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Presented by:

Yohanes Satrio

Dr. Nur Kholis, Sp.OT
 Support
 Protection
 Leverage
 The Matrix : Type I collagen, Other non-collagenous
proteins, Growth factor, Bone morphogenetic protein
 Bone Mineral : Calcium, Phosphate
 Bone Cells : osteoblasts, osteocytes and osteoclasts.
 Endochondral Ossification
 Intramembranous Ossification
 Usual manner in which tubular bones develop
 The physis consists of four distinct zones:
1. Zone of resting chondrocytes
2. Proliferative zone
3. Hypertrophic zone
4. Zone of calcified cartilage
 Mesenchymal cells differentiate into osteoblasts and
old bone is removed from the inside of the cylinder by
osteoclastic endosteal resorption
 Intramembranous periosteal new bone formation also
occurs as a response to periosteal stripping due to
trauma, infection or tumour growth, and its
appearance is a useful radiographic pointer
 Carried out by the osteoclasts under the influence of
stromal cells (including osteoblasts) and both local
and systemic activators
 Promoted by PTH
 The sequential process of bone resorption and
formation has been likened to sculpting
 Old bone replaced by new bone
 Calcium
 Phosphorus
 Magnesium
 Vitamin D
 Parathyroid Hormone
 Calcitonin
 Gonadal Hormones