Microstructural changes in the irradiated and osteoradionecrotic bone: a SEM study

Ultrastructural Pathology, vol. 48, pp. 128–136

Abstract

Radiation exposure is a major health concern due to bone involvement including mandible, causing deleterious effects on bone metabolism, and healing with an increasing risk of infection and osteoradionecrosis. This study aims to investigate the radiotherapy-induced microstructural changes in the human mandible by scanning electron microscopy (SEM). Mandibular cortical bone biopsies were obtained from control, irradiated, and patients with osteoradionecrosis (ORN). Bone samples were prepared for light microscopy and SEM. The SEM images were analyzed for the number of osteons, number of Haversian canal (HC), diameter of osteon (D.O), the diameter of HC (D.HC), osteonal wall thickness (O.W.Th), number of osteocytes, and number of osteocytic dendrites. The number of osteons, D.O, D.HC, O.W.Th, the number of osteocytes, and osteocytic dendrites were significantly decreased in both irradiated and ORN compared to controls (p < .05). The number of HCs decreased in irradiated and ORN bone compared to the control group. However, this was statistically not significant. The deleterious effect of radiation continues gradually altering the bone quality, structure, cellularity, and vascularity in the long term (>5 years mean radiation biopsy interval). The underlying microscopic damage in bone increases its susceptibility and contributes further to radiation-induced bone changes or even ORN.

Authors 10

1. P. Sridhar Reddy

   University of Eastern Finland

   Affiliation as printed

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland;

2. K. Villikka

   University of Eastern Finland

   Affiliation as printed

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland;

3. Bina Kashyap

   University of Eastern Finland

   Affiliation as printed

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland;

4. Hannah Dekker

   Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

   Department of Oral and Maxillofacial Surgery/Oral Pathology,

5. Engelbert A. J. M. Schulten

   Academic Center for Dentistry Amsterdam · Amsterdam University Medical Centers · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

   Department of Oral and Maxillofacial Surgery/Oral Pathology,

6. Jopi J. W. Mikkonen

   University of Eastern Finland

   Affiliation as printed

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

   SIB Labs, University of Eastern Finland, Kuopio, Finland

   Institute of Dentistry, University of Eastern Finland, Kuopio, Finland;

   SIB Labs, University of Eastern Finland, Kuopio, Finland;

7. Mikael J. Turunen

   University of Eastern Finland

   Affiliation as printed

   Department of Applied Physics, University of Eastern Finland, Kuopio, Finland

   Department of Applied Physics, University of Eastern Finland, Kuopio, Finland;

8. Arto P. Koistinen

   University of Eastern Finland

   Affiliation as printed

   SIB Labs, University of Eastern Finland, Kuopio, Finland

   SIB Labs, University of Eastern Finland, Kuopio, Finland;

9. Nathalie Bravenboer Aachen Department of Internal Medicine Division of Endocrinology and Centre for Bone Quality

   Leiden University Medical Center · Amsterdam University Medical Centers · Vrije Universiteit Amsterdam

   Affiliation as printed

   Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

   Department of Internal Medicine, Division of Endocrinology and Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands

   Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands;

10. Arja M. Kullaa corresponding

    University of Eastern Finland

    Affiliation as printed

    Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

    Institute of Dentistry, University of Eastern Finland, Kuopio, Finland;