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A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
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The irradiated human mandible: A quantitative study on bone vascularity.
H Dekker1, N Bravenboer2, D van Dijk3
1Amsterdam UMC and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Department of Oral and Maxillofacial Surgery/Oral Pathology, De Boelelaan 1117, Amsterdam, the Netherlands.
Oral Oncology
|December 12, 2018
Summary
Irradiated mandibular bone marrow shows reduced vascular density and area fraction. Higher radiation doses (≥50 Gy) and longer intervals post-radiotherapy affect larger vessels, decreasing small vessel percentage.
Area of Science:
- Oral and Maxillofacial Surgery
- Radiation Oncology
- Vascular Biology
Background:
- Osteoradionecrosis (ORN) pathogenesis is linked to hypovascularization.
- Understanding microvascular changes in irradiated mandibular bone is crucial for ORN management.
Purpose of the Study:
- To evaluate the microvascular system in mandibular bone marrow of irradiated patients.
- To compare vascular characteristics between irradiated and control groups.
Main Methods:
- Mandibular bone biopsies from 20 irradiated patients and 24 controls.
- CD34 antibody staining to visualize endothelial cells and quantify vascular density (VD) and vascular area fraction (VAF).
- Analysis of vessel size, perimeter, and diameter, distinguishing between large and small vessels.
Main Results:
- Irradiated bone marrow exhibited lower VD and VAF compared to controls.
- Higher radiation doses (≥50 Gy) correlated with increased mean vessel perimeter and diameter, and a lower percentage of small vessels.
- Longer intervals post-radiotherapy were associated with larger mean vessel perimeter and fewer small vessels.
Conclusions:
- Radiation doses ≥50 Gy predominantly impact smaller vessels in mandibular bone marrow.
- The proportion of small vessels decreases over time after irradiation.
- Further research into the microvascular system's role in ORN mechanisms is warranted.
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