下颌骨放射性骨坏死骨组织的电镜观察

上海口腔医学 ›› 2015, Vol. 24 ›› Issue (5): 395-399.

下颌骨放射性骨坏死骨组织的电镜观察

李松¹, 房殿吉², 王占义¹, 翟璐璐³, 宁兆荣⁴, 郭延伟⁴

1.长春市口腔医院口腔颌面外科,吉林长春 130000；
2.上海市闵行区牙病防治所口腔颌面外科,上海 200011；
3.吉林大学植物科学学院,吉林长春 130000；
4.佳木斯大学附属第二医院口腔医院口腔颌面外科,黑龙江佳木斯 154000

收稿日期:2014-12-18 修回日期:2015-02-10 出版日期:2015-10-20 发布日期:2015-11-03
通讯作者: 房殿吉, E-mail: dianjifang@gmail.com
作者简介:李松（1983-）,女,硕士,主治医师,

A electron microscope study of bone tissue in mandibular osteoradionecrosis

LI Song¹, FANG Dian-ji², WANG Zhan-yi¹, ZHAI Lu-lu³, NING Zhao-rong⁴, GUO Yan-wei⁴

1.Department of Oral and Maxillofacial Surgery, Changchun Hospital of Stomatology. Changchun 130000, Jilin Province;
2. Department of Oral and Maxillofacial Surgery, Minhang District Dental Hospital. Shanghai 200011;
3. College of Plant Science, Jilin University. Changchun 130062, Jilin Province;
4. Department of Oral and Maxillofacial Surgery, Jiamusi University Hospital of Stomatology. Jiamusi 154000, Heilongjiang Province, China

Received:2014-12-18 Revised:2015-02-10 Online:2015-10-20 Published:2015-11-03
Contact: E-mail:lisong_songsong@sina.com

摘要/Abstract

摘要： 目的在建立小型猪下颌骨放射性骨坏死动物模型基础上,应用电镜技术研究下颌骨放射性骨坏死形成、发展的超微结构动态变化过程。方法对6只小型猪右侧下颌骨进行25 Gy和28 Gy一次性照射,建立小型猪右侧下颌骨放射性骨坏死动物模型,分别于照射结束后3、4、5个月切取右侧下颌骨放射性骨坏死部位死骨,制备标本,进行电镜检查分析。结果照射后的早期骨胶原纤维即受到破坏,骨细胞先出现细胞膜破坏,随后胞质出现空泡,细胞器裂解,最后出现核变化。大剂量照射后骨细胞的破坏出现早而重,并且加速了骨细胞的裂解、死亡。结论骨细胞细胞膜及细胞质较细胞核对放射线更为敏感,照射后骨细胞死亡过程首先发生在细胞膜及细胞质内,与以往认为细胞核损伤在先的观点不同。

关键词: 放射性骨坏死, 小型猪, 电镜

Abstract: PURPOSE:After establishing the animal model, electron microscope was used to observe the dynamic ultrastructural changes during the process of mandibular osteoradionecrosis (ORN) for investigation of the possible pathogenesis. METHODS: A single dose of irradiation (IR25Gy, 28Gy) was delivered via a electronic liner accelerator to right mandible of 6 miniature pigs by utilizing the 3D-CRT technique. Samples of sequestrations were extracted at 3, 4 and 5 months after irradiation for electron microscopic analysis. RESULTS: Osteocollagenous fibers were destroyed shortly after irradiation. Cellular membrane was destroyed at early stage. Then vacuole formed in the cytoplasm and organelle began to split. At last, nucleus disaggregated. CONCLUSIONS: Doses of irradiation are closely related to degree of sequestration. Cellular membrane and cytoplasm are more sensitive to the irradiation than cellular nucleus which is different from the previous findings.

Key words: Supported, by, National, Natural, Science, Foundation, of, China, (81170935).

李松, 房殿吉, 王占义, 翟璐璐, 宁兆荣, 郭延伟. 下颌骨放射性骨坏死骨组织的电镜观察[J]. 上海口腔医学, 2015, 24(5): 395-399.

LI Song, FANG Dian-ji, WANG Zhan-yi, ZHAI Lu-lu, NING Zhao-rong, GUO Yan-wei. A electron microscope study of bone tissue in mandibular osteoradionecrosis[J]. Shanghai Journal of Stomatology, 2015, 24(5): 395-399.

参考文献

[1] Lyons A, Osher J, Wamer E, et al. Osteoradionecrosis-a review current concepts in defining the extent of the disease and a new classification proposal [J]. Br J Oral Maxillofac Surg, 2014, 52(5): 392-395.
[2] Jereczek-Fossa BA, Orecchia R. Radiotherapy-induced mandibular bone complications[J]. Cancer Treat Rev, 2002, 28(1): 65-74.
[3] Marx RE. A new concept in the treatment of osteoradionecrosis[J]. J Oral Maxillofac Surg, 1983, 41(6): 351-357.
[4] Al-Nawas B, Duschner H, Grötz KA. Early cellular alterations in bone after radiation therapy and its relation to osteoradionecrosis [J]. J Oral Maxillofac Surg, 2004, 62(8): 1045.
[5] Sweeny L, Lancaster WP, Dean NR, et al. Use of recombinant bone morphogenetic protein 2 in free flap reconstruction for osteronecrosis of the mandible [J]. J Oral Maxillofac Surg, 2012, 70(8): 1991-1996.
[6] Xu J, Zheng Z, Fang D, et al. Mesenchymal stromal cell-based treatment of jaw osteoradionecrosis in swine[J]. Cell Transplant, 2012, 21(8): 1679-1686.
[7] 孙勇刚, 孙开华, 王光和, 等. 颌骨及颌周软组织放射性损害的超微结构观察 [J].中华口腔医学杂志,1996,31(3): 147-149.
[8] Eisen MD, Weinstein GS, Chalian A, et al. Morbidity after midline mandibulotomy and radiation therapy [J]. Am J Otolaryngol, 2000, 21(5): 312-317.
[9] Oh HK, Chambers MS, Garden AS, et al. Risk of osteoradionecrosis after extraction of impacted third molars in irradiated head and neck cancer patients [J]. J Oral Maxillofac Surg, 2004, 62(2): 139-144.
[10] Murray CG, Herson J, Daly TE, et al. Radiation necrosis of the mandible: a 10 year study. PartⅡ. Dental factors; onset, duration and management of necrosis [J]. Int J Radiat Oncol Biol Phys, 1980, 6(5): 549-553.
[11] Epsten JB, Wong FL, Stevenson-Moore P. Osteoradionecrosis: clinical experience and a proposal for classification [J]. J Oral Maxillofac Surg, 1987, 45(2): 104-110.
[12] Reuther T, Schuster T, Mende U, et al. Osteoradionecrosis of the jaws as a side effect of radiotherapy of head and neck tumour patients-a report of a thirty year retrospective review [J]. Int J Oral Maxillofac Surg, 2003, 32(3): 289-295.
[13] Beumer J, Harrison R, Sanders B, et al. Osteoradionecrosis: predisposing factors and outcomes of therapy[J]. Head Neck Surg, 1984, 6(4): 819-827.
[14] Schwartz HC, Kagan AR. Osteoradionecrosis of the mandible: scientific basis for clinical staging[J]. Am J Clin Oncol,2002,25(2): 168-171.
[15] Glanzmann C, Grötz KW. Radionecrosis of the mandibula: a retrospective analysis of the incidence and risk factors [J]. Radiother Oncol, 1995, 36(2): 94-100.
[16] Sanger JR, Matloub HS, Yousif NJ, et al. Management of osteoradionecrosis of the mandible[J]. Clin Plast Surg,1993,20(3): 517-530.