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Osteoclasts in Bone Remodeling01:31

Osteoclasts in Bone Remodeling

Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during bone...
Bone Remodeling01:40

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
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Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
06:17

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Published on: April 12, 2022

Osteoradionecrosis: an update.

C Madrid1, M Abarca, K Bouferrache

  • 1Service of Oral Surgery, Oral Medicine and Hospital Dentistry, Department of Ambulatory Care and Community Medicine, University of Lausanne, Rue du Bugnon 44, 1011 Lausanne, Switzerland. carlos.madrid@hospvd.ch

Oral Oncology
|May 12, 2010
PubMed
Summary

Osteoradionecrosis (ORN) of the mandible, a severe side effect of head and neck cancer treatment, involves fibro-atrophic mechanisms. Prevention focuses on pre-radiation dental care, while new protocols address mild to moderate ORN stages.

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Area of Science:

  • Oncology
  • Oral Surgery
  • Radiation Oncology

Background:

  • Osteoradionecrosis (ORN) of the mandible is a severe complication following head and neck cancer treatment.
  • The pathogenesis is increasingly understood as a fibro-atrophic process involving inflammation and vascular damage.

Purpose of the Study:

  • To review the pathogenesis, risk factors, and current management strategies for osteoradionecrosis of the mandible.
  • To highlight emerging preventive and therapeutic approaches based on a deeper understanding of ORN pathophysiology.

Main Methods:

  • Literature review of osteoradionecrosis pathogenesis and treatment.
  • Analysis of risk factors including radiation, surgery, and lifestyle.
  • Evaluation of preventive strategies and therapeutic interventions.

Main Results:

  • A fibro-atrophic mechanism involving free radicals, endothelial dysfunction, and microvascular thrombosis is proposed for ORN.
  • Key risk factors include post-radiation dental extractions, radiation dose, surgery, and substance abuse.
  • Steroid use may offer a protective effect by inhibiting inflammation.

Conclusions:

  • Preventive dental extractions before radiotherapy remain crucial for ORN prevention.
  • New protocols are being developed for early-stage ORN, with free tissue transfer as the standard for advanced cases.