Abstract

Objectives: Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow. Materials and methods: Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2). Results: Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels. Conclusions: Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.

LanguageEnglish
Pages126-130
Number of pages5
JournalOral Oncology
Volume87
DOIs
Publication statusPublished - 1 Dec 2018

Cite this

@article{d980cb07c09e4a6ca43be994037bb34f,
title = "The irradiated human mandible: A quantitative study on bone vascularity",
abstract = "Objectives: Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow. Materials and methods: Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2). Results: Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels. Conclusions: Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.",
keywords = "Mandible, Microvascular network, Microvasculature, Microvessel, Oral cancer, Osteoradionecrosis, Radiotherapy",
author = "H. Dekker and N. Bravenboer and {van Dijk}, D. and E. Bloemena and Rietveld, {D. H.F.} and {ten Bruggenkate}, {Chr M.} and Schulten, {E. A.J.M.}",
note = "Copyright {\circledC} 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.",
year = "2018",
month = "12",
day = "1",
doi = "10.1016/j.oraloncology.2018.10.030",
language = "English",
volume = "87",
pages = "126--130",
journal = "Oral Oncology",
issn = "1368-8375",
publisher = "Elsevier Limited",

}

TY - JOUR

T1 - The irradiated human mandible

T2 - Oral Oncology

AU - Dekker, H.

AU - Bravenboer, N.

AU - van Dijk, D.

AU - Bloemena, E.

AU - Rietveld, D. H.F.

AU - ten Bruggenkate, Chr M.

AU - Schulten, E. A.J.M.

N1 - Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objectives: Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow. Materials and methods: Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2). Results: Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels. Conclusions: Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.

AB - Objectives: Hypovascularisation is thought to play an important role in the pathogenesis of osteoradionecrosis. The objective of this study was to assess the microvascular system in the irradiated mandibular bone marrow. Materials and methods: Mandibular bone biopsies were taken from 20 irradiated patients and 24 controls. Blood vessels were visualized using CD34 antibody stain to detect endothelial cells. The vascular density (VD) and vascular area fraction (VAF) were measured. Mean vessel lumen area, perimeter and diameter of the vessels were calculated for each vessel. A distinction was made between large and small vessels (cut-off point <400 µm2). Results: Vascular density and vascular area fraction were lower in the irradiated group. The mean vascular perimeter and mean vascular diameter were higher in samples with a local radiation dose of ≥50 Gy, whereas the percentage of small vessels was lower. Larger vessel perimeter is associated with higher radiation dose. A longer interval between biopsy and radiotherapy is associated with a larger mean vessel perimeter and a lower percentage of small vessels. Conclusions: Radiation dosages higher than 50 Gy mainly affect the smaller vessels. With increased time after irradiation, the share of smaller vessels in the mandibular bone marrow seems to decrease. In search of the exact mechanisms of irradiation damage and osteoradionecrosis of the mandible, the role of the microvascular system in the mandibular bone marrow should be further explored.

KW - Mandible

KW - Microvascular network

KW - Microvasculature

KW - Microvessel

KW - Oral cancer

KW - Osteoradionecrosis

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=85055733385&partnerID=8YFLogxK

U2 - 10.1016/j.oraloncology.2018.10.030

DO - 10.1016/j.oraloncology.2018.10.030

M3 - Article

VL - 87

SP - 126

EP - 130

JO - Oral Oncology

JF - Oral Oncology

SN - 1368-8375

ER -