Bone vitality in induced radionecrosis of the mandible estimated by osteocytic population counting

To understand the changes of the irradiated mandibular bone, we tried to define, in space, how the lesions of the osseous tissue appear and involve. We estimated the vitality of the removed jaw fragments by counting the number of inhabited lacunae (I.L.) and empty lacunae (E.L.) in the sections, without previous decalcification, after surface staining with methylene blue. The results, expressed as percentages of the total amount of osteocytes lacunae, have been compared with the microradiographic aspect of the sections. The most paradoxical finding is that the highest percentages of osteocytes appear in the most destroyed areas. As a conclusion, one may wonder how to proceed to avoid the radiotherapy being followed by attempts for repair: attempts which, indeed, are the source of the complications.