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目的：研究近年来颌骨放射性骨坏死（ＯＲＮＪ）病例的临床和病理特点，为进一步提高防治水平提供参考。方法：对１９９１年以来我科收治的２６例ＯＲＮＪ病例就临床表现和病理特点诸方面进行总结分析。结果：半数以上病例照射总剂量超过８０Ｇｙ，２３例（８８．４％）有明确创伤感染史。组织病理学检查反映出ＯＲＮＪ病变时期下牙槽动脉并未闭塞，病变四周的骨髓腔内仍可见活跃的新骨生成，毛细血管增殖。结论：高剂量放射是当前临床ＯＲＮＪ发病的显著特点，创伤与感染仍是ＯＲＮＪ发病的重要因素。组织病理学检查结果进一步解释了一些诸如Ｘ线检查、核素骨显像上ＯＲＮＪ病灶及周围密度增高影、放射线浓聚等重要临床征象。
Objective: To study the clinical and pathological features of osteonecrosis of the jaw (ORNJ) in recent years and provide references for further improvement of the prevention and treatment. Methods: A total of 26 ORNJ cases admitted to our department since 1991 were analyzed in terms of clinical manifestations and pathological features. Results: More than half of the cases were exposed to a total dose of more than 80Gy, 23 cases (88.4%) had a clear history of wound infection. Histopathological examination showed that the alveolar artery was not occluded during the ORNJ lesion, and active new bone formation and capillary proliferation were still seen in the marrow cavity around the lesion. Conclusion: High-dose radiation is a prominent clinical feature of ORNJ. Trauma and infection are still important factors in the pathogenesis of ORNJ. Histopathologic findings further explain some of the important clinical features such as X-ray examination, ORNJ lesions on the radionuclide bone imaging and surrounding densities, and radioactive enrichment.