Hydrogen-rich saline may be an effective and specific novel treatment for osteoradionecrosis of the jaw.

Abstract

Osteoradionecrosis of the jaw is a severe complication arising after radiotherapy for head and neck cancers. The predominant mechanism underlying radiation-induced tissue damage involves hydroxyl radicals produced through radiolysis of water. Molecular hydrogen selectively neutralizes cytotoxic reactive oxygen species, particularly hydroxyl radicals, without disturbing normal redox signaling. Hydrogen-rich saline, a convenient delivery form of molecular hydrogen, has demonstrated beneficial outcomes across various experimental models including metabolic syndrome, cerebral and hepatic ischemia-reperfusion injury, and obstructive jaundice-related liver damage. Based on these observations, the authors propose the hypothesis that hydrogen-rich saline could serve as an effective and targeted approach for both preventing and managing osteoradionecrosis of the jaw, warranting further experimental and clinical investigation.

Mechanism

Molecular hydrogen is proposed to selectively scavenge hydroxyl radicals generated by radiation-induced radiolysis of water, thereby reducing oxidative cellular damage associated with osteoradionecrosis of the jaw.