title: The periosteal microcirculation in health and disease: An update on clinical significance.
abstract: Apart from its nutritive functions, the periosteum critically affects bone regeneration via its stem/osteoprogenitor cell content. Normal healing after bone fractures, trauma-orthopedic interventions and invasive dental procedures is critically linked to the reestablishment of the periosteal microcirculation, but the reconstruction, replacement or repair of lost tissues may also be performed with autologous periosteum. Besides the initiation of cell differentiation during bone repair and remodeling processes, the periosteum together with the endosteum plays significant roles in the pathogenesis of both hormone-related and trauma-induced osteoporotic alterations in the bone metabolism. Nevertheless, the axial bones, and in particular the jawbones, and the appendicular bones display differences not only in their blood supply and fracture healing characteristics, but also in respect of the development of osteoporosis and their reactions to treatment modalities (i.e. bisphosphonates). These reactions may also be linked to the differences in periosteal microcirculatory reactions. The present overview summarizes the relevant data of microcirculatory studies focusing on the periosteal reactions in different anatomical locations together with the optimal background methodologies, study models and the most significant observations.
authors.affiliation: Institute of Surgical Research, University of Szeged, Szeged, Hungary. Electronic address: szabo.andrea.exp@med.u-szeged.hu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Szabó
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Szeged, Szeged, Hungary.
authors.forename: Ágnes
authors.initials: Á
authors.lastname: Janovszky
authors.affiliation: Department of Traumatology and Hand Surgery, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary.
authors.forename: Levente
authors.initials: L
authors.lastname: Pócs
authors.affiliation: Institute of Surgical Research, University of Szeged, Szeged, Hungary.
authors.forename: Mihály
authors.initials: M
authors.lastname: Boros
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D004164:Diphosphonates / Q000627:therapeutic use; D004195:Disease Models, Animal; D017102:Fracture Healing; D050723:Fractures, Bone / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D000069416:Intravital Microscopy; D008833:Microcirculation / Q000187:drug effects; D018715:Microscopy, Video; D019647:Oral Surgical Procedures / Q000009:adverse effects; D019637:Orthopedic Procedures / Q000009:adverse effects; D010024:Osteoporosis / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D010521:Periosteum / Q000098:blood supply* / Q000187:drug effects / Q000378:metabolism / Q000601:surgery; D012039:Regional Blood Flow; D016896:Treatment Outcome
chemical_list: D004164:Diphosphonates
keywords: Inflammation; Intravital videomicroscopy; Ischemia–reperfusion; Osteonecrosis; Osteoporosis; Periosteal microcirculation