Early-stage pathogenic sequence of jaw osteoradionecrosis in vivo

J Dent Res. 2012 Jul;91(7):702-8. doi: 10.1177/0022034512448661. Epub 2012 May 16.

Abstract

The mechanism underlying jaw osteoradionecrosis (ORN) is not fully understood, particularly in the early stages. To investigate bone and vessel pathogenesis in the early stages of jaw ORN, we generated a mandibular ORN model in miniature pigs (minipigs) by applying a combination of single-dose 25-Gy irradiation (IR) and tooth extraction. We studied 6 ORN model minipigs and 6 control, non-irradiated minipigs. We measured dynamic morphological changes, bone-remodeling-associated gene expression, sphingomyelinase activity, and local blood flow. Bone remodeling, including bone resorption and new bone formation, was observed within 15 days post-IR. Later, an ORN-related imbalance in bone metabolism gradually occurred, with loss of bone regeneration capacity, collagen collapse, and microvascular obliteration. Within 24 hrs post-IR, sphingomyelinase significantly increased in irradiated tissues. At 1 wk post-IR, local blood flow increased, but at 15 days post-IR, it significantly decreased to 50% below normal levels. This study provided details of the sequential occurrences in early-stage ORN in a large animal model. Our results suggested that reduced local blood flow and consequent hypovascularity may have caused an imbalance in bone remodeling. This suggested that microvessel damage may play a key role in the initiation of ORN.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis
  • Bone Regeneration / radiation effects
  • Cranial Irradiation / adverse effects*
  • In Situ Nick-End Labeling
  • Mandible / blood supply
  • Mandible / radiation effects
  • Mandibular Diseases / enzymology
  • Mandibular Diseases / pathology*
  • Microvessels / radiation effects
  • Osteoradionecrosis / enzymology
  • Osteoradionecrosis / pathology*
  • Random Allocation
  • Regional Blood Flow / radiation effects
  • Sphingomyelin Phosphodiesterase / metabolism
  • Swine
  • Swine, Miniature

Substances

  • Sphingomyelin Phosphodiesterase