Experimental Radio-Osteonecrosis of the Jaws

Gowgiel, Joseph M.

doi:10.1177/00220345600390011401

Cited by 79 publications

(10 citation statements)

References 7 publications

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“…8,9,10,11 Unfortunately, most of the studies examining the tissue effects of XRT on normal bone have been qualitative in nature and have eschewed quantitative analyses. Quantitative measures of the histopathologic effects of XRT on the bones of the craniofacial skeleton have yet to be delineated in an in vivo model.…”

Section: Discussionmentioning

confidence: 99%

Dose-Response Effect of Human Equivalent Radiation in the Murine Mandible: Part I. A Histomorphometric Assessment

Tchanque-Fossuo

Monson

Farberg

et al. 2011

Plastic and Reconstructive Surgery

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Background Our lab previously demonstrated that radiation significantly alters new bone formation in the murine mandible impeding the use of distraction osteogenesis (DO) as a viable reconstructive option after radiatiotherapy in Head and Neck Cancer (HNC). We hypothesize that the deleterious effects of radiation on regenerate formation results from a dose response (DR) depletion of essential osteogenic cells. Our specific aim is to use quantitative histomorphometry (QHM) to objectively measure the human equivalent DR effects of radiation on the integrity of the mandible’s cellular and tissue composition. Methods 20 Sprague-Dawley rats were randomIzed into three radiation dosage groups: low (5.91Gy), middle (7Gy) and high (8.89Gy) delivered in 5 daily fractions. These dosages approximated 75%, 100%, and 150% respectively of the bioequivalent dose the mandible experiences in the clinical regimen of HNC patients. Hemimandibles were harvested 56 days post-radiation, and stained with Gomori Trichrome. QHM was performed using Bioquant software and analysis with a one-way ANOVA Kruskal-Wallis test. Results Our data revealed a statistically significant diminution in the mean number of osteocytes . We also demonstrated a corresponding significant increase in the mean values of empty lacunae. Both of these QHM changes demonstrated a DR relationship. Conclusion Our study supports our hypothesis that radiation induces a DR depletion in osteocytes and an increase in empty lacunae. These reliable and reproducible metrics can now be utilized to determine the efficacy of therapies aimed at safeguarding the cells essential for optimal bone regeneration and potentially enhance the use of DO in HNC patients.

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Section: Discussionmentioning

confidence: 99%

Dose-Response Effect of Human Equivalent Radiation in the Murine Mandible: Part I. A Histomorphometric Assessment

Tchanque-Fossuo

Monson

Farberg

et al. 2011

Plastic and Reconstructive Surgery

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“…Watson and Scarborough reported three crucial factors in the development of ORN based purely on clinical observations; exposure to radiotherapy above a critical dose; [16] local injury; and infection [9]. Early experimental models of the pathophysiology of ORN showed evidence of bacteria in tissues affected by ORN and documented microscopic tissue changes, namely thickening of arterial and arteriolar walls, loss of osteocytes and osteoblasts and the filling of bony cavities with inflammatory cells [10].…”

Section: Theories Of the Pathophysiology Of Osteoradionecrosismentioning

confidence: 99%

Osteoradionecrosis of the Jaws: Clinico-Therapeutic Management: A Literature Review and Update

Nadella

Kodali

Guttikonda

et al. 2015

J. Maxillofac. Oral Surg.

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Osteoradionecrosis is one of the most serious oral complications of head and neck cancer treatment. It is a severe delayed radiation-induced injury, characterized by bone tissue necrosis and failure to heal for at least 3 months. In most cases osteoradionecrosis gradually progresses, becoming more extensive and painful that leads to infection and pathological fracture. The present paper provides a literature review and update on the risk factors underlying osteoradionecrosis, its clinical and diagnostic particulars, prevention and most widely accepted treatment options including the latest treatment modalities. Lastly, a new early management protocol is proposed based on the current clinical criteria relating to osteonecrosis secondary to treatment with bisphosphonates, together with the adoption of new therapies supported by increased levels of evidence.

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“…Findings of an early and transient vascular dilatation (12) or thrombus formation (15, 19, 26) could not be substantiated in the present study. Extravasations of red blood cells or plugging of Haversian canals (14,18,28) or thickening of blood vessel walls (19, 21, 32) were not observed in this vital microscopic study as the blood flow in all vessels was, in general, excellent throughout the observation periods at all 3 dose levels. This is in general also true for the fibrous and immature bone tissue, even in the instances when it filled out the whole chamber.…”

Section: Discussionmentioning

confidence: 69%

Dynamics of Irradiation Injury to Bone Tissue

Jacobsson

Albrektsson

Turesson

1985

Acta Radiologica: Oncology

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The dynamic changes after a single dose of 15, 25 or 40 Gy 60Co were followed in a titanium vital microscopic bone chamber which permitted observation of the same tissue compartment for over 2 years. The chamber consists of a hollow screw containing 2 glass rods 100 micron apart. The device was inserted into the cortex of the proximal tibial metaphysis of a rabbit. During a healing period of 4 to 6 weeks the space between the glass rods became filled with bone and vessels and in some cases fat. Once a steady state in bone remodelling had been achieved, the animals were irradiated. Vital microscopy was then performed at regular intervals. Mature bone was relatively radioresistant since remodelling continued at a normal rate. In contrast, immature woven bone remained unlamellarized and in some animals tended to increase in amount. The vascular architecture was largely unaltered, even after 40 Gy. Thrombosis or hemorrhage clearly attributable to irradiation was not noted. Initially, the number of fat cells was reduced but repopulation was later seen in several cases.

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Experimental Radio-Osteonecrosis of the Jaws

Cited by 79 publications

References 7 publications

Dose-Response Effect of Human Equivalent Radiation in the Murine Mandible: Part I. A Histomorphometric Assessment

Dose-Response Effect of Human Equivalent Radiation in the Murine Mandible: Part I. A Histomorphometric Assessment

Osteoradionecrosis of the Jaws: Clinico-Therapeutic Management: A Literature Review and Update

Dynamics of Irradiation Injury to Bone Tissue

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