For citations: Verbo E.V., Kraitor A.S. Osteoradionecrosis of jaws: pathogenesis conception. Golova I Sheya Head and neck. Russian Journal. 2018;6(1):65–70 (in Russian).
A detailed analysis of the world literature data, covering almost a hundred-year history of studying the osteoradionecrosis of the jaws, is presented in the article. The stages of this insidious process development are described and systematized for deeper understanding of its pathogenesis. According to the theory of radiationinduced fibrosis, the key event in the progression of osteoradionecrosis is the activation and dysregulation of fibroblastic activity, which leads to tissue atrophy in the previously irradiated region. The destruction of endothelial cells in combination with vascular thrombosis causes necrosis of microvessels, local ischemia and tissue loss. Destruction of the natural cell barrier leads to various cytokines leakage that turn fibroblasts into myofibroblasts. The release of cytokines mediated by active oxygen forms leads to unregulated fibroblastic activation and the myofibroblastic proliferation. Ultimately, myofibroblasts undergo apoptosis, and even decades after radiotherapy only a small number of bone cells remain poorly vascularized and fibrotic. Thus, only a new source of adequate blood supply from remote areas to the previously irradiated area can stop the pathological process and create conditions for optimal social adaptation.
Key words: osteoradionecrosis, stages of development, microsurgical autotransplantation of tissues.
Authors declare no conflict of interests for this article.
Source of financing. Unspecified.
For citations: Verbo E.V., Kraitor A.S. Osteoradionecrosis of jaws: pathogenesis conception. Golova I Sheya Head and neck. Russian Journal. 2018;6(1):65–70 (in Russian).
The authors are responsible for the originality of the presented data and the possibility of publishing illustrative material – tables, drawings, photographs of patients.