Process by which the overall size and shape of bone is
established is called as bone modeling. It extends from
embryonic bone development to the pre-adult period of
human growth, which is continuous and covers a large
surface. It represents a change that occurs within the
mineralized bone without a concomitant alteration of the
architecture of the tissues. Thus, there is change in the
initial bone architecture.
Bone remodeling or bone turnover occur in order to
allow the replacement of old bone by new bone. It does
not stop when adulthood is reached, although its rate
slows down, which is cyclical and usually covers a small
area. It involves two processes - bone resportion and bone
apposition. Thus, modeling and remodeling occur
throughout life to allow bone to adapt to the external
and internal demands.
As the osteoclasts move through the bone, the leading
edge of resorption is termed the cutting cone and is
characterized in cross section by a scalloped array of
Howship’s lacunae, each housing osteoclasts. When
portion of an earlier osteon is left unresorbed, it becomes
an interstitial lamella. Behind the cutting cone is the
migration of mononucleated cells onto the roughened
cylinder. As these cells differentiate into osteoblasts, they
produce a coating termed the cement or reversal line. It
is a thin layer of glycoproteins comprising atleast bone
sialoprotein and osteopontin that acts as a cohesive,
mineralized layer between the old bone and the new bone
to be secreted. On top of the cement line osteoblasts begin to lay down new bone matrix,
mineralizing it from the
outer to inner side. The entire area of the osteon where
active formation occurs is termed the filling cone. As
formation proceeds, some osteoblasts become osteocytes.
Once formation is complete, the Haversian canal contains
a central blood vessel and a layer of inactive osteoblasts,
the lining cells that communicate by means of cell
processes with the embedded osteocytes.
The repeated deposition and removal of bone tissue
accommodates the growth of a bone without losing
function or its relationship to neighboring structures
during the remodeling phase.
The various bone resorbing factors are: Systemic
factors (parathyroid hormone, parathyroid related
peptide, Vitamin D3 and thyroid hormone); Local factors
(prostanoids, lipoxygenase metabolites, IL – 1, TNF – ,
TNF – , IL – 6); Growth factors (EGF, TGF – , TGF – ,
PDGF) and Bacterial factors (lipopolysaccharides,
capsular material, peptidoglycans, lipoteichoic acids).
Ten Cate described the sequence of events in the
resorptive process as below:
1. Attachment of osteoclasts to the mineralized surface
of bone.
2. Creation of a sealed acidic environment through
action of the proton pump, which demineralizes bone
and exposes the organic matrix
3. Degradation of the exposed organic matrix to its
constituents amino acids by the action of released
enzymes, such as acid phosphatase and cathepsine
4. Sequestering of mineral ions and amino acids within
the osteoclast. Rest is explained in chapter no. 24 Bone
Defects.
