Mandibular immunity and tissue reaction.
I. Frydas1, E. Toniato, S. Martinotti2, and P. Di Emidio3
1Laboratory of Environmental Engineering, Department of Chemical Engineering Aristotelian University of Thessaloniki, Greece
2Scienze Mediche Orali e Biotecnologiche, University of Chieti, Chieti, Italy
3Department of Neurosurgery and Maxillofacial Surgery, “G. Mazzini” Hospital, Teramo, Italy
Key words: mandibular, immunity, reconstruction, inflammation
Mandibular immunity and tissue reaction are very important in the reconstruction of the jaw. The reconstruction of the mandible after neoplastic and chronic inflammatory diseases certainly presents problems of biocompatibility of the material used and therefore can give undesired immune reactions. In this paper we report some considerations on this subject.
Patients with mandibular osteonecrosis may be affected by infections, inflammation and tissue degeneration (1-2). Therefore, maxillofacial bone destruction can result in osteonecrosis which can be due to various factors including drugs, agents that inhibit angiogenesis and inhibitors of protein synthesis which can alter the function of osteoclasts (3-4). Inflammations and/or infections, immunodeficiency and vitamin D deficiency, are elements that alter the physiology of the jaw bone, and participate in these degenerative processes (5). In these cases the therapy has not yet been established and is therefore difficult and mostly ineffective (6). Drugs that act on the inhibition of osteonecrosis, on infections and inflammation are often used (7).
The reconstruction of the mandibular bone, after osteonecrosis, is increasingly studied at an experimental level (8). Nowadays, many materials experimentally implanted in the jaws do not give relevant inflammatory responses and this opens up new therapeutic hopes (9). In some cases, during bone reconstruction, mild inflammation may occur due to activation of immune cells (10). For example, various types of phosphate cement implanted in tissues and in bone tissue give rise to the formation of mononucleate cells and fibrosis, with an increase in hydroxyapatite crystals, a dynamic process linked to the time of implantation (11). A histological analysis shows cement fixation and functional bone formation (12). The cement is well-tolerated by the bone tissue, and less so by the soft tissues (13). Thus, the new bone formation can be generated by elements such as calcium phosphate and hydroxyapatite crystals, with new vessel formation and new scaffolding (14).
The new bone tissue, approximately 35%, is gradually reshaped in well-functioning lamellar bone, demonstrating the effectiveness of the method (15). In fact the, new bone formation allows to restore the mandibular function even if the effect is partial (16).
The study of murine mesenchymal cells from the murine mandibular bone has allowed great progress in the area of tissue regeneration (17). However, the activation of immune cells compromises the development and expansion of mesenchymal stem cells that actively participate in the body’s immunity (18).
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