Marcos Martins Curi1, Camila Lopes Cardoso2, Heliton Gustavo de Lima3, Luiz Paulo Kowalski4, Manoela Domingues Martins5. 1. Chair, Department of Stomatology, Hospital Santa Catarina, São Paulo, Brazil; Professor, Department of Oral Surgery, University Sagrado Coração, Bauru, Brazil. 2. Professor, Department of Oral Surgery, University Sagrado Coração, Bauru, Brazil. 3. PhD Student, Department of Oral Medicine, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil. Electronic address: heliton.lima@usp.br. 4. Chair, Department of Head and Neck Surgery and Otorhinolaryngology, Cancer Hospital A.C. Camargo, São Paulo, Brazil. 5. Professor, Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Abstract
PURPOSE: Surgery of irradiated tissue has an increased complication rate because of the development of hypovascular, hypocellular, and hypoxic tissue. This study was undertaken to perform histopathologic and histomorphometric analyses of irradiation tissue injury in bone and the surrounding soft tissues. MATERIAL AND METHODS: The histopathologic findings of 40 human mandibular bones and the surrounding soft tissue specimens obtained from different patients who underwent surgical procedures for treatment of osteoradionecrosis of the jaws were reviewed. RESULTS: Histopathologic examination showed 7 processes in the following order of appearance: hyperemia, endarteritis, thrombosis, cell loss, hypovascularity, increase of fat in the bone marrow cavity, and fibrosis. Histomorphometric analysis showed significant hypocellularity (P = .007), hypovascularity (P < .001), and fibrosis (P < .001) in irradiated specimens compared with control specimens. CONCLUSION: These results showed that radiation injuries affect the bone and surrounding soft tissues. However, the irradiation-induced injuries, such as cellular loss (hypocellularity) and fibrosis, were more expressive in bone tissue than in the surrounding soft tissues.
PURPOSE: Surgery of irradiated tissue has an increased complication rate because of the development of hypovascular, hypocellular, and hypoxic tissue. This study was undertaken to perform histopathologic and histomorphometric analyses of irradiation tissue injury in bone and the surrounding soft tissues. MATERIAL AND METHODS: The histopathologic findings of 40 human mandibular bones and the surrounding soft tissue specimens obtained from different patients who underwent surgical procedures for treatment of osteoradionecrosis of the jaws were reviewed. RESULTS: Histopathologic examination showed 7 processes in the following order of appearance: hyperemia, endarteritis, thrombosis, cell loss, hypovascularity, increase of fat in the bone marrow cavity, and fibrosis. Histomorphometric analysis showed significant hypocellularity (P = .007), hypovascularity (P < .001), and fibrosis (P < .001) in irradiated specimens compared with control specimens. CONCLUSION: These results showed that radiation injuries affect the bone and surrounding soft tissues. However, the irradiation-induced injuries, such as cellular loss (hypocellularity) and fibrosis, were more expressive in bone tissue than in the surrounding soft tissues.