This slide describes about pathological calcification of implants.

1. PATHOLOGIC CALCIFICATION
OF IMPLANTS
SWASTIKA SHRESTHA/SUCHEET YADAV
COLLEGE OF BIOMEDICAL ENGINEERING AND APPLIED SCIENCES

2. CONTENT:
1. Calcification
2. Types of calcification
3. Effect of calcification
4. Mineralization
5. Classification of bio prosthetic heart valves
6.

3. CALCIFICATION
• Calcification is a accumulation of calcium salts in a body tissue.
• Normally occurs in the formation of bone but calcium can be deposited abnormally in soft tissue
causing it to harden
• It may also refer to the process of normal mineral deposition in biological systems such as the formation
of stromatolites or millosc shells.
• Disport our body's normal process.

4. TYPES OF CALCIFICATION:
• Calcification may be classified on whether there is mineral balance or not, and the location of
calcification.
• On the basis of mineral balance
• Dystrophic
• Metastatic
• On the basis of location of calcification
• Extrinsic
• Intrinsic

5. DYSTROPHIC CALCIFICATION:
• When the deposition occurs locally in dying tissue, it is known as dystrophic calcification.
• It occurs despite of normal serum level of calcium and the absence of derangements in calcium
metabolism.
• It occurs in the area of necrosis.
• In atheroma’s of advance atherosclerosis.
• In aging or damaged heart valves.
• Dead Parasites.
• Cancers.

6. FIGURE OF DYSTROPHIC CALCIFICATION
• Appears macroscopically, fine, white granules or clumps often as Griffey deposit.

7. METASTATIC CALCIFICATION:
• The deposition of calcium salts in normal tissue is called metastatic calcification.
• It almost always resolves from hyper calcimia secondary to some disturbance in calcium metabolism
• Occurs in area having high pH, eg: Lungs ,stomach, blood vessels, cornea
• Occurs due to hyper parathyroidism

8. FIGURE OF METASTATIC CALCIFICATION:

9. EXTRINSIC CALCIFICATION:
• Occurs in the surface of implants
• Often associated with attached tissue or cells

10. INTRINSIC CALCIFICATION:
• Occurs with the structural components

11. MINIRALIZATION:
• Miniraliation refers to a process where an inorganic substance precipites in an organic matrix
• Thesr may be due to normal biological processes that take place during the life of an organism such as
formation of bones egg shells teeth coral and other exoskeletons.
• Mineralization of a biomaterial is generally enhanced at the site of internal mechanical deformations, such as
the flexing points in circulatory divices

12. CALCIFICATION OF BIO PROSTHETICS HEART VALVES
• Calcification of cardio vascular prosthetic implants is a common and important problem.
• Variety of cardio vascular prostheses are affected clinically by calcification, including bioprosthetic heart
valves aortic homo grafts and trileaflet polymeric valve prostheses
• Calcification of bioprosthetic tissue is primarily intrinsic, realeted to cuspal connectint tissue cella and
fragments, and collagen.
• More than half of such valves implanted in patients fail within 12 to 15 years.
• When a heart valve become calcified the leaflets becomes narrowed (stenotic). The stenotic hert valve
in turn leads to increases resistance blood flow

13. COUSE OF HEARTVALVE CALCIFICATION
• There are multiple reasons that valve calcify
• One particular reason is attributed to the normal ware and tear of the heart valves because of the fact
that heart is the hardest working muscle in the body
• Smoking, diabetes, chronic kidney diseases and elevated cholesterol contributes in calcification.
• Another reason is that the valves are treated or present with a chemical called glutaraldehyde which
attracts calcium.
• Immune reaction that the body has to the artificial animal valves

14. CALCIFICATION OF CONTACT LENSES
• Calcium phosphate deposits leas to the opacification of soft contact lenses, which ae composed of poly-2-
hydroxyethymethylacrylate (HEMA)
• Calcium from tear is considers to be the source of diposits found on HEMA contact lenses
• Calcific deposit grow progressively larger with time and are virtually imposible to remove without destroying
the lense

15. CALCIFICATION OF CONTACT LENSES (CONT…)
• However at present, there is an incomplete understanding of the cause of this calcification
• No soft lens material is yet available which is not susceptible to this problem although the polyglycerylmethyl
metha acrylate lens has been shown to far beter than HEMA soft lens

16. CALCIFICATION OF CUDS
• Calcification of contraceptive divices has been suspected of causing dysfunction, leading to either
detachment of devices or contraceptive failure
• Accumulation of calcific plague on coppers containing IUDs can prevent the realese of ionic copper,
there by altering the effictiveness of divices, since copper release is needed to prevent conception
• IUDs that function for longer period have greater amount of deposition, although there is lesser
accumulation on divices that releases conception preventing hormones.

17. DIAGNOSING CALCIFICATION:
• Calcification are visually found via X-rays
• Xray tests use electromagnetic radiation to take pictures of internal orgainsand usally cause no
discomfort
• Clinician will likely detect any calcification issue right away with radiographic diagnosis

18. DIAGNOSING CALCIFICATION: (CONT…)
• Sometimes calcium deposit are found in areas of cancer.
• Clinician can prescribe Biopsy (usally fine niddle) to collect a tissue sample.
• The tissue is than sent to laboratory for testing.
• If no cancer cells are found clinician will label the calcification as bening ( transformation of
protooncogene to oncogene )

19. PRECAUTIONS:
• In case of heart valve calcification, you may need surgery to open or replace the valve if the calcium
build up is severe enough to affect the valves function
• Kidney stone treatments help break down calcium buildup in kidneys

20. PRECAUTIONS:( (CONT…)
• Calcium deposits in your joint implants and tendons don’t always cause painful symptomps, but they
can effect range of motion and cause discomfort
• Treatments may include taking anti- inflammatory medicines and applying ice packs
• If pain does not go away your doctor may reconnend surgery

21. PRECAUTIONS(CONT…)
• There is no proven way to prevent calcifications, as they are a result of a various biological processes
• But calcification on bioprosthetic devices can be minimized by balancing the chemical components used
in it but cannot be minimized to zero level

22. CONCLUSION
• Calcification is a biological process which sometimes is necessary for body but calcification can also cuse
a serious problems.