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báo cáo khoa học: " Infection, vascularization, remodelling - are stem cells the answers for bone diseases of the jaws?"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Infection, vascularization, remodelling - are stem cells the answers for bone diseases of the jaws? | Handschel and Meyer Head Face Medicine 2011 7 5 http www.head-face-med.eom content 7 1 5 HEAD FACE MEDICINE EDITORIAL Open Access Infection vascularization remodelling - are stem cells the answers for bone diseases of the jaws Jorg Handschel Ulrich Meyer Abstract Osteonecrosis after craniofacial radiation ORN osteomyelitis and bisphosphonates related necrosis of the jaw BRONJ are the predominant bone diseases in Cranio- and Maxillofacial surgery. Although various hypothesis for the pathophysiological mechanisms including infection altered vascularisation or remodelling exist the treatment is still a challenge for clinicians. As the classical pharmacological or surgical treatment protocols have only limited success stem cells might be a promising treatment option indicated by recently published data. In maxillofacial surgery clinicians face three diseases of the jaws predominantly osteonecrosis after craniofacial radiation ORN osteomyelitis and bisphosphonates related necrosis of the jaw BRONJ . Numerous reports exist suggesting various pathological mechanisms and treatment modalities for these diseases 1 2 . Although these publications elucidate the prevalence risk factors and treatment strategies they have provided limited data on details of the underlying pathophysiology especially differences in the three above mentioned diseases. The local or total immun-supressive therapy of many patients e.g. cancer patients and the universal presence of hundreds of microorganisms in the oral cavity provide a perfect environment for chronic infections like osteomyelitis. It is unclear if this contributes to BROMJ too. Currently most evidence exist that the necrotic tissue becomes infected as opposed to the infected tissue becomes necrotic 3 . Regarding the effects on the immune system inconsistent data are reported in the literature. On the one hand bisphosphonates inhibit T lymphocyte activation and proliferation and suppress monocytes production of various pro-inflammatory