMUS
ANTERIOR BORDER OF CORONOID PROCESS
CHIN REGION

31
Q

BONE RESORPTION RESULTS

A

INNER SURFACE OF MANDIBULE
ANTERIOR BORDER OF RAMUS
POSTERIOR BORDER OF CORONOID PROCESS

32
Q

RESULT OF BONE DEPOSITION AND RESORPTION

A

INCREASES TRANSERVE DIMENSION
ADJUSTS THICKNESS OF RAMUS
DISPLACEMENT OF CORONOID PROCESS
MODELING OF THE LOWER FACE

33
Q

BISPHOSPHONATE EXAMPLES

A

ALENDRONATE, RISEDRONATE, IBANDRONATE, ZOLEDRONIC ACID

34
Q

OSTEOPENIA

A

STRESS SHIELDING OR A REDUCTION IN BONE DENSITY (CAN OCCUR AS A RESULT OF A PROSTHESIS)

Craniofacial Bone Biology (11 decks)

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