Osteoradionecrosis of the jaws (ORNJ) is a severe complication that occurs after radiotherapy of head and neck malignancies. Clinically, conservative treatments and surgeries for ORNJ exhibited certain therapeutic effects, whereas the regenerative disorder of the post-radiation jaw remains a pending problem to be solved. In recent years, the recognition of the role of the immune microenvironment has led to a shift from an osteoblasts (OBs) or bone marrow mesenchymal stromal cells (BMSCs)-centered view of bone regeneration to the concept of a complicated microecosystem that supports bone regeneration. Current advances in osteoimmunology have uncovered novel targets within the immune microenvironment to help improve various regeneration therapies, notably therapies potentiating the interaction between BMSCs and immune cells. However, these researches lack a thorough understanding of the immune microenvironment and the interaction network of immune cells in the course of bone regeneration, especially for the post-operative defect of ORNJ. This review summarized the composition of the immune microenvironment during bone regeneration, how the immune microenvironment interacts with the skeletal system, and discussed existing and potential strategies aimed at targeting cellular and molecular immune microenvironment components.

颌骨放射性骨坏死 (ORNJ) 是头颈部恶性肿瘤放疗后发生的严重并发症。临床上，ORNJ的保守治疗和手术均显示出一定的治疗效果，而放射后颌骨的再生障碍仍然是一个悬而未决的问题。近年来，对免疫微环境作用的认识导致从以成骨细胞 (OB) 或骨髓间充质基质细胞 (BMSC) 为中心的骨再生观点转变为支持骨再生的复杂微生态系统的概念. 骨免疫学的当前进展已经在免疫微环境中发现了新的目标，以帮助改善各种再生疗法，特别是增强 BMSC 与免疫细胞之间相互作用的疗法。然而，这些研究缺乏对骨再生过程中免疫微环境和免疫细胞相互作用网络的深入了解，尤其是对于ORNJ的术后缺陷。本综述总结了骨再生过程中免疫微环境的组成、免疫微环境如何与骨骼系统相互作用，并讨论了针对细胞和分子免疫微环境成分的现有和潜在策略。