Bone formation

Ossification (or osteogenesis) in bone remodeling is the process of laying down new bone material by cells called osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in the formation of normal, healthy bone tissue:Intramembranous ossification is the direct laying down of bone into the primitive connective tissue (mesenchyme), while endochondral ossification involves cartilage as a precursor. In fracture healing, endochondral osteogenesis is the most commonly occurring process, for example in fractures of long bones treated by plaster of Paris, whereas fractures treated by open reduction and internal fixation with metal plates, screws, pins, rods and nails may heal by intramembranous osteogenesis.

Heterotopic ossification is a process resulting in the formation of bone tissue that is often atypical, at an extraskeletal location. Calcification is often confused with ossification. Calcification is synonymous with the formation of calcium-based salts and crystals within cells and tissue. It is a process that occurs during ossification, but not vice versa.

The exact mechanisms by which bone development is triggered remains unclear, but it involves growth factors and cytokines in some way.

Intramembranous ossification forms the flat bones of the skull, clavicle and mandible.

Endochondral ossification is the formation of long bones and other bones. This requires a hyaline cartilage precursor. There are two centres of ossification for endochondral ossification.

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