SlideShare a Scribd company logo
Guided by-
Dr. Akshey Sharma
Dr. Rajesh Bhanot
Dr. Pardeep Bansal
Dr. Gagan Chahal
Presented by-
Dr. Swati Mittal
PG student 1st year
Deptt of Prosthodontics
As dentists, it is vital for us to have a complete
understanding of the general metabolism of calcium
as it helps in the formation and maintenance of the
teeth and their supporting bony structure.
Approximately 99% of the total body weight of
calcium is present in the skeleton.
 The remaining 1% is found in the cell
membranes and extracellular fluid.
 It is this small percentage of calcium that is vital
to all life processes.
1. Contributes to hardness of bone and is a major
component of teeth.
2. Stabilises the cell membrane and their permeability.
3. Maintenance of excitability of nerve and muscles.
4. Normal skeletal and cardiac muscle contraction.
5. Blood coagulation – Ca++ is required for the
conversion of many inactive enzymes in the
coagulation process.
Infants (< 1 year) = 300-500 mg/ day
Children (1 – 18 years) = 0.8-1.2 g/day
Adult men and women = 800 mg/day
Pregnancy and lactation = 1.0-2gm/day
 Milk is a good source for calcium. Calcium content of cow
milk is about 100mg/100ml.
 Egg, fish & vegetables are medium source for calcium.
 Cereals (wheat, rice) contains small amount of calcium.
But cereals are the staple diet in India. Therefore, cereals
form the major source of calcium in Indian diet.
 Several different kinds of calcium compounds are used
in calcium supplements. Each compound contains
varying amounts of the mineral calcium.
 Common calcium supplements may be labeled as:
 Calcium carbonate - Tums® and Caltrate®
 Calcium citrate- Citracal® and Solgar®
 If the calcium in diet and from supplements exceeds
the tolerable upper limit, you could increase your risk
of health problems, such as:
 Kidney stones
 Prostate cancer
 Constipation
 Calcium buildup in your blood vessels
 Impaired absorption of iron and zinc
 Calcium absorption in the small intestine occurs by both
active & passive diffusion.
 Uptake of calcium by active transport predominates in:
duodenum
jejunum;
 Simple diffusion predominates in:
ileum
 Most of the ingested calcium is normally eliminated in the
feces, although the kidneys have the capacity to excrete
large amounts by reducing tubular reabsorption of calcium
 VitaminD –Calcitriol induces the synthesis of the carrier protein
(Calbindin) in the intestinal epithelial cells & so facilitates the
absorption of calcium.
 Parathyroid hormones increases calcium transport from the
intestinal cells.
 Amino acids, especially lysine & arginine increase absorption.
 Lactose : enhance passive Ca uptake; its effect is valuable because of
it presence in milk.
 Phytates — Phytates are substances found in some plant foods that can bind
calcium in the intestine and decrease its absorption.
 Oxalates are present in some leafy vegetables which cause formation of
insoluble calcium oxalates .
 In malabsorption syndromes , fatty acid is not absorbed , causing formation
of insoluble calcium salt of fatty acid .
 High phosphate content will cause precipitation as calcium phosphate.
 Absorption is also decreased with increase intake of protein & fiber in diet.
 This term is used to describe the amount of Ca++
either stored or lost by the body over a specific period
of time.
 When the assimilation of calcium from dietary sources
is less than the metabolic requirements and the
obligatory losses , then calcium is withdrawn from the
skeleton to maintain the critical concentration of the
element in the blood and tissue fluids.
 Calcium homeostasis is the mechanism by which
the body maintains adequate calcium levels.
Positive Ca2+ balance
 Is seen in growing children, where intestinal Ca2+
absorption exceeds urinary excretion and the
difference is deposited in the growing bones.
Negative Ca2+ balance
 Is seen in women during pregnancy or lactation,
where intestinal Ca2+ absorption is less than
urinary excretion and the difference comes from
the maternal bones.
 The primary source of available calcium is trabecular
bone, not cortical bone.
 The sites of trabecular bone which supply mobile
calcium are the jaws, ribs, bodies of the vertebrae, and
the ends of the long bones.
 A significant finding from animal experimentation is
that, when skeletal depletion of calcium occurs as a
result of stimulation of the parathyroid gland, alveolar
bone is affected first, the ribs and the vertebrae are
affected second, and the long bones third.
 Prolonged depletion results in disorganization and
loss of trabeculae, followed by cortical remodeling or
structural failure.
 A complex set of interlocking mechanisms takes place
in order to allow man to survive major dietary Ca
intake fluctuations. These mechanisms are mainly
controlled by the endocrine systems.
 Three main hormones acting at 3 different sites are
responsible for Ca metabolism.
1. Vit. D3 - Bone.
2. Parathormone - Kidney
3. Calcitonin - Intestine
 Physiologically active form of vitamin D is a hormone
called calcitriol or 1,25 – dihydroxycholecalciferol
(1,25 – DHCC).
 It stimulates Ca uptake by osteoblasts of the bone and
promotes calcification or mineralization and
remodelling , thus increasing the blood calcium
levels.
Calcium metabolism
 The prime function is to elevate the serum calcium
levels.
 Action on kidney – increases Ca reabsorption by
kidney tubules.
 Action on bone – decalcification or demineralization
of bone – increase blood Ca levels.
 Promotes calcification by increasing activity of
osteoblasts.
 Decreases bone resorption.
 Increases excretion of Ca in urine.
Thus, has a decreasing influence on blood Ca.
 Estrogen is a hormone that plays an important role in
helping increase calcium absorption.
 After menopause, estrogen levels drop and so may
calcium absorption.
 Hormone replacement therapy has been shown to
increase the production of vitamin D thus increasing
calcium absorption.
Calcium metabolism
 Hypercalcemia - Increased level of Ca in the blood.
 Symptoms
- Tiredeness
- Loss of appetite.
- Nausea, vomitting.
- Constipation.
 Conditions in which it occurs
- Hyperparathyroidism.
- Acute osteoporosis.
- Vit. D intoxication.
- Thyrotoxicosis.
- Polyuria.
- Dehydration.
- Loss of muscle tone.
- Decreased excitability of
muscles and nerves.
 Hypocalcemia - Decreased levels of Ca in the blood.
 Below 8.8mg/dl mild tremors
 Less than 7.5mg/dl tetany
 Symptoms
- Tetany (Carpopedal spasm).
 This occurs in cases of –
- Insufficient Ca in the diet.
- Hypoparathyroidism.
- Insufficient vit. D in the diet.
- Increase in calcitonin levels.
 Osteoporosis is the most common of all bone diseases in adults,
especially in old age.
 It results from diminished organic bone matrix rather than from
poor bone calcification.
 In osteoporosis the osteoblastic activity in the bone usually is
less than normal, and consequently the rate of bone osteoid
deposition is depressed.
 Characterized by demineralization of bone resulting in
progressive loss of bone mass.
 Elderly persons (>60 years) of both sexes are at risk.
 More predominantly in postmenopausal women.
 Etiology – ability to produce calcitriol from vitamin D
is reduced with age.
 Results in frequent bone fractures – major cause of
disability.
 The spine, hips, ribs, and wrists are common areas of
bone fractures from osteoporosis although
osteoporosis-related fractures can occur in almost any
skeletal bone.
 Osteoporosis can be present without any
symptoms for decades because osteoporosis
doesn't cause symptoms until bone fractures.
 Therefore, patients may not be aware of their
osteoporosis until they suffer a painful fracture.
 The symptom associated with osteoporotic
fractures usually is pain; the location of the pain
depends on the location of the fracture.
 Repeated spinal fractures can lead to chronic lower
back pain as well as loss of height and/or curving
of the spine due to collapse of the vertebrae.
 Osteoporosis can be described as a lack of bone density or
poverty of bone tissue.
 Many patients exhibit continuing bone resorption under
well-made dental prostheses.
 These patients return with complaints of discomfort and
inability to tolerate their prostheses, showing rapid,
inexplicable bone loss.
 Most of these patients are postmenopausal women.
 There are many systemic factors which contribute to
alveolar bone loss and decreased ability to tolerate
dental prostheses.
 Osteoporosis should always be considered as a
possibility.
 The condition of osteoporosis results in bone loss in the
maxillae and mandible as well as in other bones of the
body.
 Studies have shown that nutritional supplementation
can yield impressive results.
 Albanese used a supplement of 750 mg of calcium per
day over a 3-year period and found that the
supplemented patients showed cessation of bone loss
or an increase of up to 12% in bone density when
compared to a test group showing continued bone
loss.
 Jowsey suggests calcium supplementation of 1,000
mg/day.
 Wical and Brussee treated patients with 750 mg of calcium
per day for 1 year.
When compared to a similar
nonsupplemented group, the reduction of bone loss was an
impressive 34% in the maxillae and 39% in the mandible.
 In contrast, several studies reported no benefit to bone
density from daily calcium supplementation.
Calcium metabolism and
osteoporotic ridge resorption
R. P. Blank, H. A. Diehl, G. T. Ballard, and R. C. Melendez (JPD NOV 1987)
 Osteoporosis may be defined simply as a condition of
insufficient bone.
 This deficiency undermines skeletal strength, resulting in
fractures that occur with minimal stress in the spine, distal
radius and ulna, and in the femoral neck.
 Of the 190,000 hip fractures occurring annually, 80% are in
postmenopausal women.
 The relationship of osteoporosis to alveolar and
residual ridge resportion is of justifiable concern to the
dental profession.
 Although generalized bone loss is characteristic of
osteoporosis, the first sign may be alveolar bone loss,
followed by loss in the vertebrae and long bones.
 It may be difficult to treat edentulous patients who
manifest the excessive residual ridge resorption often
associated with osteoporosis.
 By the time osteoporosis is generally diagnosed, 50%
to 75% of the original bone material has been lost from
the skeleton.
 Increasing calcium intake by means of dairy foods and
supplementation is the method most practiced in the
prevention and treatment of osteoporosis to optimize
calcium balance.
 Studies indicate protection against age-related bone
loss in the hand bones and residual ridge bone with
increased calcium intake.
 In contrast, several studies reported no benefit to bone
density from daily calcium supplementation.
 This variance in reported data helps to explain the
wide range in recommended dietary calcium intake
from various health organizations.
 The current recommended dietary allowance (RDA) is
800 mg of calcium/day,
 The most recent National Institutes of Health (NIH)
proposal calls for 1000 to 1500 mg of daily calcium.
 The World Health Organization (WHO)
recommendation is only 400 to 500 mg of
calcium/day.
 Calcium intake in most populations around the
world is 300 to 500 mg/day without any evidence
of osteoporosis.
 Bone resorption of residual ridges is common. The rate
of resorption varies among different individuals and
within the same individual at different times.
 Factors related to the rate of resorption are divided
into anatomic, metabolic, functional, and prosthetic
factors.
 Anatomic factors include the size, shape, and density
of ridges, the thickness and character of the mucosa
covering, and the ridge relationships.
 Metabolic factors include all of the multiple
nutritional, hormonal, and other metabolic factors
which influence the relative cellular activity of the
boneforming cells (osteoblasts) and the bone
resorbing cells (osteoclasts).
 Functional factors include the frequency, intensity,
duration, and direction of forces applied to bone
which are translated into cellular activity, resulting in
either bone formation or bone resorption.
 Prosthetic factors include the myriad of techniques,
materials, concepts, principles, and practices which
are incorporated into the prostheses.
Although the various factors can
be divided into these four groups for academic
purposes, they are all interrelated.
Calcium metabolism
 The diets of subjects with minimal bone resorption
were compared with the diets of subjects with severe
alveolar destruction.
 The results indicate a positive correlation among low
calcium intake, and severe ridge resorption.
 Emphasis was placed on the importance of considering
dietary factors in the diagnosis and treatment of
prosthodontic problems which arise from the excessive
resorption of residual ridges.
 It was concluded that systemic conditions are
important in the etiology of residual ridge resorption.
The resistance of bone to mechanical stresses depends
on its physiologic state.
 Of the many systemic influences which affect the bone
responses of patients, dietary factors may be subject to
the dentist’s control just as are factors of denture
construction.
 Nutritional deficiencies and imbalances, as well
as mechanical factors, should receive
consideration in diagnosis and treatment
planning for prosthodontic patients.
 Biochemistry U. Satyanarayan
 Sheldon Winkler ,A.I.T.B.S. Publishers , Essentials of
complete denture Prosthodontics,2nd edition
 Relationship of osteoporosis to excessive residual ridge
resorption ; J. Crystal Baxter (JPD July 1974)
 Calcium metabolism and osteoporotic ridge resorption
R. P. Blank, H. A. Diehl, G. T. Ballard, and R. C.
Melendez (JPD Nov 1987)
 Some clinical factors related to rate of resorption of
residual ridges ; Atwood (JPD Aug 2001)
 Studies of residual ridge resorption. The
relationship of dietary calcium and phosphorus to
residual ridge resorption ; Wical and Swoope (JPD July
1974)

More Related Content

What's hot

Dental Pulp
Dental Pulp Dental Pulp
Dental Pulp
madhusudhan reddy
 
Gypsum products
Gypsum productsGypsum products
Gypsum products
Weam Faroun
 
Dental pulp
Dental pulpDental pulp
Dental pulp
Ashok Ayer
 
Calcium metabolism
Calcium metabolism Calcium metabolism
Calcium metabolism
Sapna Vadera
 
Theories of mineralization
Theories of mineralizationTheories of mineralization
Theories of mineralization
Babin Karmacharya
 
Role of facial muscles in complete denture prosthesis
Role of facial muscles  in complete denture  prosthesisRole of facial muscles  in complete denture  prosthesis
Role of facial muscles in complete denture prosthesis
Ravi banavathu
 
Vitamins and its oral manifestations
Vitamins and its oral manifestationsVitamins and its oral manifestations
Vitamins and its oral manifestations
Priyanka Kamble
 
Development of Mandible
Development of MandibleDevelopment of Mandible
Development of Mandible
Menatalla Elhindawy
 
Denture Base Resin
Denture Base Resin Denture Base Resin
Denture Base Resin
Self employed
 
Cementum
CementumCementum
Cementum
benita regi
 
vitamin D - dental applications
vitamin D - dental applicationsvitamin D - dental applications
vitamin D - dental applications
Sohail Mohammed
 
Dentin
DentinDentin
Cementum
CementumCementum
Cementum
Hesham Dameer
 
Stainless steel in orthodontics
Stainless steel in orthodonticsStainless steel in orthodontics
Stainless steel in orthodontics
Ishan297
 
Theories of Mineralisation
Theories of MineralisationTheories of Mineralisation
Theories of Mineralisation
Amrit Jaishi
 
Muscles of Mastication
Muscles of MasticationMuscles of Mastication
Muscles of Mastication
Dr. Anshul Sahu
 
Elastomeric impression materials
Elastomeric impression materialsElastomeric impression materials
Elastomeric impression materials
Arunima Upendran
 
Alveolar bone
Alveolar boneAlveolar bone
Alveolar bone
Hesham Dameer
 
Cementum
Cementum Cementum
Cementum
Akram bhuiyan
 
cementum
cementumcementum
cementum
Parth Thakkar
 

What's hot (20)

Dental Pulp
Dental Pulp Dental Pulp
Dental Pulp
 
Gypsum products
Gypsum productsGypsum products
Gypsum products
 
Dental pulp
Dental pulpDental pulp
Dental pulp
 
Calcium metabolism
Calcium metabolism Calcium metabolism
Calcium metabolism
 
Theories of mineralization
Theories of mineralizationTheories of mineralization
Theories of mineralization
 
Role of facial muscles in complete denture prosthesis
Role of facial muscles  in complete denture  prosthesisRole of facial muscles  in complete denture  prosthesis
Role of facial muscles in complete denture prosthesis
 
Vitamins and its oral manifestations
Vitamins and its oral manifestationsVitamins and its oral manifestations
Vitamins and its oral manifestations
 
Development of Mandible
Development of MandibleDevelopment of Mandible
Development of Mandible
 
Denture Base Resin
Denture Base Resin Denture Base Resin
Denture Base Resin
 
Cementum
CementumCementum
Cementum
 
vitamin D - dental applications
vitamin D - dental applicationsvitamin D - dental applications
vitamin D - dental applications
 
Dentin
DentinDentin
Dentin
 
Cementum
CementumCementum
Cementum
 
Stainless steel in orthodontics
Stainless steel in orthodonticsStainless steel in orthodontics
Stainless steel in orthodontics
 
Theories of Mineralisation
Theories of MineralisationTheories of Mineralisation
Theories of Mineralisation
 
Muscles of Mastication
Muscles of MasticationMuscles of Mastication
Muscles of Mastication
 
Elastomeric impression materials
Elastomeric impression materialsElastomeric impression materials
Elastomeric impression materials
 
Alveolar bone
Alveolar boneAlveolar bone
Alveolar bone
 
Cementum
Cementum Cementum
Cementum
 
cementum
cementumcementum
cementum
 

Similar to Calcium metabolism

Calciummetabolism 150129022239-conversion-gate01-converted-converted
Calciummetabolism 150129022239-conversion-gate01-converted-convertedCalciummetabolism 150129022239-conversion-gate01-converted-converted
Calciummetabolism 150129022239-conversion-gate01-converted-converted
Amit Kumar
 
Calcium and its metabolism.pptx
Calcium and its metabolism.pptxCalcium and its metabolism.pptx
Calcium and its metabolism.pptx
AnamikaSingh309208
 
Rejuva ppt.pptx
Rejuva ppt.pptxRejuva ppt.pptx
Rejuva ppt.pptx
NaumanAli90
 
Calcium
CalciumCalcium
Clinical evaluation calcium
Clinical evaluation calciumClinical evaluation calcium
Clinical evaluation calcium
kenwon_
 
Clinical evaluation calciumkenwon
Clinical evaluation calciumkenwonClinical evaluation calciumkenwon
Clinical evaluation calciumkenwon
kenwon_
 
CLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONECLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONE
G AARATHILFA
 
Basic science of bone
Basic science of boneBasic science of bone
Basic science of bone
Amanj Gardi
 
The best cal and phos met sem/ dental crown & bridge courses
The best cal and phos met sem/ dental crown & bridge coursesThe best cal and phos met sem/ dental crown & bridge courses
The best cal and phos met sem/ dental crown & bridge courses
Indian dental academy
 
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Indian dental academy
 
Nutrition
NutritionNutrition
Minerals and trace elements.ppt
Minerals and trace elements.pptMinerals and trace elements.ppt
Minerals and trace elements.ppt
MisbahSehar6
 
RICKETS.pptx
RICKETS.pptxRICKETS.pptx
RICKETS.pptx
elijahgitonga3
 
calcium and oral health
calcium and oral healthcalcium and oral health
calcium and oral health
Shweta Deolekar
 
CALCI-Q tablets: The Calcium fortified with minerals
CALCI-Q tablets: The Calcium fortified with mineralsCALCI-Q tablets: The Calcium fortified with minerals
CALCI-Q tablets: The Calcium fortified with minerals
SriramNagarajan16
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolism
soumyadudhani
 
Calcium metabolism disorders
Calcium metabolism disordersCalcium metabolism disorders
Calcium metabolism disorders
MsccMohamed
 
Rickets
RicketsRickets
Rickets
orthoprince
 
Calcium metabolism
Calcium  metabolismCalcium  metabolism
Calcium metabolism
DrChintansinh Parmar
 
Calcium 3
Calcium 3Calcium 3

Similar to Calcium metabolism (20)

Calciummetabolism 150129022239-conversion-gate01-converted-converted
Calciummetabolism 150129022239-conversion-gate01-converted-convertedCalciummetabolism 150129022239-conversion-gate01-converted-converted
Calciummetabolism 150129022239-conversion-gate01-converted-converted
 
Calcium and its metabolism.pptx
Calcium and its metabolism.pptxCalcium and its metabolism.pptx
Calcium and its metabolism.pptx
 
Rejuva ppt.pptx
Rejuva ppt.pptxRejuva ppt.pptx
Rejuva ppt.pptx
 
Calcium
CalciumCalcium
Calcium
 
Clinical evaluation calcium
Clinical evaluation calciumClinical evaluation calcium
Clinical evaluation calcium
 
Clinical evaluation calciumkenwon
Clinical evaluation calciumkenwonClinical evaluation calciumkenwon
Clinical evaluation calciumkenwon
 
CLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONECLINICAL BIOCHEMISTRY OF BONE
CLINICAL BIOCHEMISTRY OF BONE
 
Basic science of bone
Basic science of boneBasic science of bone
Basic science of bone
 
The best cal and phos met sem/ dental crown & bridge courses
The best cal and phos met sem/ dental crown & bridge coursesThe best cal and phos met sem/ dental crown & bridge courses
The best cal and phos met sem/ dental crown & bridge courses
 
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
Calcium and phosphorus metabolism / dental implant courses by Indian dental a...
 
Nutrition
NutritionNutrition
Nutrition
 
Minerals and trace elements.ppt
Minerals and trace elements.pptMinerals and trace elements.ppt
Minerals and trace elements.ppt
 
RICKETS.pptx
RICKETS.pptxRICKETS.pptx
RICKETS.pptx
 
calcium and oral health
calcium and oral healthcalcium and oral health
calcium and oral health
 
CALCI-Q tablets: The Calcium fortified with minerals
CALCI-Q tablets: The Calcium fortified with mineralsCALCI-Q tablets: The Calcium fortified with minerals
CALCI-Q tablets: The Calcium fortified with minerals
 
Calcium metabolism
Calcium metabolismCalcium metabolism
Calcium metabolism
 
Calcium metabolism disorders
Calcium metabolism disordersCalcium metabolism disorders
Calcium metabolism disorders
 
Rickets
RicketsRickets
Rickets
 
Calcium metabolism
Calcium  metabolismCalcium  metabolism
Calcium metabolism
 
Calcium 3
Calcium 3Calcium 3
Calcium 3
 

More from Asmita Sodhi

Implant lecture
Implant lecture Implant lecture
Implant lecture
Asmita Sodhi
 
Case selection & treatment planning
Case selection & treatment planningCase selection & treatment planning
Case selection & treatment planning
Asmita Sodhi
 
Minimal invasive drainage
Minimal invasive drainageMinimal invasive drainage
Minimal invasive drainage
Asmita Sodhi
 
Ragging a menace
Ragging a menace Ragging a menace
Ragging a menace
Asmita Sodhi
 
Iimportance of keeping records in dental practice
Iimportance of  keeping records in dental practice Iimportance of  keeping records in dental practice
Iimportance of keeping records in dental practice
Asmita Sodhi
 
Role of primary stability for osseointegration
Role of primary stability for osseointegrationRole of primary stability for osseointegration
Role of primary stability for osseointegration
Asmita Sodhi
 
Primary stability a predictable parameter
Primary stability a predictable parameter Primary stability a predictable parameter
Primary stability a predictable parameter
Asmita Sodhi
 
Methods used to_assess_implant_stability.unlocked
Methods used to_assess_implant_stability.unlockedMethods used to_assess_implant_stability.unlocked
Methods used to_assess_implant_stability.unlocked
Asmita Sodhi
 
Methods used to_assess_implant_stability
Methods used to_assess_implant_stabilityMethods used to_assess_implant_stability
Methods used to_assess_implant_stability
Asmita Sodhi
 
Measurement of primary and secondary stability
Measurement of primary and secondary stability Measurement of primary and secondary stability
Measurement of primary and secondary stability
Asmita Sodhi
 
Implant stability the password
Implant stability the password Implant stability the password
Implant stability the password
Asmita Sodhi
 
Implant stability rfa
Implant stability rfaImplant stability rfa
Implant stability rfa
Asmita Sodhi
 
Implant stability measurement (2)
Implant stability measurement (2)Implant stability measurement (2)
Implant stability measurement (2)
Asmita Sodhi
 
Implant stability measurement (1)
Implant stability measurement (1)Implant stability measurement (1)
Implant stability measurement (1)
Asmita Sodhi
 
Implant stability intech
Implant stability intechImplant stability intech
Implant stability intech
Asmita Sodhi
 
Implant stability in immediate implant
Implant stability in immediate implantImplant stability in immediate implant
Implant stability in immediate implant
Asmita Sodhi
 
Implant stability 2013
Implant stability 2013Implant stability 2013
Implant stability 2013
Asmita Sodhi
 
Implant stability1
Implant stability1Implant stability1
Implant stability1
Asmita Sodhi
 
Full mouth rehabilitation
Full mouth rehabilitationFull mouth rehabilitation
Full mouth rehabilitation
Asmita Sodhi
 
Thumb sucking is a behavior found in humans
Thumb sucking is a behavior found in humansThumb sucking is a behavior found in humans
Thumb sucking is a behavior found in humans
Asmita Sodhi
 

More from Asmita Sodhi (20)

Implant lecture
Implant lecture Implant lecture
Implant lecture
 
Case selection & treatment planning
Case selection & treatment planningCase selection & treatment planning
Case selection & treatment planning
 
Minimal invasive drainage
Minimal invasive drainageMinimal invasive drainage
Minimal invasive drainage
 
Ragging a menace
Ragging a menace Ragging a menace
Ragging a menace
 
Iimportance of keeping records in dental practice
Iimportance of  keeping records in dental practice Iimportance of  keeping records in dental practice
Iimportance of keeping records in dental practice
 
Role of primary stability for osseointegration
Role of primary stability for osseointegrationRole of primary stability for osseointegration
Role of primary stability for osseointegration
 
Primary stability a predictable parameter
Primary stability a predictable parameter Primary stability a predictable parameter
Primary stability a predictable parameter
 
Methods used to_assess_implant_stability.unlocked
Methods used to_assess_implant_stability.unlockedMethods used to_assess_implant_stability.unlocked
Methods used to_assess_implant_stability.unlocked
 
Methods used to_assess_implant_stability
Methods used to_assess_implant_stabilityMethods used to_assess_implant_stability
Methods used to_assess_implant_stability
 
Measurement of primary and secondary stability
Measurement of primary and secondary stability Measurement of primary and secondary stability
Measurement of primary and secondary stability
 
Implant stability the password
Implant stability the password Implant stability the password
Implant stability the password
 
Implant stability rfa
Implant stability rfaImplant stability rfa
Implant stability rfa
 
Implant stability measurement (2)
Implant stability measurement (2)Implant stability measurement (2)
Implant stability measurement (2)
 
Implant stability measurement (1)
Implant stability measurement (1)Implant stability measurement (1)
Implant stability measurement (1)
 
Implant stability intech
Implant stability intechImplant stability intech
Implant stability intech
 
Implant stability in immediate implant
Implant stability in immediate implantImplant stability in immediate implant
Implant stability in immediate implant
 
Implant stability 2013
Implant stability 2013Implant stability 2013
Implant stability 2013
 
Implant stability1
Implant stability1Implant stability1
Implant stability1
 
Full mouth rehabilitation
Full mouth rehabilitationFull mouth rehabilitation
Full mouth rehabilitation
 
Thumb sucking is a behavior found in humans
Thumb sucking is a behavior found in humansThumb sucking is a behavior found in humans
Thumb sucking is a behavior found in humans
 

Recently uploaded

MARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
MARIGREEN PROJECT - overview, Oana Cristina PârvulescuMARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
MARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
Faculty of Applied Chemistry and Materials Science
 
Analytical methods for blue residues characterization - Oana Crina Bujor
Analytical methods for blue residues characterization - Oana Crina BujorAnalytical methods for blue residues characterization - Oana Crina Bujor
Analytical methods for blue residues characterization - Oana Crina Bujor
Faculty of Applied Chemistry and Materials Science
 
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
Sérgio Sacani
 
Surface properties of the seas of Titan as revealed by Cassini mission bistat...
Surface properties of the seas of Titan as revealed by Cassini mission bistat...Surface properties of the seas of Titan as revealed by Cassini mission bistat...
Surface properties of the seas of Titan as revealed by Cassini mission bistat...
Sérgio Sacani
 
Lake classification and Morphometry.pptx
Lake classification and Morphometry.pptxLake classification and Morphometry.pptx
Lake classification and Morphometry.pptx
boobalanbfsc
 
VIII-Geography FOR CBSE CLASS 8 INDIA.pdf
VIII-Geography FOR CBSE CLASS 8 INDIA.pdfVIII-Geography FOR CBSE CLASS 8 INDIA.pdf
VIII-Geography FOR CBSE CLASS 8 INDIA.pdf
poorvarajgolkar
 
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
US Environmental Protection Agency (EPA), Center for Computational Toxicology and Exposure
 
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
Sérgio Sacani
 
Potential of Marine Renewable and Non renewable energy.pptx
Potential of Marine Renewable and Non renewable energy.pptxPotential of Marine Renewable and Non renewable energy.pptx
Potential of Marine Renewable and Non renewable energy.pptx
J. Bovas Joel BFSc
 
Biochar impregnation as slow release fertilizer - Violeta Alexandra Ion
Biochar impregnation as slow release fertilizer - Violeta Alexandra IonBiochar impregnation as slow release fertilizer - Violeta Alexandra Ion
Biochar impregnation as slow release fertilizer - Violeta Alexandra Ion
Faculty of Applied Chemistry and Materials Science
 
Post RN - Biochemistry (Unit 7) Metabolism
Post RN - Biochemistry (Unit 7) MetabolismPost RN - Biochemistry (Unit 7) Metabolism
Post RN - Biochemistry (Unit 7) Metabolism
Areesha Ahmad
 
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
Faculty of Applied Chemistry and Materials Science
 
Phytoremediation: Harnessing Nature's Power with Phytoremediation
Phytoremediation: Harnessing Nature's Power with PhytoremediationPhytoremediation: Harnessing Nature's Power with Phytoremediation
Phytoremediation: Harnessing Nature's Power with Phytoremediation
Gurjant Singh
 
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
Dr NEETHU ASOKAN
 
Classification and role of plant nutrients - Roxana Madjar
Classification and role of plant nutrients - Roxana MadjarClassification and role of plant nutrients - Roxana Madjar
Classification and role of plant nutrients - Roxana Madjar
Faculty of Applied Chemistry and Materials Science
 
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
Sérgio Sacani
 
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
marigreenproject
 
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
Faculty of Applied Chemistry and Materials Science
 
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
Sérgio Sacani
 
NuGOweek 2024 Ghent programme__flyer.pdf
NuGOweek 2024 Ghent programme__flyer.pdfNuGOweek 2024 Ghent programme__flyer.pdf
NuGOweek 2024 Ghent programme__flyer.pdf
pablovgd
 

Recently uploaded (20)

MARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
MARIGREEN PROJECT - overview, Oana Cristina PârvulescuMARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
MARIGREEN PROJECT - overview, Oana Cristina Pârvulescu
 
Analytical methods for blue residues characterization - Oana Crina Bujor
Analytical methods for blue residues characterization - Oana Crina BujorAnalytical methods for blue residues characterization - Oana Crina Bujor
Analytical methods for blue residues characterization - Oana Crina Bujor
 
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
A NICER VIEW OF THE NEAREST AND BRIGHTEST MILLISECOND PULSAR: PSR J0437−4715
 
Surface properties of the seas of Titan as revealed by Cassini mission bistat...
Surface properties of the seas of Titan as revealed by Cassini mission bistat...Surface properties of the seas of Titan as revealed by Cassini mission bistat...
Surface properties of the seas of Titan as revealed by Cassini mission bistat...
 
Lake classification and Morphometry.pptx
Lake classification and Morphometry.pptxLake classification and Morphometry.pptx
Lake classification and Morphometry.pptx
 
VIII-Geography FOR CBSE CLASS 8 INDIA.pdf
VIII-Geography FOR CBSE CLASS 8 INDIA.pdfVIII-Geography FOR CBSE CLASS 8 INDIA.pdf
VIII-Geography FOR CBSE CLASS 8 INDIA.pdf
 
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
Accessing Data to Support Pesticide Residue and Emerging Contaminant Analysis...
 
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
Detection of the elusive dangling OH ice features at ~2.7 μm in Chamaeleon I ...
 
Potential of Marine Renewable and Non renewable energy.pptx
Potential of Marine Renewable and Non renewable energy.pptxPotential of Marine Renewable and Non renewable energy.pptx
Potential of Marine Renewable and Non renewable energy.pptx
 
Biochar impregnation as slow release fertilizer - Violeta Alexandra Ion
Biochar impregnation as slow release fertilizer - Violeta Alexandra IonBiochar impregnation as slow release fertilizer - Violeta Alexandra Ion
Biochar impregnation as slow release fertilizer - Violeta Alexandra Ion
 
Post RN - Biochemistry (Unit 7) Metabolism
Post RN - Biochemistry (Unit 7) MetabolismPost RN - Biochemistry (Unit 7) Metabolism
Post RN - Biochemistry (Unit 7) Metabolism
 
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
AlgaeBrew project - Unlocking the potential of microalgae for the valorisatio...
 
Phytoremediation: Harnessing Nature's Power with Phytoremediation
Phytoremediation: Harnessing Nature's Power with PhytoremediationPhytoremediation: Harnessing Nature's Power with Phytoremediation
Phytoremediation: Harnessing Nature's Power with Phytoremediation
 
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
Bioconversion of sago waste and oil cakes into biobutanol using Environmental...
 
Classification and role of plant nutrients - Roxana Madjar
Classification and role of plant nutrients - Roxana MadjarClassification and role of plant nutrients - Roxana Madjar
Classification and role of plant nutrients - Roxana Madjar
 
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
A Strong He II λ1640 Emitter with an Extremely Blue UV Spectral Slope at z=8....
 
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
17. 20240529_Ingrid Olesen_MariGreen summer school.pdf
 
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
End of pipe treatment: Unlocking the potential of RAS waste - Carlos Octavio ...
 
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
Simulations of pulsed overpressure jets: formation of bellows and ripples in ...
 
NuGOweek 2024 Ghent programme__flyer.pdf
NuGOweek 2024 Ghent programme__flyer.pdfNuGOweek 2024 Ghent programme__flyer.pdf
NuGOweek 2024 Ghent programme__flyer.pdf
 

Calcium metabolism

  • 1. Guided by- Dr. Akshey Sharma Dr. Rajesh Bhanot Dr. Pardeep Bansal Dr. Gagan Chahal Presented by- Dr. Swati Mittal PG student 1st year Deptt of Prosthodontics
  • 2. As dentists, it is vital for us to have a complete understanding of the general metabolism of calcium as it helps in the formation and maintenance of the teeth and their supporting bony structure.
  • 3. Approximately 99% of the total body weight of calcium is present in the skeleton.  The remaining 1% is found in the cell membranes and extracellular fluid.  It is this small percentage of calcium that is vital to all life processes.
  • 4. 1. Contributes to hardness of bone and is a major component of teeth. 2. Stabilises the cell membrane and their permeability. 3. Maintenance of excitability of nerve and muscles. 4. Normal skeletal and cardiac muscle contraction. 5. Blood coagulation – Ca++ is required for the conversion of many inactive enzymes in the coagulation process.
  • 5. Infants (< 1 year) = 300-500 mg/ day Children (1 – 18 years) = 0.8-1.2 g/day Adult men and women = 800 mg/day Pregnancy and lactation = 1.0-2gm/day
  • 6.  Milk is a good source for calcium. Calcium content of cow milk is about 100mg/100ml.  Egg, fish & vegetables are medium source for calcium.  Cereals (wheat, rice) contains small amount of calcium. But cereals are the staple diet in India. Therefore, cereals form the major source of calcium in Indian diet.
  • 7.  Several different kinds of calcium compounds are used in calcium supplements. Each compound contains varying amounts of the mineral calcium.  Common calcium supplements may be labeled as:  Calcium carbonate - Tums® and Caltrate®  Calcium citrate- Citracal® and Solgar®
  • 8.  If the calcium in diet and from supplements exceeds the tolerable upper limit, you could increase your risk of health problems, such as:  Kidney stones  Prostate cancer  Constipation  Calcium buildup in your blood vessels  Impaired absorption of iron and zinc
  • 9.  Calcium absorption in the small intestine occurs by both active & passive diffusion.  Uptake of calcium by active transport predominates in: duodenum jejunum;  Simple diffusion predominates in: ileum  Most of the ingested calcium is normally eliminated in the feces, although the kidneys have the capacity to excrete large amounts by reducing tubular reabsorption of calcium
  • 10.  VitaminD –Calcitriol induces the synthesis of the carrier protein (Calbindin) in the intestinal epithelial cells & so facilitates the absorption of calcium.  Parathyroid hormones increases calcium transport from the intestinal cells.  Amino acids, especially lysine & arginine increase absorption.  Lactose : enhance passive Ca uptake; its effect is valuable because of it presence in milk.
  • 11.  Phytates — Phytates are substances found in some plant foods that can bind calcium in the intestine and decrease its absorption.  Oxalates are present in some leafy vegetables which cause formation of insoluble calcium oxalates .  In malabsorption syndromes , fatty acid is not absorbed , causing formation of insoluble calcium salt of fatty acid .  High phosphate content will cause precipitation as calcium phosphate.  Absorption is also decreased with increase intake of protein & fiber in diet.
  • 12.  This term is used to describe the amount of Ca++ either stored or lost by the body over a specific period of time.  When the assimilation of calcium from dietary sources is less than the metabolic requirements and the obligatory losses , then calcium is withdrawn from the skeleton to maintain the critical concentration of the element in the blood and tissue fluids.
  • 13.  Calcium homeostasis is the mechanism by which the body maintains adequate calcium levels. Positive Ca2+ balance  Is seen in growing children, where intestinal Ca2+ absorption exceeds urinary excretion and the difference is deposited in the growing bones.
  • 14. Negative Ca2+ balance  Is seen in women during pregnancy or lactation, where intestinal Ca2+ absorption is less than urinary excretion and the difference comes from the maternal bones.
  • 15.  The primary source of available calcium is trabecular bone, not cortical bone.  The sites of trabecular bone which supply mobile calcium are the jaws, ribs, bodies of the vertebrae, and the ends of the long bones.
  • 16.  A significant finding from animal experimentation is that, when skeletal depletion of calcium occurs as a result of stimulation of the parathyroid gland, alveolar bone is affected first, the ribs and the vertebrae are affected second, and the long bones third.  Prolonged depletion results in disorganization and loss of trabeculae, followed by cortical remodeling or structural failure.
  • 17.  A complex set of interlocking mechanisms takes place in order to allow man to survive major dietary Ca intake fluctuations. These mechanisms are mainly controlled by the endocrine systems.  Three main hormones acting at 3 different sites are responsible for Ca metabolism. 1. Vit. D3 - Bone. 2. Parathormone - Kidney 3. Calcitonin - Intestine
  • 18.  Physiologically active form of vitamin D is a hormone called calcitriol or 1,25 – dihydroxycholecalciferol (1,25 – DHCC).  It stimulates Ca uptake by osteoblasts of the bone and promotes calcification or mineralization and remodelling , thus increasing the blood calcium levels.
  • 20.  The prime function is to elevate the serum calcium levels.  Action on kidney – increases Ca reabsorption by kidney tubules.  Action on bone – decalcification or demineralization of bone – increase blood Ca levels.
  • 21.  Promotes calcification by increasing activity of osteoblasts.  Decreases bone resorption.  Increases excretion of Ca in urine. Thus, has a decreasing influence on blood Ca.
  • 22.  Estrogen is a hormone that plays an important role in helping increase calcium absorption.  After menopause, estrogen levels drop and so may calcium absorption.  Hormone replacement therapy has been shown to increase the production of vitamin D thus increasing calcium absorption.
  • 24.  Hypercalcemia - Increased level of Ca in the blood.  Symptoms - Tiredeness - Loss of appetite. - Nausea, vomitting. - Constipation.  Conditions in which it occurs - Hyperparathyroidism. - Acute osteoporosis. - Vit. D intoxication. - Thyrotoxicosis. - Polyuria. - Dehydration. - Loss of muscle tone. - Decreased excitability of muscles and nerves.
  • 25.  Hypocalcemia - Decreased levels of Ca in the blood.  Below 8.8mg/dl mild tremors  Less than 7.5mg/dl tetany  Symptoms - Tetany (Carpopedal spasm).  This occurs in cases of – - Insufficient Ca in the diet. - Hypoparathyroidism. - Insufficient vit. D in the diet. - Increase in calcitonin levels.
  • 26.  Osteoporosis is the most common of all bone diseases in adults, especially in old age.  It results from diminished organic bone matrix rather than from poor bone calcification.  In osteoporosis the osteoblastic activity in the bone usually is less than normal, and consequently the rate of bone osteoid deposition is depressed.
  • 27.  Characterized by demineralization of bone resulting in progressive loss of bone mass.  Elderly persons (>60 years) of both sexes are at risk.  More predominantly in postmenopausal women.  Etiology – ability to produce calcitriol from vitamin D is reduced with age.  Results in frequent bone fractures – major cause of disability.
  • 28.  The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.  Osteoporosis can be present without any symptoms for decades because osteoporosis doesn't cause symptoms until bone fractures.
  • 29.  Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture.  The symptom associated with osteoporotic fractures usually is pain; the location of the pain depends on the location of the fracture.  Repeated spinal fractures can lead to chronic lower back pain as well as loss of height and/or curving of the spine due to collapse of the vertebrae.
  • 30.  Osteoporosis can be described as a lack of bone density or poverty of bone tissue.  Many patients exhibit continuing bone resorption under well-made dental prostheses.  These patients return with complaints of discomfort and inability to tolerate their prostheses, showing rapid, inexplicable bone loss.  Most of these patients are postmenopausal women.
  • 31.  There are many systemic factors which contribute to alveolar bone loss and decreased ability to tolerate dental prostheses.  Osteoporosis should always be considered as a possibility.  The condition of osteoporosis results in bone loss in the maxillae and mandible as well as in other bones of the body.
  • 32.  Studies have shown that nutritional supplementation can yield impressive results.  Albanese used a supplement of 750 mg of calcium per day over a 3-year period and found that the supplemented patients showed cessation of bone loss or an increase of up to 12% in bone density when compared to a test group showing continued bone loss.
  • 33.  Jowsey suggests calcium supplementation of 1,000 mg/day.  Wical and Brussee treated patients with 750 mg of calcium per day for 1 year. When compared to a similar nonsupplemented group, the reduction of bone loss was an impressive 34% in the maxillae and 39% in the mandible.  In contrast, several studies reported no benefit to bone density from daily calcium supplementation.
  • 34. Calcium metabolism and osteoporotic ridge resorption R. P. Blank, H. A. Diehl, G. T. Ballard, and R. C. Melendez (JPD NOV 1987)  Osteoporosis may be defined simply as a condition of insufficient bone.  This deficiency undermines skeletal strength, resulting in fractures that occur with minimal stress in the spine, distal radius and ulna, and in the femoral neck.  Of the 190,000 hip fractures occurring annually, 80% are in postmenopausal women.
  • 35.  The relationship of osteoporosis to alveolar and residual ridge resportion is of justifiable concern to the dental profession.  Although generalized bone loss is characteristic of osteoporosis, the first sign may be alveolar bone loss, followed by loss in the vertebrae and long bones.  It may be difficult to treat edentulous patients who manifest the excessive residual ridge resorption often associated with osteoporosis.
  • 36.  By the time osteoporosis is generally diagnosed, 50% to 75% of the original bone material has been lost from the skeleton.  Increasing calcium intake by means of dairy foods and supplementation is the method most practiced in the prevention and treatment of osteoporosis to optimize calcium balance.
  • 37.  Studies indicate protection against age-related bone loss in the hand bones and residual ridge bone with increased calcium intake.  In contrast, several studies reported no benefit to bone density from daily calcium supplementation.  This variance in reported data helps to explain the wide range in recommended dietary calcium intake from various health organizations.
  • 38.  The current recommended dietary allowance (RDA) is 800 mg of calcium/day,  The most recent National Institutes of Health (NIH) proposal calls for 1000 to 1500 mg of daily calcium.  The World Health Organization (WHO) recommendation is only 400 to 500 mg of calcium/day.  Calcium intake in most populations around the world is 300 to 500 mg/day without any evidence of osteoporosis.
  • 39.  Bone resorption of residual ridges is common. The rate of resorption varies among different individuals and within the same individual at different times.  Factors related to the rate of resorption are divided into anatomic, metabolic, functional, and prosthetic factors.
  • 40.  Anatomic factors include the size, shape, and density of ridges, the thickness and character of the mucosa covering, and the ridge relationships.  Metabolic factors include all of the multiple nutritional, hormonal, and other metabolic factors which influence the relative cellular activity of the boneforming cells (osteoblasts) and the bone resorbing cells (osteoclasts).
  • 41.  Functional factors include the frequency, intensity, duration, and direction of forces applied to bone which are translated into cellular activity, resulting in either bone formation or bone resorption.  Prosthetic factors include the myriad of techniques, materials, concepts, principles, and practices which are incorporated into the prostheses. Although the various factors can be divided into these four groups for academic purposes, they are all interrelated.
  • 43.  The diets of subjects with minimal bone resorption were compared with the diets of subjects with severe alveolar destruction.  The results indicate a positive correlation among low calcium intake, and severe ridge resorption.
  • 44.  Emphasis was placed on the importance of considering dietary factors in the diagnosis and treatment of prosthodontic problems which arise from the excessive resorption of residual ridges.  It was concluded that systemic conditions are important in the etiology of residual ridge resorption. The resistance of bone to mechanical stresses depends on its physiologic state.
  • 45.  Of the many systemic influences which affect the bone responses of patients, dietary factors may be subject to the dentist’s control just as are factors of denture construction.  Nutritional deficiencies and imbalances, as well as mechanical factors, should receive consideration in diagnosis and treatment planning for prosthodontic patients.
  • 46.  Biochemistry U. Satyanarayan  Sheldon Winkler ,A.I.T.B.S. Publishers , Essentials of complete denture Prosthodontics,2nd edition  Relationship of osteoporosis to excessive residual ridge resorption ; J. Crystal Baxter (JPD July 1974)  Calcium metabolism and osteoporotic ridge resorption R. P. Blank, H. A. Diehl, G. T. Ballard, and R. C. Melendez (JPD Nov 1987)
  • 47.  Some clinical factors related to rate of resorption of residual ridges ; Atwood (JPD Aug 2001)  Studies of residual ridge resorption. The relationship of dietary calcium and phosphorus to residual ridge resorption ; Wical and Swoope (JPD July 1974)