title: Micromorphology of the dental pulp is highly preserved in cancer patients who underwent head and neck radiotherapy.
abstract: BACKGROUND
  Teeth are often included in the radiation field during head and neck radiotherapy, and recent clinical evidence suggests that dental pulp is negatively affected by the direct effects of radiation, leading to impaired sensitivity of the dental pulp. Therefore, this study aimed to investigate the direct effects of radiation on the microvasculature, innervation, and extracellular matrix of the dental pulp of patients who have undergone head and neck radiotherapy.
  
  
  METHODS
  Twenty-three samples of dental pulp from patients who finished head and neck radiotherapy were analyzed. Samples were histologically processed and stained with hematoxylin-eosin for morphologic evaluation of the microvasculature, innervation, and extracellular matrix. Subsequently, immunohistochemical analysis of proteins related to vascularization (CD34 and smooth muscle actin), innervation (S-100, NCAM/CD56, and neurofilament), and extracellular matrix (vimentin) of the dental pulp was performed.
  
  
  RESULTS
  The morphologic study identified preservation of the microvasculature, nerve bundles, and components of the extracellular matrix in all studied samples. The immunohistochemical analysis confirmed the morphologic findings and showed a normal pattern of expression for the studied proteins in all samples.
  
  
  CONCLUSIONS
  Direct effects of radiotherapy are not able to generate morphologic changes in the microvasculature, innervation, and extracellular matrix components of the dental pulp in head and neck cancer patients.
authors.affiliation: Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil.
authors.forename: Karina Morais
authors.initials: KM
authors.lastname: Faria
authors.affiliation: Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Thais Bianca
authors.initials: TB
authors.lastname: Brandão
authors.affiliation: Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Ana Carolina Prado
authors.initials: AC
authors.lastname: Ribeiro
authors.affiliation: Dental Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Adriele Ferreira Gouvêa
authors.initials: AF
authors.lastname: Vasconcellos
authors.affiliation: Radiotherapy Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Icaro Thiago
authors.initials: IT
authors.lastname: de Carvalho
authors.affiliation: Radiotherapy Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Fernando Freire
authors.initials: FF
authors.lastname: de Arruda
authors.affiliation: Clinical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Castro Junior
authors.affiliation: Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil.
authors.forename: Vanessa Cristina
authors.initials: VC
authors.lastname: Gross
authors.affiliation: Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil.
authors.forename: Oslei Paes
authors.initials: OP
authors.lastname: Almeida
authors.affiliation: Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil.
authors.forename: Marcio Ajudarte
authors.initials: MA
authors.lastname: Lopes
authors.affiliation: Oral Diagnosis Department, Semiology and Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil. Electronic address: alanroger@fop.unicamp.br.
authors.forename: Alan Roger
authors.initials: AR
authors.lastname: Santos-Silva
mesh_terms: D000199:Actins / Q000032:analysis; D000293:Adolescent; D000328:Adult; D018952:Antigens, CD34 / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D004396:Coloring Agents; D003731:Dental Caries / Q000209:etiology; D003743:Dental Enamel / Q000528:radiation effects; D003782:Dental Pulp / Q000098:blood supply / Q000166:cytology / Q000294:innervation / Q000528:radiation effects*; D003804:Dentin / Q000528:radiation effects; D005109:Extracellular Matrix / Q000528:radiation effects; D005260:Female; D005347:Fibroblasts / Q000528:radiation effects; D005456:Fluorescent Dyes; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007382:Intermediate Filaments / Q000737:chemistry; D008297:Male; D055806:Microvessels / Q000528:radiation effects; D008875:Middle Aged; D009412:Nerve Fibers / Q000528:radiation effects; D019006:Neural Cell Adhesion Molecules / Q000032:analysis; D011879:Radiotherapy Dosage; D009418:S100 Proteins / Q000032:analysis; D014746:Vimentin / Q000032:analysis
chemical_list: D000199:Actins; D018952:Antigens, CD34; D019002:CD56 Antigen; D004396:Coloring Agents; D005456:Fluorescent Dyes; C522918:NCAM1 protein, human; D019006:Neural Cell Adhesion Molecules; D009418:S100 Proteins; D014746:Vimentin
keywords: Cancer; dental pulp; radiation caries; radiotherapy; side effects