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Borges JS, Paula IS, de Araújo Reis NT, de Lima Oliveira AP, Soares CJ, Soares PBF. Effects of different doses of ionizing radiation on alveolar bone repair in post-extraction tooth socket: an experimental study in rats. Clin Oral Investig 2023; 27:7583-7593. [PMID: 37906304 DOI: 10.1007/s00784-023-05348-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE This study aimed to evaluate the dose-response effects of ionizing radiation (IR) on alveolar bone repair and bone strength after tooth extraction. MATERIALS AND METHODS A total of 32 male Wistar rats were used in the study, 28 animals were included in the final analysis, and n = 7 for each experimental group. Mandibular first molars were extracted. After 7 days, the animals were randomly divided into four groups according to single-dose irradiation: NIr, control group; Ir15, irradiated at 15 Gy; Ir20, irradiated at 20 Gy; and Ir30, irradiated at 30 Gy. The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric, and biomechanical analyses 14 days after extraction. Data were analyzed using one-way ANOVA followed by Tukey's post hoc test (α = 0.05). RESULTS Micro-CT analysis revealed that IR led to lower values of bone volume (BV, in mm3) (0.68 ± 0.08, P < 0.001) and bone volume fraction, ratio of the segmented bone volume to the total volume of the region of interest (BV/TV, in %) (44.1 ± 8.3, P < 0.001) for the Ir30 group compared to the control group. A significantly lower amount of newly formed bone was observed in the Ir30 (P = 0.005) than in the Ir15 group. The histomorphometric results of quantification of bone matrix neoformation and the micro-CT were in agreement, demonstrating greater damage to the Ir30 group. IR30 cells showed a lower percentage of densely packed collagen than control cells. No significant differences were found in the biomechanical parameters. CONCLUSION IR affects alveolar bone repair. A dose of 30 Gy reduced the bone healing process owing to a smaller amount of newly formed bone and a lower percentage of densely packed collagen. Therefore, a dose of 30 Gy can be used to successfully establish an animal model of an irradiated mandible that mimics the irradiated clinical conditions. CLINICAL RELEVANCE Radiotherapy can lead to severe side effects and tooth extraction is a major risk factor. A proper understanding of the pathological mechanisms of radiation in alveolar bone repair requires the establishment of a suitable animal model of clinical conditions.
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Affiliation(s)
- Juliana Simeão Borges
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Isabella Santos Paula
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Nayara Teixeira de Araújo Reis
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Ana Paula de Lima Oliveira
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Priscilla Barbosa Ferreira Soares
- Department of Periodontology and Implantology, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Connors JP, Garvin P, Silver J, Lindsay A, Solovyova O. Acetabular fixation in total hip arthroplasty in the previously irradiated pelvis: a review of basic science and clinical outcomes. Arch Orthop Trauma Surg 2022; 143:3517-3524. [PMID: 35984490 DOI: 10.1007/s00402-022-04589-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022]
Abstract
Radiation therapy is a common primary, adjuvant, or palliative treatment for many intrapelvic tumors, including primary gastrointestinal, genitourinary, and hematopoietic tumors, as well as metastatic disease to bone. Radiation has well documented microbiologic and clinical effects on bone ranging from radiation osteitis to early degenerative changes of the hip joint and avascular necrosis of the femoral head. Conventional total hip arthroplasty methods have demonstrated high rates of failure in this population, with historical data describing aseptic loosening rates as high as 44-52%, as radiation have been shown to preferentially diminish osteoblast and osteocyte number and function and limit capacity for both cement interdigitation and biologic bony ingrowth. A review of the clinical literature suggests that patients with prior pelvic irradiation are at higher risk for both septic and aseptic loosening of acetabular components, as well as lower postoperative Harris Hip Score (HHS) when compared to historical controls. With limited evidence, trabecular metal shells with multi-screw fixation and cemented polyethene liners, as well as cemented cup-cage constructs both appear to be durable acetabular fixation options, though the indications for each remains elusive. Further prospective data are needed to better characterize this difficult clinical problem.
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Affiliation(s)
- John Patrick Connors
- Department of Orthopaedic Surgery, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA.
| | - Patrick Garvin
- Department of Orthopaedic Surgery, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Jacob Silver
- Department of Orthopaedic Surgery, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Adam Lindsay
- Department of Orthopaedic Surgery, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA
| | - Olga Solovyova
- Department of Orthopaedic Surgery, University of Connecticut Health Center, 263 Farmington Ave, Farmington, CT, 06030, USA
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Zhang P, Yao L, Shan G, Chen Y. A model of radiation-induced temporomandibular joint damage in mice. Int J Radiat Biol 2022; 98:1-10. [PMID: 35467478 DOI: 10.1080/09553002.2022.2069298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 02/24/2022] [Accepted: 04/14/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE A small animal radiation research platform (SARRP) equipped with a miniature beam system, an image-guided positioning system, and a dose planning system was used to develop and evaluate a mouse model of radiation-induced temporomandibular damage. METHODS Left jaw disks of adult male C57BL/6 mice and C3H mice were targeted using the SARRP for image-guided irradiation. The total radiation dose was 75 Gy. Experiment 1 (Scoping study): Mice in the C57BL/6 mouse test and control groups were sacrificed at 1, 3, 6, 9, 12, 15, and 18 weeks after irradiation, whereas mice in the C3H test and control groups were sacrificed at 1, 3, 6, 9, and 12 weeks after irradiation. Experiment 2 (Full -scale validation study): Mice in the C57BL/6 mouse test and control groups were sacrificed at 1, 3 and 6 weeks after irradiation. Histopathological analysis of the temporomandibular skeletal muscle in each group was performed using hematoxylin and eosin (H&E) and Masson staining; the temporal mandibular bone was examined through H&E staining. RESULTS SARRP delivered the rated dose to the temporomandibular joints of C57BL/6 and C3H mice. C3H and C57BL/6 mice in the test group showed different degrees of osteocytic necrosis and osteoporosis at different time points. H&E staining of skeletal muscle tissue showed slight fibrosis in the C57BL/6 test at 3 and 6 weeks time point. CONCLUSION We established a model of radiation-induced damage in the temporomandibular joint of C57BL/6 mice and demonstrated that the observed physiological and histological changes correspond to radiation damage observed in humans. Furthermore, the SARRP can deliver precise radiation doses.
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Affiliation(s)
- Peng Zhang
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Lejing Yao
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Guoping Shan
- Department of Radiology Physics, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Yuanyuan Chen
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
- Department of Radiology Oncology, Zhejiang Key Laboratory of Radiation Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China
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Seo MH, Lee MY, Eo MY, Lee SK, Woo KM, Kim SM. Development of a standardized mucositis and osteoradionecrosis animal model using external radiation. J Korean Assoc Oral Maxillofac Surg 2020; 46:240-249. [PMID: 32855371 PMCID: PMC7469963 DOI: 10.5125/jkaoms.2020.46.4.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives Although the side effects of radiation therapy vary from mucositis to osteomyelitis depending on the dose of radiation therapy, to date, an experimental animal model has not yet been proposed. The aim of this study was to develop an animal model for assessing complications of irradiated bone, especially to quantify the dose of radiation needed to develop a rat model. Materials and Methods Sixteen Sprague-Dawley rats aged seven weeks with a mean weight of 267.59 g were used. Atraumatic extraction of a right mandibular first molar was performed. At one week after the extraction, the rats were randomized into four groups and received a single dose of external radiation administered to the right lower jaw at a level of 14, 16, 18, or 20 Gy, respectively. Clinical alopecia with body weight changes were compared and bony volumetric analysis with micro-computed tomography (CT), histologic analysis with H&E were performed. Results The progression of the skin alopecia was different depending on the irradiation dose. Micro-CT parameters including bone volume, bone volume/tissue volume, bone mineral density, and trabecular spaces, showed no significant differences. The progression of osteoradionecrosis (ORN) along with that of inflammation, fibrosis, and bone resorption, was found with increased osteoclast or fibrosis in the radiated group. As the radiation dose increases, osteoclast numbers begin to decrease and osteoclast tends to increase. Osteoclasts respond more sensitively to the radiation dose, and osteoblasts are degraded at doses above 18 Gy. Conclusion A standardized animal model clinically comparable to ORN of the jaw is a valuable tool that can be used to examine the pathophysiology of the disease and trial any potential treatment modalities. We present a methodology for the use of an experimental rat model that incorporates a guideline regarding radiation dose.
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Affiliation(s)
- Mi Hyun Seo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min Young Lee
- Laboratory Animal Center, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
| | - Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Suk Keun Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Kyung Mi Woo
- Department of Pharmacology & Dental Therapeutics, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Li J, Yin P, Chen X, Kong X, Zhong W, Ge Y, She Y, Xian X, Qi L, Lin Z, Moe J, Fang S. Effect of α2‑macroglobulin in the early stage of jaw osteoradionecrosis. Int J Oncol 2020; 57:213-222. [PMID: 32377713 PMCID: PMC7252453 DOI: 10.3892/ijo.2020.5051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 03/30/2020] [Indexed: 12/17/2022] Open
Abstract
Advanced osteoradionecrosis (ORN) is one of the most serious complications in patients with head and neck cancer, resulting in poor prognosis. Numerous studies have therefore focused on the pathogenesis and interventions of ORN early stage. The present study aimed to investigate whether α2-macroglobulin (α2M) could prevent early-stage jaw osteoradionecrosis caused by radiotherapy (RT). Following local injection of α2M, a single dose of 30 Gy was delivered to rats for pathological exploration. For 28 days, the irradiated mandible and soft tissues were examined for potential changes. Furthermore, primary human bone marrow mesenchymal stem cells pretreated with α2M followed by 8 Gy irradiation (IR) were also used. Tartrate-resistant acid phosphatase assay, terminal uridine deoxynucleotidyl nick end labeling assay and immunohistochemical staining were performed on irradiated mandibular bone, tongue or buccal mucosa tissues from rats. Cell proliferation was assessed by evaluating the cell morphology by microscopy and by using the cell counting kit-8. Fluorescence staining, flow cytometry and western blotting were conducted to detect the reactive oxygen species level, cell apoptosis and protein expression of superoxide dismutase 2 (SOD2), heme oxygenase-1 (HO-1) and phosphorylated Akt following irradiation. The results demonstrated that α2M attenuated physical inflammation, osteoclasts number and fat vacuole accumulation in mandibular bone marrow and bone marrow cell apoptosis following IR in vivo. Furthermore, α2M pretreatment suppressed the expression of 8-hydroxy-2′-deoxyguanosine in mandibular bone and tongue paraffin embedded sections, which is a marker of oxidative damage, and increased SOD2 expression in mucosa and tongue paraffin embedded sections. The present study demonstrated the efficient regulation of antioxidative enzymes, including SOD2 and heme oxygenase-1, and reduction in oxidative damage by α2M. In addition, in vitro results confirmed that α2M may protect cells from apoptosis and suppress reactive oxygen species accumulation. Overall, the present study demonstrated that α2M treatment may exert some radioprotective effects in early-stage ORN via antioxidant mechanisms, and may therefore be considered as a potential alternative molecule in clinical prophylactic treatments.
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Affiliation(s)
- Jie Li
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Ping Yin
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xueying Chen
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xiangbo Kong
- Department of Stomatology, Sun Yat‑sen Memorial Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510120, P.R. China
| | - Wanzhen Zhong
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Yaping Ge
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Yangyang She
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Xuehong Xian
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Lei Qi
- Department of Oral and Cranio‑maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai 200001, P.R. China
| | - Zhi Lin
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
| | - Justine Moe
- Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI 48109, USA
| | - Silian Fang
- Department of Oral and Maxillofacial Surgery, The Sixth Affiliated Hospital of Sun Yat‑sen University, Guangzhou, Guangdong 510655, P.R. China
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Yan Q, Zhang L, Liu Y, Zhu Y, Sun J, Shi Q, Zhang Y. Deep HDR Imaging via A Non-local Network. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2020; 29:4308-4322. [PMID: 32054579 DOI: 10.1109/tip.2020.2971346] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
One of the most challenging problems in reconstructing a high dynamic range (HDR) image from multiple low dynamic range (LDR) inputs is the ghosting artifacts caused by the object motion across different inputs. When the object motion is slight, most existing methods can well suppress the ghosting artifacts through aligning LDR inputs based on optical flow or detecting anomalies among them. However, they often fail to produce satisfactory results in practice, since the real object motion can be very large. In this study, we present a novel deep framework, termed NHDRRnet, which adopts an alternative direction and attempts to remove ghosting artifacts by exploiting the non-local correlation in inputs. In NHDRRnet, we first adopt an Unet architecture to fuse all inputs and map the fusion results into a low-dimensional deep feature space. Then, we feed the resultant features into a novel global non-local module which reconstructs each pixel by weighted averaging all the other pixels using the weights determined by their correspondences. By doing this, the proposed NHDRRnet is able to adaptively select the useful information (e.g., which are not corrupted by large motions or adverse lighting conditions) in the whole deep feature space to accurately reconstruct each pixel. In addition, we also incorporate a triple-pass residual module to capture more powerful local features, which proves to be effective in further boosting the performance. Extensive experiments on three benchmark datasets demonstrate the superiority of the proposed NDHRnet in terms of suppressing the ghosting artifacts in HDR reconstruction, especially when the objects have large motions.
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Effects of pentoxifylline and tocopherol on a rat-irradiated jaw model using micro-CT cortical bone analysis. Eur Arch Otorhinolaryngol 2019; 276:3443-3452. [DOI: 10.1007/s00405-019-05600-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/08/2019] [Indexed: 01/03/2023]
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Yamasaki MC, Roque-Torres GD, Peroni LV, Nascimento EHL, Salmon B, Oliveira ML, Freitas DQ, Correr-Sobrinho L. A modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. Clin Oral Investig 2019; 24:1561-1567. [PMID: 31401733 DOI: 10.1007/s00784-019-03054-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/05/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To propose a modified protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. MATERIAL AND METHODS A total of 45 male Wistar rats were used in this study. Firstly, 25 rats were divided into 5 groups (n = 5) according to the radiation dose protocol: without irradiation and irradiated with 15 Gy, 20 Gy, 25 Gy, or 30 Gy using a linear accelerator. Secondly, 15 other rats were divided into 3 groups (n = 5) according to the time of extraction of the three right mandibular molars: 7, 10, or 14 days after irradiation of 20 Gy. Lastly, dental extractions were performed in 5 other rats without irradiation (C-E10) for comparison with those of the group of dental extractions 10 days after irradiation (I-E10). RESULTS The irradiated animals survived throughout the study period only at single doses of 15 Gy and 20 Gy. The suitable time for dental extractions after irradiation to induce mandibular osteoradionecrosis was defined as 10 days. Macroscopic evaluation of the right hemimandibles showed presence of osteoradionecrosis in I-E10 group and complete gingival healing in C-E10 group. CONCLUSION A single radiation dose of 20 Gy focused on head and neck region combined with the extraction of the three mandibular molars 10 days after irradiation constitutes a feasible protocol of mandibular osteoradionecrosis induction in rats with external beam radiation therapy. CLINICAL RELEVANCE Establishing a solid and widely available protocol of mandibular osteoradionecrosis induction is essential in the search for methods to prevent this complex disease.
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Affiliation(s)
- Mayra Cristina Yamasaki
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil.
| | - Gina Delia Roque-Torres
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Leonardo Vieira Peroni
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Eduarda Helena Leandro Nascimento
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Benjamin Salmon
- Orofacial Pathologies, Imaging and Biotherapies Laboratory, Paris Descartes University, Sorbonne Paris Cité, 2496, Montrouge, EA, France.,Dental Medicine Department, Bretonneau Hospital HUPNVS, AP-HP, Paris, France
| | - Matheus Lima Oliveira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, PO Box 52, Piracicaba, SP, 13414-903, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Division of Dental Materials, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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Yamasaki MC, Nejaim Y, Roque-Torres GD, Freitas DQ. Meloxicam as a Radiation-Protective Agent on Mandibles of Irradiated Rats. Braz Dent J 2018; 28:249-255. [PMID: 28492757 DOI: 10.1590/0103-6440201701271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/07/2017] [Indexed: 12/23/2022] Open
Abstract
This study evaluated the action of ionizing radiation and the possible radioprotective effect of the non-steroidal anti-inflammatory drug meloxicam on the bone physiology of rat mandibles by assessing the alveolar socket healing and bone strength. Forty male Wistar rats were divided in 4 groups (n=10): control (CG), irradiated (IG), meloxicam (MG), meloxicam irradiated (MIG). A dose of 0.2 mg/kg meloxicam was administered to MG and MIG. After this, IG and MIG were irradiated with 15 Gy radiation dose in the mandible. Forty days after the above procedures, the mandibular first molars were extracted and the animals were killed after 15 or 30 days (n=5). Micro-computed tomography and bending test were used to evaluate alveolar socket healing and bone strength, respectively. At 15 days, bone volume, bone volume fraction and trabecular thickness were higher in the CG and MG than in the IG and MIG; and trabecular separation was higher in the IG compared with the others. At 30 days, there was a difference only in trabecular separation, which was higher in IG than in CG and MG, and MIG did not differ from the others. Bone strength was lower in IG compared with CG and MG, and MIG did not differ from the others. In conclusion, the ionizing radiation affected the bone physiology of rat mandibles, delaying the alveolar socket healing and reducing the bone strength. Moreover, the meloxicam had a positive effect on the trabecular separation in alveolar socket healing and on the bone strength.
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Affiliation(s)
- Mayra Cristina Yamasaki
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Yuri Nejaim
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Gina Delia Roque-Torres
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, UNICAMP - Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Park HS, Lee J, Kim JW, Kim HY, Jung SY, Lee SM, Park CH, Kim HS. Preventive effects of tonsil-derived mesenchymal stem cells on osteoradionecrosis in a rat model. Head Neck 2017; 40:526-535. [PMID: 29140591 DOI: 10.1002/hed.25004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 08/05/2017] [Accepted: 09/26/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effects of tonsil-derived mesenchymal stem cells (MSCs) on osteoradionecrosis (ORN). METHOD We generated a mandibular ORN rat model using a combination of 20-Gy single-dose irradiation and tooth extraction. Study groups were negative control (tooth extraction only), ORN group (irradiation, tooth extraction), Matrigel-1 group (Matrigel; BD Biosciences, San Jose, CA; irradiation, Matrigel application immediately after tooth extraction), tonsil-derived MSC-1 group (irradiation, tonsil-derived MSC application immediately after tooth extraction), Matrigel-4 group (irradiation, Matrigel application 4 weeks after tooth extraction), and tonsil-derived MSC-4 group (irradiation, tonsil-derived MSC application 4 weeks after tooth extraction). RESULT Bone mineral density was significantly lower in the ORN group than in the negative control group. The tonsil-derived MSC-1 group showed significantly higher bone mineral density than did the ORN and tonsil-derived MSC-4 groups. CONCLUSION A single 20-Gy dose of irradiation combined with tooth extraction successfully generated ORN in the rat model. The tonsil-derived MSCs can be effective for bone regeneration in ORN, particularly when applied immediately after dentoalveolar trauma or surgery.
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Affiliation(s)
- Hae Sang Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University, School of Medicine, Chuncheon, Republic of Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, School of Medicine, Chuncheon, Republic of Korea
| | - Jihae Lee
- Department of Radiation Oncology, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea
| | - Ha Young Kim
- Department of Molecular Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Soo Yeon Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, EwhaWomans University, Seoul, Republic of Korea
| | - Sung Min Lee
- Department of Otorhinolaryngology - Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University, School of Medicine, Chuncheon, Republic of Korea
| | - Chan Hum Park
- Department of Otorhinolaryngology - Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University, School of Medicine, Chuncheon, Republic of Korea.,Nano-Bio Regenerative Medical Institute, Hallym University, School of Medicine, Chuncheon, Republic of Korea
| | - Han Su Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, EwhaWomans University, Seoul, Republic of Korea
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Sawada K, Miron RJ, Leiser D, Caballé-Serrano J, Bosshardt DD, Schaller B, Buser D, Gruber R. High-dose irradiation of bone chips preserves the in vitro activity of bone-conditioned medium. J Oral Sci 2016; 58:325-31. [PMID: 27665970 DOI: 10.2334/josnusd.16-0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Extracorporeal irradiation sterilizes resected tumor bone used as autografts in reconstruction surgery. Therapeutic irradiation is a standard technique in head and neck cancer therapy that aims to preserve organ function. Bone irradiation has a complex, mostly inhibitory, effect on remodeling and regeneration, although the underlying mechanisms are still not fully understood. It remains unclear if extracorporeal irradiation affects the paracrine-like activity of the corresponding autografts. We recently reported that bone-conditioned medium from autogenous bone chips contains a number of factors that might affect cell activity. In the present study, we investigated the effects of extracorporeal irradiation of porcine cortical bone chips on the activity of the corresponding bone-conditioned medium. The effects of bone-conditioned medium on the expressions of transforming growth factor-beta (TGF-β) target genes in oral fibroblasts were assessed. Bone-conditioned medium from bone chips exposed to a total radiation dose up to 120 Gy did not affect expressions of TGF-β target genes, including adrenomedullin, BTB/POZ domain-containing protein 11, proteoglycan 4, NADPH oxidase 4, and interleukin 11, in oral fibroblasts. In conclusion, bone irradiation does not alter the capability of the corresponding bone-conditioned medium to provoke a robust fibroblastic cell response in vitro. (J Oral Sci 58, 325-331, 2016).
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Affiliation(s)
- Kosaku Sawada
- Department of Cranio Maxillofacial Surgery, Inselspital, University of Bern
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Zong C, Cai B, Wen X, Alam S, Chen Y, Guo Y, Liu Y, Tian L. The role of myofibroblasts in the development of osteoradionecrosis in a newly established rabbit model. J Craniomaxillofac Surg 2016; 44:725-33. [PMID: 27150352 DOI: 10.1016/j.jcms.2016.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/01/2016] [Accepted: 03/14/2016] [Indexed: 11/29/2022] Open
Abstract
This study aimed to establish a proper animal model of osteoradionecrosis of jaws (ORNJ) and to observe preliminarily the characteristics of myofibroblasts, the key effector cell of fibrosis, in ORNJ. Rabbit mandibles were irradiated at three different doses based on a human equivalent radiation schedule, and examined by gross manifestation, single-photon emission computed tomography (SPECT), micro-computed tomography, sequential fluorochrome labeling, and histology. Immunohistochemistry staining of α-SMA was applied to detect the existence of myofibroblasts. The exposed necrotic bone, which is the main indication of ORNJ, started to be observed at all rabbits at 9 Gy. With the radiation dose increasing, the microarchitecture of the irradiated mandibles was more destroyed, the metabolism and mineralization of the irradiated mandibles diminished, the osteocytes number decreased, and more mature bones were substituted by fibrosis in the irradiated mandibles. In addition, as the radiation dose increased, the myofibroblast number increased and collected around the separated sequestrum, which indicated that myofibroblasts might relate to the pathogenesis of ORNJ. In summary, a clinically translational ORNJ model was successfully established in our study, and the role of myofibroblasts in the pathogenesis of ORNJ is described for the first time.
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Affiliation(s)
- Chunlin Zong
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bolei Cai
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Xinxin Wen
- Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Syed Alam
- National Health Service Lothian, West Lothian, United Kingdom
| | - Yuanli Chen
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuxuan Guo
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yanpu Liu
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Lei Tian
- Department of Cranio-facial Trauma and Orthognathic Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China; The State Key Laboratory of Military Stomatology, School of Stomatology, Fourth Military Medical University, Xi'an, China.
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Jin IG, Kim JH, Wu HG, Kim SK, Park Y, Hwang SJ. Effect of bone marrow-derived stem cells and bone morphogenetic protein-2 on treatment of osteoradionecrosis in a rat model. J Craniomaxillofac Surg 2015. [DOI: 10.1016/j.jcms.2015.06.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Neves EG, Ramos-Perez FMDM, Freitas DQ, Bóscolo FN, Almeida SM. Radioprotective effect of sodium selenite on developing teeth. Braz Dent J 2015; 24:375-9. [PMID: 24173260 DOI: 10.1590/0103-6440201302193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 05/17/2013] [Indexed: 06/22/2024] Open
Abstract
Radioprotective agents like selenium are used to reduce the damage caused by radiation in healthy tissues. The aim of this study was to evaluate the effect of sodium selenite on the development of the molars of offspring of rats irradiated during odontogenesis. Twenty pregnant rats were randomly divided into 4 groups: control, irradiated, selenium and selenium/irradiated. The selenium and selenium/irradiated groups received 0.3 mg/kg of sodium selenite at 18 days of pregnancy. The rats of the irradiated and selenium/irradiated groups received a single dose of 4 Gy of X rays on the abdominal region at the 19th day of pregnancy. The offspring was sacrificed at 3 and 4 days after birth for evaluation of the birefringence of the enamel organic matrix, and at 30 days for evaluation of the intercuspal dimensions of the molars. The selenium/irradiated group was similar to the irradiated group with respect to the thickness and irregularity of the enamel organic matrix region in the evaluated birefringence, as the intercuspal dimensions of the molars. In conclusion, sodium selenite had no radioprotective action on the development of the molars of offspring of rats irradiated during odontogenesis and had a toxic effect in the initial time.
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Affiliation(s)
- Ellen Gaby Neves
- Department of Oral Diagnosis, Oral Radiology Area, Piracicaba School of Dentistry, UNICAMP - University of Campinas, PiracicabaSP, Brazil
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Brożyna B, Szymańska H, Ptaszyński K, Woszczyński M, Lechowska-Piskorowska J, Gajewska M, Rostkowska J, Chełmiński K, Bulski W, Krajewski R. Tissue response after implantation of pure titanium and bioresorbable screws in scapula with postoperative irradiation: an experimental study on rats. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:443-52. [PMID: 26346909 DOI: 10.1016/j.oooo.2015.06.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The study focuses on the comparison of tissue reaction to titanium and bioresorbable implants with and without postoperative irradiation on an animal model. MATERIALS AND METHODS Thirty-nine LEW/W rats were randomly assigned to experimental or control groups. One titanium and one bioresorbable screw (poly-L-lactide [PLLA] and L- and D-lactide poly-L/D-lactide [PDLLA]) were implanted into the left scapulas of 24 rats. Half of them received 30 Gy to the operation site and the other half received 42 Gy. In the control groups, 3 rats received 30 Gy, and 6 rats received 42 Gy to the scapula area without operation; and 6 rats had implants inserted as in the experimental group, but received no postoperative irradiation. The scapulas were removed 14 or 30 days after irradiation and a histologic analysis was performed. RESULTS The host tissue reaction to titanium and PLLA-PDLLA screws without postoperative irradiation was of similar intensity. In irradiated animals, the inflammatory tissue reaction was more evident around the titanium screws than around the bioresorbable screws, irrespective of the radiation dose and of the time that elapsed from the irradiation. The reaction was more evident on the 14th day than on the 30th day after the last radiation dose (70 and 86 days after surgery, respectively). The intensity of the inflammatory tissue reaction, irrespective of the implant type, was more intense in the group irradiated with 42 Gy. CONCLUSIONS PLLA-PDLLA implants appear to cause less tissue reaction after irradiation and could be safer reconstructive devices than titanium implants for patients undergoing surgery and adjuvant radiotherapy for cancer.
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Affiliation(s)
- Bogusław Brożyna
- Department of Head and Neck Cancer, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Hanna Szymańska
- Department of Genetics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Konrad Ptaszyński
- Department of Pathology, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Marek Woszczyński
- Department of Genetics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Joanna Lechowska-Piskorowska
- Department of Genetics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Marta Gajewska
- Department of Genetics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland.
| | - Joanna Rostkowska
- Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Krzysztof Chełmiński
- Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland.
| | - Wojciech Bulski
- Department of Medical Physics, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
| | - Romuald Krajewski
- Department of Head and Neck Cancer, The Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Roentgen Str. 5, 02781 Warsaw, Poland
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Bléry P, Espitalier F, Hays A, Crauste E, Demarquay C, Pilet P, Sourice S, Guicheux J, Malard O, Benderitter M, Weiss P, Mathieu N. Development of mandibular osteoradionecrosis in rats: Importance of dental extraction. J Craniomaxillofac Surg 2015; 43:1829-36. [PMID: 26433771 DOI: 10.1016/j.jcms.2015.08.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/10/2015] [Accepted: 08/17/2015] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To develop an animal model of mandibular osteoradionecrosis (ORN) using a high-energy radiation source (as used in human therapeutics) and to assess the role of tooth extraction on ORN development. MATERIALS AND METHODS (STUDY DESIGN) Ten animals were irradiated with a single 35- or 50-Gy dose. Three weeks later, the second left mandibular molar was extracted from three animals in each group. Nine weeks after irradiation, the animals were euthanized, with an injection of contrast agent in the bloodstream to highlight vascularization. Mandibles were harvested and studied using micro-CT, histology, tartrate-resistant acid phosphatase activity and scanning electron microscopy. RESULTS This study demonstrates that a single 50-Gy dose associated with molar extraction is necessary for ORN development. In these conditions, absence of healing of the mucosa and bone, dental effects, fibrosis, an increase in osteoclast activity and a decrease in vascularization were observed. We also determined that molar extraction increases the impact of the cellular effects of radiation. CONCLUSION The mandibular ORN animal model was validated after 50-Gy irradiation and molar extraction. The results of this study therefore support an animal ORN model and tissue engineering strategies will now be developed to regenerate bone for patients with head and neck cancer.
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Affiliation(s)
- Pauline Bléry
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; Faculté de Chirurgie Dentaire (Head: Prof. Y. Amouriq), Université de Nantes, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; IRCCyN, CNRS 6597, IVC (Head: Prof. Patrick Le Callet), Polytech'Nantes, rue Christian Pauc, 44306 Nantes Cedex 3, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France; Service d'Odontologie Restauratrice et Chirurgicale (Head: Prof. Y. Amouriq), CHU de Nantes, PHU4OTONN, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France.
| | - Florent Espitalier
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France; Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale (Head: Prof. P. Bordure), CHU de Nantes, Pôle Hospitalo-Universiatire 4 OTONN, France
| | - Alexandra Hays
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France
| | - Eléonore Crauste
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France
| | - Christelle Demarquay
- IRSN Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PRP-HOM/SRBE/LR2I (Head: Dr. M. Benderitter), 31 avenue de la division Leclerc BP17, 92260 Fontenay aux Roses, France
| | - Paul Pilet
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France
| | - Sophie Sourice
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France
| | - Jérôme Guicheux
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France
| | - Olivier Malard
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France; Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale (Head: Prof. P. Bordure), CHU de Nantes, Pôle Hospitalo-Universiatire 4 OTONN, France
| | - Marc Benderitter
- IRSN Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PRP-HOM/SRBE/LR2I (Head: Dr. M. Benderitter), 31 avenue de la division Leclerc BP17, 92260 Fontenay aux Roses, France
| | - Pierre Weiss
- Inserm U791 (Head: Prof. P. Weiss), LIOAD, Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; Faculté de Chirurgie Dentaire (Head: Prof. Y. Amouriq), Université de Nantes, 1 Place Alexis Ricordeau, 44042 Nantes Cedex 1, France; CHU Nantes, Pôle Hospitalo-Universitaire 4 OTONN (Head: Dr. G. Amador del Valle), 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France
| | - Noëlle Mathieu
- IRSN Institut de Radioprotection et de Sûreté Nucléaire, IRSN/PRP-HOM/SRBE/LR2I (Head: Dr. M. Benderitter), 31 avenue de la division Leclerc BP17, 92260 Fontenay aux Roses, France
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Jackson RS, Voss SG, Wilson ZC, Remmes NB, Stalboerger PG, Keeney MG, Moore EJ, Janus JR. An Athymic Rat Model for Mandibular Osteoradionecrosis Allowing for Direct Translation of Regenerative Treatments. Otolaryngol Head Neck Surg 2015; 153:526-31. [DOI: 10.1177/0194599815593278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 06/05/2015] [Indexed: 10/23/2022]
Abstract
Objective We aim to create a model of mandibular osteoradionecrosis in athymic rats. Athymic rats provide an immunosuppressed environment whereby human stem cells and biomaterials can be used to investigate regenerative solutions for osteoradionecrosis, bridging the gap between in vivo testing and clinical application. Study Design Prospective animal study. Setting Academic otolaryngology department laboratory. Subjects and Methods After Institutional Animal Care and Use Committee approval, 10 athymic nude rats were divided into 2 groups. The experimental group (n = 6) underwent irradiation (20 Gy), while the control group (n = 4) underwent sham irradiation catheter placement only. All 10 rats underwent extraction of the second mandibular molar 7 days later. The rats were sacrificed 28 days after dental extraction, and their mandibles were harvested. The mandibles were examined with histologic analysis and bone volume analysis based on 3-dimensional micro–computed tomography. Results All 10 rats survived the experiment period. Radiographic and histologic analysis revealed decreased bone formation in the experimental group compared with the control group. Jaw region volume ratio was 0.83 for the experimental group versus 0.97 in the control group ( P = .003). The region-of-interest volume ratio was 0.75 in the experimental group and 0.97 in the control group ( P = .005). Histologically, there were increased osteoclasts ( P = .02) and decreased osteoblasts ( P = .001) as well as increased fibrosis in the experimental group versus the control group. Conclusion Mandibular osteoradionecrosis can be effectively and reproducibly produced in an athymic rat model. This will allow further research to study regenerative medicine in an athymic rat model.
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Affiliation(s)
- Ryan S. Jackson
- Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen G. Voss
- Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Zachary C. Wilson
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicholas B. Remmes
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Michael G. Keeney
- Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric J. Moore
- Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeffrey R. Janus
- Department of Otolaryngology–Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Chronopoulos A, Zarra T, Tröltzsch M, Mahaini S, Ehrenfeld M, Otto S. Osteoradionecrosis of the mandible: A ten year single-center retrospective study. J Craniomaxillofac Surg 2015; 43:837-46. [DOI: 10.1016/j.jcms.2015.03.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 03/20/2015] [Accepted: 03/23/2015] [Indexed: 01/08/2023] Open
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Sønstevold T, Johannessen AC, Stuhr L. A rat model of radiation injury in the mandibular area. Radiat Oncol 2015; 10:129. [PMID: 26050968 PMCID: PMC4464243 DOI: 10.1186/s13014-015-0432-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/28/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Radiation technology focuses on delivering the radiation as precisely as possible to the tumor, nonetheless both acute and long-term damage to surrounding normal tissue may develop. Injuries to the surrounding normal tissue after radiotherapy of head and neck cancer are difficult to manage. An animal model is needed to elucidate good treatment modalities. The aim of this study was to establish a rat model where a certain radiation dose gives reproducible tissue reactions in the mandibular area corresponding to injuries obtained in humans. METHOD The left mandible of male Sprague Dawley rats was irradiated by external radiotherapy (single fraction 15 Gy, total dose 75 Gy) every second week five times. Endpoint was six weeks after last radiation treatment, and the test group was compared to non-irradiated controls. Morphological alterations of the soft tissues, bone and tooth formation, as well as alterations of salivation, vascularity and collagen content were assessed. An unpaired, non-parametric Mann-Whitney test was used to compare the statistical differences between the groups. RESULTS Analysis of the soft tissues and mandible within the radiation field revealed severe unilateral alopecia and dermatitis of the skin, extensive inflammation of the submandibular gland with loss of serous secretory cells, hyperkeratinization and dense connective fiber bundles of the gingival tissue, and disturbed tooth development with necrosis of the pulp. Production of saliva and the vascularity of the soft tissues were significantly reduced. Furthermore, the collagen fibril diameter was larger and the collagen network denser compared to non-irradiated control rats. CONCLUSION We have established an animal model of radiation injury demonstrating physiological and histological changes corresponding to human radiation injuries, which can be used for future therapeutic evaluations.
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Affiliation(s)
- Tonje Sønstevold
- Department of Biomedicine, Faculty of Medicine and Dentistry University of Bergen, Serviceboks 7804, N-5020, Bergen, Norway.
| | - Anne Christine Johannessen
- The Gade Laboratory for Pathology, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
| | - Linda Stuhr
- Department of Biomedicine, Faculty of Medicine and Dentistry University of Bergen, Serviceboks 7804, N-5020, Bergen, Norway.
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Tillner F, Thute P, Bütof R, Krause M, Enghardt W. Pre-clinical research in small animals using radiotherapy technology – a bidirectional translational approach. Z Med Phys 2014; 24:335-51. [DOI: 10.1016/j.zemedi.2014.07.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 07/18/2014] [Accepted: 07/18/2014] [Indexed: 01/17/2023]
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21
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Fan H, Kim SM, Cho YJ, Eo MY, Lee SK, Woo KM. New approach for the treatment of osteoradionecrosis with pentoxifylline and tocopherol. Biomater Res 2014; 18:13. [PMID: 26331064 PMCID: PMC4552457 DOI: 10.1186/2055-7124-18-13] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 09/12/2014] [Indexed: 12/26/2022] Open
Abstract
Osteoradionecrosis (ORN) of the jaw is a significant complication of radiotherapy for oral cavity cancer. In addition to antibiotic medication, treatment options such as hyperbaric oxygen therapy, surgical approaches, and combined therapy with pentoxifylline and tocopherol have been recently introduced. In this review article, we will discuss the definition and classifications of osteoradionecrosis, its etiology and pathophysiology, previous treatment options, oral and maxillofacial complications of radiotherapy, basic information on pentoxifylline and tocopherol, recent reports of pentoxifylline and tocopherol combined therapy, and, finally, ORN-induced animal models and future approaches.
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Affiliation(s)
- Huan Fan
- />Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 62-1 Changgyeonggungno, Jongno-gu, Seoul, 110-768 South Korea
| | - Soung Min Kim
- />Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 62-1 Changgyeonggungno, Jongno-gu, Seoul, 110-768 South Korea
| | - Yun Ju Cho
- />Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 62-1 Changgyeonggungno, Jongno-gu, Seoul, 110-768 South Korea
| | - Mi Young Eo
- />Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, 62-1 Changgyeonggungno, Jongno-gu, Seoul, 110-768 South Korea
| | - Suk Keun Lee
- />Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea
| | - Kyung Mi Woo
- />Department of Dental Pharmacology & Therapeutics, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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22
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de Moraes Ramos-Perez FM, do Espírito Santo AR, da Cruz Perez DE, Novaes PD, Bóscolo FN, Line SRP, de Almeida SM. Ionizing radiation effects on the secretory-stage ameloblasts and enamel organic extracellular matrix. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2014; 53:589-598. [PMID: 24699801 DOI: 10.1007/s00411-014-0539-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 03/23/2014] [Indexed: 06/03/2023]
Abstract
This study assessed the effects of high doses of ionizing radiation on eruption rate, odontogenic region morphology, secretory-stage ameloblasts, and enamel organic extracellular matrix (EOECM) of rat maxillary incisors. For the study, 30 male rats were divided into three experimental groups: control (non-irradiated), irradiated by 15 Gy, and irradiated by 25 Gy. Irradiated groups received a single dose of 15 or 25 Gy of X-rays in the head and neck region. The maxillary incisor eruption rate was measured. Sections of 5-µm thickness of the maxillary incisor odontogenic regions were evaluated using bright field light microscopy. Ultrathin sections of secretory ameloblasts and their EOECM were analyzed by transmission electron microscopy (TEM). Irradiated groups showed significantly diminished eruption rate values at the 4th and at the 6th day after irradiation. Reduced optical retardation values were observed in the irradiated groups. The odontogenic region of maxillary incisors from irradiated rats exhibited altered and poorly organized preameloblasts. TEM showed degeneration areas in the secretory-stage EOECM and several autophagosomes in the secretory ameloblasts from irradiated animals. In conclusion, high radiation doses delay eruption and induce disturbances in secretory ameloblasts and EOECM of rat maxillary incisors. These findings may be associated with structural defects of mature enamel.
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Affiliation(s)
- Flávia Maria de Moraes Ramos-Perez
- Área de Radiologia Odontológica, Departamento de Clinica e Odontologia Preventiva, Universidade Federal de Pernambuco, Avenida Prof. Moraes Rego, 1235, Cidade Universitária, CEP 50670-901, Recife, PE, Brazil,
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de Araujo AMM, Gomes CC, de Almeida SM, Klamt CB, Novaes PD. Effect of radiotherapy on the eruption rate and morphology of the odontogenic region of rat incisors. Arch Oral Biol 2014; 59:1242-8. [PMID: 25129812 DOI: 10.1016/j.archoralbio.2014.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 06/26/2014] [Accepted: 07/13/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The goal in this study was to evaluate the results of doses of 5 and 15 Gy of radiation in odontogenic region of the rats inferior mandibular-incisors by a histological analysis and the rate of eruptions. DESIGN Animals were divided into three groups: control, radiotherapy 5 Gy and radiotherapy 15 Gy. In which tooth-eruption-rate was measured every two days. RESULTS Animals in Group 5 Gy presented values similar to those of the control group. Animals in Group 15 Gy presented reduction in tooth-eruption-rate as of the sixth day of the experiment, vast disorganization of odontoblasts and ameloblasts, apparent reduction in cell population in the follicle region and alterations in cervical loop formation of the dental organ. CONCLUSIONS It was concluded that there was a difference between the researched doses, and histological alteration at 15 Gy lead to statistical reduction in tooth-eruption-rate.
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Affiliation(s)
- Amanda Maria Medeiros de Araujo
- Department of Clinic and Social Dentistry, School of Dentistry, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
| | - Carolina Cintra Gomes
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Solange Maria de Almeida
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Carla Beatriz Klamt
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Pedro Duarte Novaes
- Department of Morphology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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Benderitter M, Caviggioli F, Chapel A, Coppes RP, Guha C, Klinger M, Malard O, Stewart F, Tamarat R, van Luijk P, Limoli CL. Stem cell therapies for the treatment of radiation-induced normal tissue side effects. Antioxid Redox Signal 2014; 21:338-55. [PMID: 24147585 PMCID: PMC4060814 DOI: 10.1089/ars.2013.5652] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
SIGNIFICANCE Targeted irradiation is an effective cancer therapy but damage inflicted to normal tissues surrounding the tumor may cause severe complications. While certain pharmacologic strategies can temper the adverse effects of irradiation, stem cell therapies provide unique opportunities for restoring functionality to the irradiated tissue bed. RECENT ADVANCES Preclinical studies presented in this review provide encouraging proof of concept regarding the therapeutic potential of stem cells for treating the adverse side effects associated with radiotherapy in different organs. Early-stage clinical data for radiation-induced lung, bone, and skin complications are promising and highlight the importance of selecting the appropriate stem cell type to stimulate tissue regeneration. CRITICAL ISSUES While therapeutic efficacy has been demonstrated in a variety of animal models and human trials, a range of additional concerns regarding stem cell transplantation for ameliorating radiation-induced normal tissue sequelae remain. Safety issues regarding teratoma formation, disease progression, and genomic stability along with technical issues impacting disease targeting, immunorejection, and clinical scale-up are factors bearing on the eventual translation of stem cell therapies into routine clinical practice. FUTURE DIRECTIONS Follow-up studies will need to identify the best possible stem cell types for the treatment of early and late radiation-induced normal tissue injury. Additional work should seek to optimize cellular dosing regimes, identify the best routes of administration, elucidate optimal transplantation windows for introducing cells into more receptive host tissues, and improve immune tolerance for longer-term engrafted cell survival into the irradiated microenvironment.
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Affiliation(s)
- Marc Benderitter
- 1 Laboratory of Radiopathology and Experimental Therapies, IRSN , PRP-HOM, SRBE, Fontenay-aux-Roses, France
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25
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Yuhasz MM, Koch FP, Kwiatkowski A, Young C, Clune J, Travieso R, Wong K, Van Houten J, Steinbacher DM. Comparing calvarial transport distraction with and without radiation and fat grafting. J Craniomaxillofac Surg 2014; 42:1412-22. [PMID: 24864072 DOI: 10.1016/j.jcms.2014.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 04/07/2014] [Accepted: 04/08/2014] [Indexed: 11/26/2022] Open
Abstract
The purpose of this study is to: a) assess transport distraction to reconstruct cranial defects in radiated and non-radiated fields b) examine adipose grafting's effect on the bony regenerate and overlying wound, and c) elucidate sources of bone formation during transport distraction osteogenesis. Twenty-three male New Zealand white rabbits (3 months; 3.5 kg) were used, 10 non-irradiated and 13 irradiated (17 treatment, 6 control) with a one-time fraction of 35 Gy. A 16 × 16 mm defect was abutted by a 10 × 16 mm transport disc 5 weeks after irradiation, and 11 animals were fat grafted at the distraction site. Latency (1 day), distraction (1.5 mm/day), and consolidation (4 weeks) followed. Fluorochromes were injected subcutaneously and microCT, fluorescence, and histology assessed. In distracted animals without fat grafting, bone density measured 701.87 mgHA/ccm and 2271.95 mgHA/ccm in irradiated and non-irradiated animals. In distracted animals with fat grafting, bone density measured 703.23 mgHA/ccm and 2254.27 mgHA/ccm in irradiated and non-irradiated animals. Fluorescence revealed ossification emanating from the dura, periosteum, and transport segment with decreased formation in irradiated animals. Transport distraction is possible for cranial reconstruction in irradiated fields but short-term osseous fill is significantly diminished. Adipose grafting enhances wound healing in previously irradiated fields but does not enhance ossification.
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Affiliation(s)
- Mikell M Yuhasz
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Felix P Koch
- Oral and Maxillofacial Surgery, University Medical Centre Mainz & Research Fellow Plastic Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Anna Kwiatkowski
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Calvin Young
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - James Clune
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Rob Travieso
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Kenneth Wong
- Section of Plastic & Reconstructive Surgery, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Joshua Van Houten
- Yale Core Center for Musculoskeletal Disorders, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States
| | - Derek M Steinbacher
- Section of Plastic & Reconstructive Surgery, Director of Craniofacial Program, Yale School of Medicine, United States; Yale University School of Medicine, Department of Plastic and Reconstructive Surgery (John Persing, MD, Section Chief), 3rd Floor, Boardman Building, 330 Cedar Street, New Haven, CT 06520, United States.
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Lee W, Lee BD, Lee KK, Koh KJ. A magnetic resonance imaging study on changes in rat mandibular bone marrow and pulp tissue after high-dose irradiation. Imaging Sci Dent 2014; 44:43-52. [PMID: 24701458 PMCID: PMC3972405 DOI: 10.5624/isd.2014.44.1.43] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 09/25/2013] [Accepted: 10/06/2013] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study was designed to evaluate whether magnetic resonance imaging (MRI) is appropriate for detecting early changes in the mandibular bone marrow and pulp tissue of rats after high-dose irradiation. MATERIALS AND METHODS The right mandibles of Sprague-Dawley rats were irradiated with 10 Gy (Group 1, n=5) and 20 Gy (Group 2, n=5). Five non-irradiated animals were used as controls. The MR images of rat mandibles were obtained before irradiation and once a week until week 4 after irradiation. From the MR images, the signal intensity (SI) of the mandibular bone marrow and pulp tissue of the incisor was interpreted. The MR images were compared with the histopathologic findings. RESULTS The SI of the mandibular bone marrow had decreased on T2-weighted MR images. There was little difference between Groups 1 and 2. The SI of the irradiated groups appeared to be lower than that of the control group. The histopathologic findings showed that the trabecular bone in the irradiated group had increased. The SI of the irradiated pulp tissue had decreased on T2-weighted MR images. However, the SI of the MR images in Group 2 was high in the atrophic pulp of the incisor apex at week 2 after irradiation. CONCLUSION These patterns seen on MRI in rat bone marrow and pulp tissue were consistent with histopathologic findings. They may be useful to assess radiogenic sclerotic changes in rat mandibular bone marrow.
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Affiliation(s)
- Wan Lee
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| | - Byung-Do Lee
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| | - Kang-Kyoo Lee
- Department of Radiation Oncology, School of Medicine, Wonkwang University, Iksan, Korea
| | - Kwang-Joon Koh
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju, Korea
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Shamsul BS, Tan KK, Chen HC, Aminuddin BS, Ruszymah BHI. Posterolateral spinal fusion with ostegenesis induced BMSC seeded TCP/HA in a sheep model. Tissue Cell 2014; 46:152-8. [PMID: 24630213 DOI: 10.1016/j.tice.2014.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 02/06/2014] [Accepted: 02/06/2014] [Indexed: 11/26/2022]
Abstract
Autogenous bone graft is the gold standard for fusion procedure. However, pain at donor site and inconsistent outcome have left a surgeon to venture into some other technique for spinal fusion. The objective of this study was to determine whether osteogenesis induced bone marrow stem cells with the combination of ceramics granules (HA or TCP/HA), and fibrin could serve as an alternative to generate spinal fusion. The sheep's bone marrow mesenchymal stem cells (BMSCs) were aspirated form iliac crest and cultured for several passages until confluence. BMSCs were trypsinized and seeded on hydroxyapatite scaffold (HA) and tricalcium phosphate/hydroxyapatite (TCP/HA) for further osteogenic differentiation in the osteogenic medium one week before implantation. Six adult sheep underwent three-level, bilateral, posterolateral intertransverse process fusions at L1-L6. Three fusion sites in each animal were assigned to three treatments: (a) HA constructs group/L1-L2, (b) TCP/HA constructs group/L2-L3, and (c) autogenous bone graft group/L5-L6. The spinal fusion segments were evaluated using radiography, manual palpation, histological analysis and scanning electron microscopy (SEM) 12 weeks post implantation. The TCP/HA constructs achieved superior lumbar intertransverse fusion compared to HA construct but autogenous bone graft still produced the best fusion among all.
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Affiliation(s)
- B S Shamsul
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - K K Tan
- Orthopedic and Spinal Surgery Consultant Clinic, Johor Specialist Hospital, Malaysia
| | - H C Chen
- Faculty of Veterinary Medicine, Universiti Putra Malaysia, Malaysia
| | - B S Aminuddin
- Ear, Nose & Throat Consultant Clinic, Ampang Puteri Specialist Hospital, Malaysia; Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Malaysia
| | - B H I Ruszymah
- Tissue Engineering Centre, Universiti Kebangsaan Malaysia Medical Centre, Malaysia; Department of Physiology, Medical Faculty Universiti Kebangsaan Malaysia, Malaysia.
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Poort L, Lethaus B, Böckmann R, Buurman D, Jong JD, Hoebers F, Kessler P. Experimental Studies on the Irradiation of Facial Bones in Animals: A Review. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ijohns.2014.33022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lye KW, Chin FKC, Tideman H, Merkx MA, Jansen JA. Effect of postoperative radiation therapy on mandibular reconstruction using a modular endoprosthesis – A pilot study. J Craniomaxillofac Surg 2013; 41:487-95. [DOI: 10.1016/j.jcms.2012.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 11/14/2012] [Accepted: 11/14/2012] [Indexed: 01/28/2023] Open
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Açil Y, Gierloff M, Behrens C, Möller B, Gassling V, Niehoff P, Wiltfang J, Simon M. Effects of zoledronate on irradiated bone in vivo: analysis of the collagen types I, V and their cross-links lysylpyridinoline, hydroxylysylpyridinoline and hydroxyproline. Calcif Tissue Int 2013. [PMID: 23179106 DOI: 10.1007/s00223-012-9676-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Radiotherapy can lead to a reduction of bone density with an increased risk of pathological fractures. Bisphosphonates may represent a preventive treatment option by increasing the density of anorganic bone mineral. Yet it is unknown how bisphosphonates act on irradiated collagen cross-links, which play an essential role for the mechanical stability of bone. The aim of this study was to evaluate the effects of zoledronate on bone collagens and their cross-links after irradiation. The right femur of 37 rats was irradiated with a single dose of 9.5 Gy at a high dose rate using an afterloading machine. Half of the rats (n=18) received additionally a single dose zoledronate (0.1 mg/kg body weight). Fourteen and 100 days after irradiation the femora were collected for histologic evaluation and determination of the collagen cross-links lysylpyridinoline, hydroxylysylpyridinoline, and hydroxyproline. The collagen types were characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Fourteen days after treatment the lysylpyridinoline levels of all treatment groups were significantly lower compared to the untreated control. After 100 days, in the combined radiotherapy+zoledronate group significantly lower lysylpyridinoline values were determined (p=0.009). Radiotherapy and/or zoledronate did not change significantly the level of hydroxylysylpyridinoline. The concentration of hydroxyproline was 14 days after irradiation significantly higher in the combined treatment group compared to the control. No significant differences were observed 100 days after treatment. Zoledronate does not have the ability to restore the physiological bone collagen cross-link levels after radiotherapy. However, this would be necessary for regaining the physiological mechanical stability of bone after irradiation and therefore to prevent effectively radiation-induced fractures.
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Affiliation(s)
- Yahya Açil
- Department of Oral and Maxillofacial Surgery, UK-SH, Campus Kiel, Germany
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Rolim AEH, Costa LJD, Ramalho LMP. Repercussões da radioterapia na região orofacial e seu tratamento. Radiol Bras 2011. [DOI: 10.1590/s0100-39842011000600011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A radioterapia em região de cabeça e pescoço provoca inúmeras sequelas ao paciente irradiado, afetando o sistema estomatognático e com repercussões sistêmicas importantes. As sequelas da radiação ionizante podem ser extensas e, algumas vezes, permanentes, em especial nas glândulas salivares e no tecido ósseo. É relevante que o cirurgião dentista tenha conhecimento das reações adversas e das formas adequadas de prevenção e tratamento para amenizar o desconforto e melhorar a condição de vida do paciente irradiado. Portanto, a conscientização e motivação deste paciente, com a promoção de saúde oral através da adequação do meio bucal e orientações sobre ações preventivas, são essenciais para se obter o melhor prognóstico.
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Tamplen M, Trapp K, Nishimura I, Armin B, Steinberg M, Beumer J, Abemayor E, Nabili V. Standardized analysis of mandibular osteoradionecrosis in a rat model. Otolaryngol Head Neck Surg 2011; 145:404-10. [PMID: 21493310 DOI: 10.1177/0194599811400576] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To develop a rat model of mandibular osteoradionecrosis(ORN) that uses novel micro-computed tomography bone volume analysis and detailed histology to provide a more effective, quantifiable, and standardized way to study ORN in vivo. STUDY DESIGN Animal model. SETTING Academic medical center. SUBJECTS AND METHODS Modifications to our previously published rat model of mandibular ORN were done to develop an ideal protocol consisting of 10 rats (6 experimental and 4 controls) with their left middle mandibular molar removed 7 days after either 20 Gy high dose rate brachytherapy or sham irradiation. Rats were sacrificed 21 days after extraction for landmark defined bone volume and histologic analysis. RESULTS A standardized method of quantification was achieved in all samples. The radiated group (XRT) had a mean bone volume/total volume (BV/TV) of 13.8% compared to 65.9% for controls (P < .001). There were increases in osteoclasts and fibrosis, decreases in osteoblasts,and less bone in radiated samples with a mean (SD)of 5.91 (3.77) osteoclasts/high-powered field (HPF) and 4.00(1.83) osteoblasts/HPF in XRT samples compared to 1.08(1.08) osteoclasts/HPF and 22.49 (6.00) osteoblasts/HPF for controls (P <.001). CONCLUSION Our updated model continues to be clinically analogous to human mandibular ORN and improves the radiologic and histologic analysis of bony defects, providing a method for quantification of bone loss. Further cell-specific staining, including immunohistochemistry, can be used with this model to study potential cellular mechanisms of mandibular ORN and test any future therapeutic options.
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Affiliation(s)
- Matthew Tamplen
- Division of Head and Neck Surgery, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
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Cohen M, Nishimura I, Tamplen M, Hokugo A, Beumer J, Steinberg ML, Suh JD, Abemayor E, Nabili V. Animal model of radiogenic bone damage to study mandibular osteoradionecrosis. Am J Otolaryngol 2011; 32:291-300. [PMID: 20719407 DOI: 10.1016/j.amjoto.2010.06.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 06/01/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of the study was to create an animal model to study mandibular osteoradionecrosis (ORN) using high-dose rate (HDR) brachytherapy. METHODS Ten Sprague-Dawley male rats were used in this study. Six rats received a single dose of 30 Gy using an HDR remote afterloading machine via a brachytherapy catheter placed along the left hemimandible. The remaining 4 rats served as controls with catheter placement without radiation (sham). On the day following irradiation or sham, all 3 left mandibular molars were atraumatically extracted. Twenty-eight days after irradiation, mandibles were examined using nondecalcified histology with sequential fluorochrome labeling, decalcified histology, and micro-computed tomography scanning. RESULTS Irradiated rats demonstrated exposed bone at the extraction sockets, whereas the control animals had complete mucosalization. Alopecia was also seen in the irradiated group. Both histologic and radiologic analyses of the mandible specimens demonstrated a reduction in bone formation in the radiated mandibles as compared with controls. CONCLUSIONS Our HDR brachytherapy model incorporating postradiation dental extractions has successfully demonstrated reproducible radiogenic mandibular bone damage analogous to the clinical ORN. Although clinical criteria continue to be used today in describing ORN, this model can serve as a platform for future studies to define ORN and delineate its pathogenesis.
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Affiliation(s)
- Marc Cohen
- Division of Head and Neck Surgery, David Geffen School of Medicine at UCLA, University of California-Los Angeles, 10833 LeConte Avenue, Los Angeles, CA 90095, USA
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Phulpin B, Dolivet G, Marie PY, Poussier S, Gallet P, Leroux A, Graff P, Groubach F, Bravetti P, Merlin JL, Tran N. Re-assessment of chronic radio-induced tissue damage in a rat hindlimb model. Exp Ther Med 2010; 1:553-560. [PMID: 22993575 DOI: 10.3892/etm_00000087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 05/17/2010] [Indexed: 11/06/2022] Open
Abstract
Radiotherapy is successfully used to treat neoplastic lesions, but may adversely affect normal tissues within the irradiated volume. However, additional clinical and para-clinical data are required for a comprehensive understanding of the pathogenesis of this damage. We assessed a rat model using clinical records and medical imaging to gain a better understanding of irradiation-induced tissue damage. The hindlimbs of the rats in this model were irradiated with a single dose of 30 or 50 Gy. Sequential analysis was based on observation records of stage and planar scintigraphy. Additional radiography, radiohistology and histology studies were performed to detect histological alterations. All animals developed acute and late effects, with an increased severity after a dose of 50 Gy. The bone uptake of (99m)Tc-HDP was significantly decreased in a dose- and time-dependent manner. Histologically, significant tissue damage was observed. After the 50 Gy irradiation, the animals developed lesions characteristic of osteoradionecrosis (ORN). Radiographic and histological studies provided evidence of lytic bone lesions. Our rat model developed tissue damage characteristic of radiation injury after a single 30 Gy irradiation and tissue degeneration similar to that which occurs during human ORN after a 50 Gy irradiation. The development of this animal model is an essential step in exploring the pathogenesis of irradiation-induced tissue damage, and may be used to test the efficacy of new treatments.
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Affiliation(s)
- Bérengère Phulpin
- Head and Neck and Dental Surgery Units, Oncologic Surgery Department, Centre Alexis Vautrin; ; Tumor Biology Unit, EA4421 SIGReTO UHP-Nancy University, Centre Alexis Vautrin
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Jegoux F, Malard O, Goyenvalle E, Aguado E, Daculsi G. Radiation effects on bone healing and reconstruction: interpretation of the literature. ACTA ACUST UNITED AC 2010; 109:173-84. [PMID: 20123406 DOI: 10.1016/j.tripleo.2009.10.001] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Revised: 09/03/2009] [Accepted: 10/04/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Reconstructing irradiated mandibles with biomaterials is still a challenge but little investigated. We collected data that could help us understand studies in the field of regeneration with biomaterials and irradiated bone. STUDY DESIGN Systematic review of the literature. RESULTS Delay and duration of radiation delivery and total equivalent dose are the most variable parameters in the various studies, resulting in confusion when interpreting the literature. Most reproducible experiments show that radiation reduces osteogenic cell numbers, alters cytokine capacity, and delays and damages bone remodeling. Interindividual variations and how such changes become irreversible lesions are still uncertain. In the case of regeneration using biomaterials, most studies have addressed the question of reconstruction in previously irradiated bone. The results show that osseointegration is often possible, although the failure rate is higher. The sooner the implantation takes place after the end of the radiation, the higher the likelihood of failure. Few studies have focused on primary reconstruction followed by early irradiation, and most of the currently available engineering models would be altered by radiation. Good outcomes have been obtained with bone morphogenetic protein and with total bone marrow transplanation. CONCLUSION This review points out the difficulties in achieving reproducible experiments and interpreting literature in this underinvestigated field.
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Hosokawa Y, Sakakura Y, Irie K, Kudo K, Kashiwakura I. Effects of local and whole body irradiation on the appearance of osteoblasts during wound healing in tooth extraction sockets in rats. JOURNAL OF RADIATION RESEARCH 2010; 51:181-186. [PMID: 20057173 DOI: 10.1269/jrr.09103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Irradiation before tooth extraction delays wound healing in the alveolar socket. This study examined the influences of local and whole body irradiation before tooth extraction on appearance of osteoblasts in the alveolar bone of rat maxillary first molars because bone formation is observed at the initial phase of wound healing. Several osteoblasts were generated 3 days after tooth extraction, and the number of cells increased day by day. Morphological studies showed there were little differences between local irradiation and non-irradiated controls. In contrast, the extraction wound in the whole body irradiation group showed delayed healing, and there was poor granulation tissue and very few osteoblasts at the bottom of the socket. An ultrastructural study showed that the osteoblasts in the extraction socket of whole body irradiation rats were smaller, and had poorly developed organelles. Injection of bone marrow cells to whole body-irradiated animals immediately after tooth extraction partially restored the number of osteoblasts. New periosteal bone formations outside of sockets showed little delay in the whole body irradiation group. These findings suggest that bone formation in the wound healing of extraction socket requires bone marrow cells from hematopoietic organs such as the bone marrow as well as local sources around the alveolar socket, during the initial phase of wound healing.
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Affiliation(s)
- Yoichiro Hosokawa
- Department of Radiological Life Sciences, Division of Medical Life sciences, Hirosaki University, Hokkaido 061-0293, Japan.
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Fenner M, Park J, Schulz N, Amann K, Grabenbauer GG, Fahrig A, Karg J, Wiltfang J, Neukam FW, Nkenke E. Validation of histologic changes induced by external irradiation in mandibular bone. An experimental animal model. J Craniomaxillofac Surg 2009; 38:47-53. [PMID: 19951841 DOI: 10.1016/j.jcms.2009.07.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Revised: 06/02/2009] [Accepted: 07/29/2009] [Indexed: 11/29/2022] Open
Abstract
The present experimental study sought to determine the effect of high-dose irradiation on the rat mandible in order to establish an experimental model of radiogenic bone damage. The left mandibles of 20 adult Wistar rats were irradiated (single fraction 1500cGy, total dose 60Gy) by means of a hypofractionated stereotactic radiotherapy (hfSRT) over a period of 6 weeks. Follow-up was 6 weeks (group 1, n=10) and 12 weeks (group 2, n=10). The contralateral mandibles as well as 5 non-irradiated animals served as controls. Primary endpoints were fibrosis, loss of cell count, decreased immunohistochemical labelling for bone morphogenetic protein-2 (BMP-2) and osteocalcin as well as increased expression of transforming growth factor (TGF-beta). Cell loss, progressive fibrosis, and focal necrosis were detected in all irradiated sites. Quantitative measurement revealed 32.0+/-8.7% and 37.3+/-9.5% empty osteocyte lacunae for groups 1 and 2 resp., compared to 16.3+/-4.7% and 18.9+/-4.9% on the contralateral side and 7.9+/-1.7% for unirradiated controls (Mann-Whitney U test; p<.01). BMP-2 and osteocalcin labelling showed a marked decrease in irradiated and contralateral sides while TGF-beta was expressed strongly in irradiated sites only (for all p<.05). External hypofractionated irradiation with a total dose of 60Gy is feasible in rats and yields all histologic changes attributed to osteoradionecrosis (ORN) after a follow-up of 6 weeks. The irradiation protocol is suitable for an assessment of regenerative options in severe radiogenic bone damage. As a split mouth design entails major inaccuracies healthy animals have to be used as controls.
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Affiliation(s)
- Matthias Fenner
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Glueckstrasse 11, 91054 Erlangen, Germany.
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Springer ING, Niehoff P, Açil Y, Marget M, Lange A, Warnke PH, Pielenz H, Roldán JC, Wiltfang J. BMP-2 and bFGF in an irradiated bone model. J Craniomaxillofac Surg 2007; 36:210-7. [PMID: 17945502 DOI: 10.1016/j.jcms.2007.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Basic fibroblast growth factor (bFGF) is considered to enhance angiogenesis and to support bone formation in the presence of vital bone cells. Bone morphogenetic protein-2 (rhBMP-2) is known to induce bone formation. The aim of this study was to analyze the effect of bFGF and rhBMP-2 in the irradiated mandible. MATERIAL AND METHODS The right mandibles of 24 rats were irradiated with a single dose of 20 Gy at a high-dose-rate (HDR) after loading machine (bio effective equivalent dose to ca. 45 x 2 Gy). After 12 weeks 100 microg rhBMP-2 (n=6 animals, group 1), 100 microg bFGF (n=6 animals, group 2) and 100 microg rhBMP-2 plus 100 microg bFGF (n=6 animals, group 3) were injected along the right mandible (left mandible: no irradiation, no growth factor). Another 6 animals (group 4) remained untreated after the irradiation. After another 7 weeks the specimens were examined by non-decalcified histology. RESULTS Bone apposition of the experimental versus control sides was not statistically significantly different when one of the growth factors was applied alone (rhBMP-2: p=0.917; bFGF: p=0.345). Average bone apposition was significantly decreased on the experimental sides of group 3 (rhBMP-2+bFGF: p=0.046) and group 4 (p=0.008). Average bone densities were unaffected in all settings (for all p>0.1). CONCLUSIONS The application of bFGF and the application of rhBMP-2 alone did result in predictable bone generation in the irradiated mandible with the bone apposition being equal to that of the non-irradiated side. The application of both growth factors together or none at all after irradiation results in significantly reduced bone apposition.
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Affiliation(s)
- Ingo N G Springer
- Department of Oral and Maxillofacial Surgery, University of Kiel, Germany.
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