摘要
目的观察颌骨放射性骨坏死（ｏｓｔｅｏｒａｄｉｏｎｅｒｏｓｉｓｏｆｊａｗ，ＯＲＮＪ）病变时颌骨内微血管系统的病理损害，探讨ＯＲＮＪ的病理发生机制。方法采取６０Ｃｏ对１０只狗右侧颌面部进行６０～８０Ｇｙ照射，并于照射后３、６个月拔牙，通过定期局部观察、Ｘ线摄片和组织病理学方法诊断ＯＲＮＪ的发生，并对其进行颌骨的微血管铸型检测。结果放疗后１２个月先后有７例发生了ＯＲＮＪ。血管铸型标本除１例病变广泛、波及下牙槽动脉造成其闭塞外，其余６例下牙槽动脉及其分支连续性完好。坏死区域均出现血管网络缺失、病灶边缘及下牙槽动脉周围有不规则的毛细血管增殖且与Ｘ线片上新骨增生部位相吻合。结论在颌骨放疗后低血管、低氧和低细胞的组织结构形成的基础上，局部创伤修复引起毛细血管增殖，进而内皮细胞分裂死亡。
Objective To study pathologic alterations of mandibular microvascular system in osteoradionecrosis of jaws (ORNJ) in order to disclose its pathologic mechanism. Methods The right maxillofacial regions of 10 dogs were exposed to cobalt 60 radiation with a total dose of 60 80Gy and dental extraction were performed at 3, 6months after radiation. The ORNJ was diagnosed by gross observation, X ray film and histopathologic examination. Then, the vascular corrosion castings of jaws were implemented and investigated. Results At 12months after radiation, 7 cases of ORNJ occured. It was discovered on the casting specimen that the continuity of inferior alveolar arteries remained intact except one case where the artery was obliterated due to lesion involvement. There were defects of vascular networks in the necrotic area with irregular capillaries proliferating in the periphery of lesions and around the inferior alveolar arteries, where x ray examination showed new bone formation. Conclusion Based on the experimental evidences, a new concept of pathogenesis of ORNJ is put forward: following the formation of “3 hypo” structures, local trauma repairing process might induce capillary proliferation which bring about a large amount of mitotic death of endotheliocytes, the microcirculation failure takes place leading to ORNJ eventually.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
1999年第1期9-12,I001,共5页
Chinese Journal of Stomatology
基金
上海市高教局博士点基金
