disturbances in mineral metabolism 1 / dental implant courses
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Disturbances in mineral metabolism 1
INDIAN DENTAL ACADEMYLeader in continuing Dental Education
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Learning Objectives
At the end the student should be able to—
• Describe,body content,Daily requirements,Dietary sources,Absorption,Excretion,Functions,Related pathologies of calcium .
• Describe,Body content,Daily requirements,Dietary sources,Absorption,Excretion,Functions,Related pathologies of phosphorus.
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Minerals • Minerals are inorganic elements that are essential
for life and provide both the structural and regulatory functions of the body.
• Macroelements (100mg) Calcium, phosphorous, sodium, potassium,
chloride, sulphur
• Microelements Iron, iodine, copper, cobalt, zinc, fluoride,
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Calcium Most abundant of all minerals in body.
Total content in adult male is about 1- 1.5 kg.
Out of this 99% is present in bones & teeth & 1% outside skeletal tissue.
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Blood calcium –
Most of blood Ca is present in plasma.
Normal serum Ca is 9-11 mg/dl.
About half of this (5mg/dl.) is present in ionised state which is functionally most active.
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Dietary requirements a) Infants – 300 -500 mg /day.
b) Children (1 -18 yrs) – 0.8 – 1.2 g/day.
c) Adult men & women- 800 mg /day.
d) Women during pregnancy, lactation & post menopause- 1.5 g/day.
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Best sources
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Good sources
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Absorption Occurs in duodenum by active energy
dependent process & passively in jejunum.
Is influenced by several factors, either promoted or inhibited.
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• Factors interfere with
calcium absorption: Phytic acid,
Oxalic acid
Hypochlorhydria or achlorhydria
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Factors help in calcium absorption:
• Vitamin D
Citrates (lower pH of intestinal tract)
High protein diets
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CALCIUM REGULATION
• PARATHORMONE• CALCITONIN• VITAMIN D• GLUCOCORTICOIDS• TESTOSTERONE• ESTROGENS
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Excretion of calcium
It is excreted partly through kidney & mostly through feces.
Feces – 80% Dermal losses – 50 mg/dl
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Functions:• Formation of bones & teeth
• Maintainance of skeletal & teeth structure
• Normal membrane permeability
• Normal heart rhythm
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• Neuromuscular excitability
• Coagulation of blood
• Muscle contraction
• Messenger in hormone action
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Pathologies related to Ca metabolism
• Hypercalcemia• Hypocalcemia• Hyperparathyroidism• Hypoparathyroidism• Osteoporosis• Rickets• Osteomalacia• Pathological calcification
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TETANY
CHVOSTEK’S SIGN TROUSSEAU’S SIGN
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Phosphorus• Important or essential mineral.
• About 1kg in adult body.
• About 80%- in combination with ca• 10%- in muscles & blood.• 10 %- in various compounds.
• Serum level- 3-4 mg/dl.
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Out of total blood Phosp.-i. 40% -In ionic formii. 50 % - in combination with other cationsiii. 10 %- bound to proteins.
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Requirements:
• Daily dietary phosphorus intake
Newborn infants: 240mg
Children & adults: 800mg
Adolescents & pregnant & lactating women: 1200mg
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Dieatery sources
• Sea food: tuna, mackerel, salmon, sardines,.• Meats: liver rabbit, chicken, eggs, egg yolk.• Nuts and seeds: pinon nuts , sunflower seeds,
walnuts, almonds,, cashews, peanuts.
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• Vegetables: garlic, onion, soybeans.• Dairy: cheeses.• Grains: wheat, oats, oatmeal, rice bran, rye,
wheat.
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Absorption:• 90% of average daily dietary intake of
phosphate is absorbed from small intestine.
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• Factors interfere with
absorption of phosphorus
Excess of calcium, iron, aluminium
Long-term antacid use
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Excretion Phosphorus • Phosphorous is excreted primarily through the
urine. • Almost 2/3rd of total phosphorous that is excreted
is found in the urine as phosphate of various cations
• phosphorous found in the feces is the non-absorbed form of phosphorous.
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Functions of Phosphates• Formation of bones• Like calcium, important component of teeth.• Important constituent of cells• Forms energy rich bonds in ATP• Forms co-enzymes• Regulates blood and urinary pH• Forms organic molecules like DNA & RNA
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Summary
mineral(Calcium, Phosphorus) in context to these following headings-
Daily requirements, Dietary sources, Absorption, Excretion, Functions, Related pathologies
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BIBLIOGRAPHY
Text book of oral pathology Shafer's, 5 & 6th edition
Color Atlas of Oral Diseases Cawson, R. 2nd edition
Oral and Maxillofacial Pathology Neville, Brad W. 2nd
Lucas’s Pathology Of Tumor’s of the Oral Tissues Cawson, R. A.,
Bennie, W. H 5th edition
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