The histological and histomorphometric changes in the mandible after radiotherapy: An animal model

Abstract Purpose Approximately 5% of irradiated head and neck cancer patients develop osteoradionecrosis of the mandible. The current non-surgical treatment options for osteoradionecrosis have limited effects and are based on a small number of studies. Therefore, we aimed to enhance the understandin...

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Bibliographic Details
Published in:Journal of cranio-maxillo-facial surgery 2017-05, Vol.45 (5), p.716-721
Main Authors: Poort, Lucas J, Ludlage, Johan H.B, Lie, Nienke, Böckmann, Roland A, Odekerken, Jim C.E, Hoebers, Frank J, Kessler, Peter A.W.H
Format: Article
Language:English
Subjects:
Animal model
Animals
Dentistry
Disease Models, Animal
Dose-Response Relationship, Radiation
Female
Histological changes
Irradiation
Mandible
Mandible - pathology
Mandible - radiation effects
Mandibular Diseases - pathology
Mandibular Diseases - physiopathology
Osteoradionecrosis
Osteoradionecrosis - pathology
Osteoradionecrosis - physiopathology
Surgery
Swine
Swine, Miniature
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Summary:Abstract Purpose Approximately 5% of irradiated head and neck cancer patients develop osteoradionecrosis of the mandible. The current non-surgical treatment options for osteoradionecrosis have limited effects and are based on a small number of studies. Therefore, we aimed to enhance the understanding of the pathophysiology of osteoradionecrosis by investigating changes induced by external irradiation in mini-pigs. Methods Sixteen Göttingen mini-pigs were divided into four groups for the application in two fractions with total equivalent radiation dosages of 25, 50, 70 Gray, and one group served as control. Thirteen weeks after irradiation, the left lateral teeth the mandible were removed and implants were placed. The pigs were sacrificed twenty-six weeks after irradiation, and the bone samples were stained with Masson's trichrome. Results The amount of fibrosis, resorption lacunae, necrosis, and the woven/lamellar bone ratios were increased after higher radiation dosages. The diameter of the lumen of the inferior alveolar artery was reduced depending on the irradiation dosages. The rate of bone remodeling decreased after irradiation. Conclusion Both surgery and increasing irradiation dosages cause architectural bone changes and damage the vascularization. This might result in a chronic hypoxic state of the mandibular bone. In general, the bone formation rate was markedly decreased after radiotherapy.
ISSN:1010-5182
1878-4119
DOI:10.1016/j.jcms.2017.02.014