OSSIFICATION

SIRIN NAMIRAH
030. 07. 245
FK USAKTI
RSUD KOTA BEKASI
INTRODUCTION
BONE FORMATION
Two types of ossification occur :
Intramembranous ossification
Endochondrial ossification
Ossification - Bone, Cells, Matrix, and Osteoblasts - JRank Articles
http://science.jrank.org/pages/4933/Ossification.html#ixzz1q3CRVKcV

Bone formation is termed osteogenesis or
ossification and begins when mesenchymal cells
provide the template for subsequent ossification
All embryonic connective tissue begins as
mesenchyme
a) Intramembranous bone formation is mediated by
the inner periosteal osteogenic layer with bone synthesized
initially without the mediation of a cartilage phase

b) Endochondral bone formation describes the
synthesis of bone on a mineralized cartilage scaffold after
epiphyseal and physeal cartilage have shaped and
elongated the developing organ
BONE FORMATION
ANATOMY OF LONG
BONE
Principles of Human Anatomy and Physiology, 11e 6
diaphysis = shaft
epiphysis = one end of a long bone
Metaphyses = the areas between the epiphysis and diaphysis
and include the epiphyseal plate in
growing bones
Articular cartilage over joint surfaces acts as friction reducer
& shock absorber
Medullary cavity = marrow cavity
Endosteum = lining of marrow cavity
Periosteum = tough membrane covering bone but not the
cartilage
fibrous layer = dense irregular CT
osteogenic layer = bone cells & blood vessels that
nourish or help with repairs

Anatomy of a Long Bone
ANATOMY OF LONG
BONE
CLASSIFICATION OF
THE BONE
PRIMARY TYPE OF THE BONE
Cortical Bone
Cancellous Bone
Woven Bone
HISTOLOGY
HISTOLOGY OF LONG
BONE
HISTOLOGY OF THE BONE
A type of connective tissue
as seen by widely spaced
cells separated by matrix
Matrix of 25% water, 25%
collagen fibers & 50%
crystalized mineral salts
4 types of cells in bone
tissue
Osteogenic cells
undergo cell division
and develop into
osteoblasts.
Osteoblasts are
bone-building cells
Osteocytes are
mature bone cells
and the principal
cells of bone tissue
Osteoclasts are
derived from
monocytes and
serve to break down
bone tissue.
BONE CELLS
Cells of Bone

Principles of Human Anatomy and Physiology, 11e
15
Osteoprogenitor cells ---- undifferentiated cells
can divide to replace themselves & can become osteoblasts
found in inner layer of periosteum and endosteum
Osteoblasts--form matrix & collagen fibers
Osteocytes ---mature cells that no longer secrete matrix
Osteoclasts---- huge cells from fused monocytes (WBC)
function in bone resorption at surfaces such as endosteum
Cells of
Bone
Osteoblasts Osteocytes Osteoclasts
Principles of Human Anatomy and Physiology, 11e 16
FUNCTION OF THE BONES
Support
Protection
Movement
Reservoir for Mineral and Adipose
Tissue
Hematopoiesis
Support various organs and
tissues
The bones of the skull protect the brain
Ribs and sternum protect the lungs and
heart
Vertebrae protect the spinal cord
Skeletal muscles use the
bones as levers to move the
body
99% of the bodys calcium is stored in bone
85% of the bodys phosphorous is stored in bone
Adipose tissue is found in the marrow of certain
bones
Blood cell formation.
All blood cells are
made in the marrow
of certain bones
HEMATOPOIESIS
RESERVOIR FOR MINERAL AND ADIPOSE TISSUE
MOVEMENT
PROTECTION
SUPPORT
OSSIFICATIO
N
INTRAMEMRANOUS ENDOCHONDRAL
Intramembranous
Ossification
Intramembranous ossification occurs during mammalian
development within the womb and is the process by which flat
bones such as some of the bones of the skull and the
collarbones are created from connective tissue
It also is the process by which injured bones heal and
occurs when bones are broken or damaged in order to
reconstruct the bone
Some bones of the skull (frontal, parietal, temporal, and
occipital bones), the facial bones, the clavicles, the pelvis, the
scapulae, and part of the mandible are formed by
intramembranous ossification

Prior to ossification, these structures exist as fibrous
membranes made of embryonic connective tissue known as
mesenchyme

22


Mesenchymal cells first cluster
together and start to secrete the
organic components of bone
matrix which then becomes
mineralized through the
crystallization of calcium salts. As
calcification occurs, the
mesenchymal cells differentiate
into osteoblasts.

The location in the tissue where
ossification begins is known as an
ossification center

Some osteoblasts are trapped w/i
bony pockets. These cells
differentiate into osteocytes.

The developing bone grows outward from the ossification center in
small struts called spicules.
Mesenchymal cell divisions provide additional osteoblasts.
The osteoblasts require a reliable source of oxygen and nutrients.
Blood vessels trapped among the spicules meet these demands and
additional vessels branch into the area. These vessels will eventually
become entrapped within the growing bone.
Initially, the intramembranous bone consists only of spongy bone.
Subsequent remodeling around trapped blood vessels can produce
osteons typical of compact bone

As the rate of growth slows, the connective tissue around the bone
becomes organized into the fibrous layer of the periosteum.
Osteoblasts close to the bone surface become the inner cellular layer
of the periosteum.
Endochondral
Ossification
Most of the bones are
developed this way

Mesenchymal cells
define area that will be
bone

Chondroblasts secrete
hyaline cartilage

Perichondrium develops
around cartilage model.
Endochondral ossification
Interstitial growth
leads to increase
in cartilage model
length.
Appositional
growth leads to
increased
thickness.
Growth of the cartilage model

Endochondral ossification
Primary ossification
proceeds inward from
external surface.
Nutrient artery penetrates
midregion of cartilage
model.
Perichondrium becomes
periosteum.
Capillaries grow into
calcified cartilage
inducing growth of
primary ossification
center.

Development of the primary ossification center

Endochondral ossification
Primary ossification
center grows towards the
end of bone.
Osteoclasts break down
trabeculae forming a
cavity.
Wall of the diaphysis is
replaced by compact
bone.

Development of the medullary cavity

Endochondral ossification
Secondary
ossification centers
develop in epiphyses
following entry of
epiphyseal arteries.
Spongy bone
remains in cavities.
Ossification
proceeds outwards
from center of
epiphysis.

Development of secondary ossification centers
Endochondral ossification
Hyaline cartilage
differentiates into
articular cartilage.
Hyaline cartilage
remains between
epiphysis and
diaphysis until adult
growth is attained
Formation of articular cartilage and epiphyseal plate
Endochondral ossification
http://classes.aces.uiuc.edu/AnSci312/Bone/Bonelect.htm
Epiphyseal Plate of Growing Long Bone
1. Zone of Reserve Cartilage
2. Zone of Cell Proliferation
3. Zone of cell and lacunar maturation and hypertrophy enlargement
4. Zone of calcification
5. Zone of cartilage removal and bone deposition.

Epiphyseal Plate of Growing Long Bone
Growth in Bone
Length
Epiphyseal cartilage
(close to the
epiphysis) of the
epiphyseal plate
divides to create more
cartilage, while the
diaphyseal cartilage
(close to the
diaphysis) of the
epiphyseal plate is
transformed into bone.
This increases the
length of the shaft.
Interstitial growth
Appositional growth
Osteoblasts secrete extracellular matrix forming osteocytes.
Bone ridges develop on either side of periosteal blood vessel.
Appositional growth
Bone ridges fold together and fuse becoming a tunnel.
Former periosteum becomes endosteum that lines the
tunnel.
Appositional growth
Osteoblasts in the endosteum deposit bone extracellular
matrix and form the concentric lamellae.
Formation of lamellae is inward, creating the osteon.
Appositional growth
Osteoblasts under the periosteum deposit new
circumferential lamellae.
Additional periosteal blood vessels are enclosed.
Appositional growth

Distraction
Osteogenesis
Distraction osteogenesis (DO) is a relatively new
method of treatment for selected deformities and
defects of the oral and facial skeleton (1903)
Russian orthopedic surgeon, Dr. Gabriel Ilizarov
slowly perfected the surgical and postoperative
management of distraction osteogenesis treatment
to correct deformities and repair defects of the
arms and legs (1950)
Distraction Osteogenesis was presented into the
Western Medical Society (mid-1960)
Distraction osteogenesis was initially used to treat
defects of the oral and facial region in 1990
is a surgical process used to reconstruct skeletal deformities and lengthen
the long bones of the body.
A osteotomy is used to fracture the bone into two segments, and the two
bone ends of the bone are gradually moved apart during the distraction
phase, allowing new bone to form in the gap
DEFINITION
Endochondral
Ossification
Intramembranous
Ossification
Transchondroid
ossification
Stage I : Fibrous
Tissue Precursor
Stage II : Creation of
Bony Scaffold
Stage III : Bony
Remodelling
Stage IV : Structural
Modification
Histologic studies identified 4 stages that result
in the eventual formation of mature bone
Fracture Healing
Endochondral
Ossification ++
Intramembranous
Ossification +
Proses Angiogenesis
(hari ke 7-14)
IL-1, IL-6, TNF-
(meningakat 24 jam,
menurun setelah fase
endochondral)
Distraction Osteogenesis
Endochondral
Ossification +
Intramembranous
Ossification ++
Proses Angiogenesis
(segera setelah aktifasi
distraksi dimulai)
IL-1, IL-6 meningkat
setelah trauma
THREE MODES OSSIFICATION DURING
DISTRACTION OSTEOGENESIS IN THE RAT
From Osaka University Medical School, Japan
NATSUO YASUI, MOTOHIKO SATO, TAKAHIRO OCHI,
TOMOATSU KIMURA, HIROHISA KAWAHATA, YUKIHIKO
KITAMURA, SHINTARO NOMURA F
The research developed a rat model of limb lengthening to study
the basic mechanism of distraction osteogenesis, using a
small monolateral external xator
In 11-week-old male
rats it performed a subperiosteal osteotomy in the
midshaft of the femur with distraction at 0.25 mm every
12 hours from seven days after operation
Radiological and histological examinations showed a
growth zone of constant thickness in the middle of the
lengthened segment, with formation of new bone at its
proximal and distal ends
Typical endochondral
bone formation was prominent in the early stage of
distraction, but intramembraneous bone formation
became the predominant mechanism of ossication at
later stages
There is also showed a third mechanism of ossification, transchondroid bone
formation.
Distraction Osteogenesis
Distraction Osteogenesis

0.25 mm every 12 hours (0.5 mm/day), and was stopped at 28 days after
operation (21 days of distraction)
Radiological Changes
Histological Findings
TRANSCHONROID BONE
FORMATION
Considering as the third type of bone formation
Chondroid bone, a tissue intermediate between bone and cartilage,
formed directly by chondrocyte-like cells, with transition from brous
tissue to bone occurring gradually and consecutively without
capillary invasion
The matrix of this chondroid bone is more like bone than cartilage,
but the cells were indistinguishable from chondrocytes (Fig. 5)

J Bone Joint Surg [Br] 1997;79-B:824-30.
Received 18 November 1996; Accepted after
revision 21 March 1997
Some hypertrophic chondrocytes undergo further differentiation into
osteoblast-like cells and participate in the initial bone formation

chondrocyte-like cells and osteocyte-like cells coexisted in
chondroid bone with no clearly distinguish-able boundary


J Bone Joint Surg [Br] 1997;79-B:824-30.
Received 18 November 1996; Accepted after
revision 21 March 1997


Round chondrocyte-like cells and smaller osteocyte-like cells coexisted
forming columnar arrangements in the chondroid bone.

Transition from brous tissue to bone via chondroid bone occurred
graddually and consecutively. Three-dimensional observation of the
chondroid bone in the sequential histological sections showed no capillary
invasion during the transition from cartilage to bone

This transchondroid bone formation was clearly different from
endochondral ossication in which the cartilage is invaded by capillaries
and new bone is deposited on the surface of eroded cartilage.
J Bone Joint Surg [Br] 1997;79-B:824-30.
Received 18 November 1996; Accepted after
revision 21 March 1997