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Physiological and pathological changes in the arterial supply of the mandible

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Author(s): Eva-Maria Dietrich | Konstantinos Antoniadis

Journal: Hellenic Archives of Oral and Maxillofacial Surgery
ISSN 1108-829X

Volume: 13;
Issue: 1;
Start page: 131;
Date: 2012;
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Keywords: inferior alveolar artery | arteriosclerosis | BMP-2 | vasculopathies | arteritides

ABSTRACT
The inferior alveolar artery, more frequentlythan previously estimated, is subject to age-relateddegenerative changes, mostly of arterioscleroticorigin. Moreover, it appears that vasculopathies andarteritides, such as polyarteritis nodosa and giant-cellarteritis, also affect the inferior alveolar artery. The roleof arterial supply is not just mechanical-passive, servingas a scaffold for osteoblasts during osteogenesis, butalso regulatory, since angiogenesis precedes and initiatesosteogenesis. Already at the time of craniofacialdevelopment, it is speculated that progenitor endothelialcells account for the synthesis of one particular morphogeneticprotein that precedes osteosynthesis anddetermines the final destination of migrating neuralcrest cells. Similarly, in the postnatal period, angiogenesisprecedes osteosynthesis and plays a vital role inbone metabolism and repair, through the synthesis ofendothelial growth factors, such as morphogenetic protein-2. Thus, clinical manifestations, such as avascularnecrosis, are now believed to result from a combinationof chronic disorder of the mandible’s arterial supplywith fibrinolysis and coagulation disorders, ratherthan from primary osteoblast dysfunctions. This closeinterplay between the vascular and bone tissues, withthe vasculature playing a guiding role, supports thehypothesis of the bone being an angiogenic tissue.
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