Study Of Yellow Phosphorus Osteomyelitis Of The Jaw And The Effect Of Bisphosphonate In SD Rat Tooth Extraction Wound

Objective:To investigate the clinical characteristics of yellow phosphorus osteomyelitis and the effects about phosphate on the tooth extraction wound in SD rat. In addition, to explore the relationship between yellow phosphorus osteomyelitis and bisphosphonate-related osteonecrosis of the jaws (BRONJ) in order to provide the basis for clinical diagnosis, treatment of phosphorus osteomyelitis and the use of bisphosphonate drugs in clinic.Methods:Part Ⅰ:Between January 2010 to December 2015, ten patients suffering with yellow phosphorus osteomyelitis, who were treated at oral and maxillofacial department of affiliated Hospital of Stomatology of Kunming Medical University, were recruited in this study, retrospectively. To analyze the clinical characteristic of the yellow phosphorus osteomyelitis using electron microscope technique and pathological section technique, the coronoid process harvested from the patients with temporomandibular joint ankylosis as control. Part Ⅱ:25 SD rat were randomly divided into three groups as follows:group Ⅰ (high dose of sodium phosphate injection, n=10), group Ⅱ (low dose of sodium phosphate injection, n=10), group Ⅲ (blank group), both group Ⅰ and Ⅱ were used to establish tooth wound healing model. And then to observe the effect of bisphosphonate (sodium phosphate injection) on the healing of tooth extraction using Micro-CT technique and hard tissue pathological section technique.Results:Part Ⅰ:1. Hematoxylin and eosin (HE) staining showed that large number of necrosis cells, disruption of the cell membrane, nucleus disappeared or scattered in yellow phosphorus osteomyelitis of jaw specimens. On the contrary, intact cells, nucleus, neatly arranged were observed in control group. Osteoblasts and osteoclasts cells were not observed in both groups.2. There were obviously differences on bone surface between two groups. Compared to the surface of the control group, the surface of lesion tissue showed rough, clutter fiber arrangement. The element types are same basically, only the ratio of the content is different, the content of phosphorus (P) element was higher in bone lesions than the control group. Part Ⅱ:1. Tooth socket bone mineral density in group Ⅱ more than both group Ⅰ and Ⅲ there are significant differences (P<0.05).2.Toluidine blue staining showed that small quantity of osteoclasts, only no osteoblasts in hard tissue of the tooth socket.Conclusions:1.The incidence phosphorus osteomyelitis is related to phosphorus and oral local inflammation closely.2.Different concentrations of bisphosphonate drugs have a different results of the tooth extraction healing.3.Yellow phosphorus osteomyelitis has some similar characteristics with bisphosphonate osteomyelitis.