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

Lucas J. Poort*, Johan H. B. Ludlage, Nienke Lie, Roland A. Bockmann, Jim C. E. Odekerken, Frank J. Hoebers, Peter A. W. H. Kessler

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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 minipigs.

Methods: Sixteen Gottingen 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. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)716-721
Number of pages6
JournalJournal of Cranio-Maxillofacial Surgery
Volume45
Issue number5
DOIs
Publication statusPublished - May 2017

Keywords

  • Histological changes
  • Mandible
  • Osteoradionecrosis
  • Irradiation
  • Animal model
  • GOTTINGEN MINIPIGS
  • TGF-BETA
  • BONE
  • OSTEORADIONECROSIS
  • IRRADIATION
  • TISSUE
  • IMPLANTS
  • INJURY
  • FLOW
  • DOG

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