title: Histopathologic and Histomorphometric Analysis of Irradiation Injury in Bone and the Surrounding Soft Tissues of the Jaws.
abstract: OBJECTIVE
  Surgery of irradiated tissue has an increased complication rate because of the development of hypovascular, hypocellular, and hypoxic tissue. This study was undertaken to perform histopathologic and histomorphometric analyses of irradiation tissue injury in bone and the surrounding soft tissues.
  
  
  METHODS
  The histopathologic findings of 40 human mandibular bones and the surrounding soft tissue specimens obtained from different patients who underwent surgical procedures for treatment of osteoradionecrosis of the jaws were reviewed.
  
  
  RESULTS
  Histopathologic examination showed 7 processes in the following order of appearance: hyperemia, endarteritis, thrombosis, cell loss, hypovascularity, increase of fat in the bone marrow cavity, and fibrosis. Histomorphometric analysis showed significant hypocellularity (P = .007), hypovascularity (P < .001), and fibrosis (P < .001) in irradiated specimens compared with control specimens.
  
  
  CONCLUSIONS
  These results showed that radiation injuries affect the bone and surrounding soft tissues. However, the irradiation-induced injuries, such as cellular loss (hypocellularity) and fibrosis, were more expressive in bone tissue than in the surrounding soft tissues.
authors.affiliation: Chair, Department of Stomatology, Hospital Santa Catarina, São Paulo, Brazil; Professor, Department of Oral Surgery, University Sagrado Coração, Bauru, Brazil.
authors.forename: Marcos Martins
authors.initials: MM
authors.lastname: Curi
authors.affiliation: Professor, Department of Oral Surgery, University Sagrado Coração, Bauru, Brazil.
authors.forename: Camila Lopes
authors.initials: CL
authors.lastname: Cardoso
authors.affiliation: PhD Student, Department of Oral Medicine, Area of Pathology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil. Electronic address: heliton.lima@usp.br.
authors.forename: Heliton Gustavo
authors.initials: HG
authors.lastname: de Lima
authors.affiliation: Chair, Department of Head and Neck Surgery and Otorhinolaryngology, Cancer Hospital A.C. Camargo, São Paulo, Brazil.
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.affiliation: Professor, Department of Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Manoela Domingues
authors.initials: MD
authors.lastname: Martins
mesh_terms: D000273:Adipose Tissue / Q000528:radiation effects; D018952:Antigens, CD34 / Q000032:analysis; D001853:Bone Marrow / Q000528:radiation effects; D016923:Cell Death / Q000528:radiation effects; D004692:Endarteritis / Q000473:pathology; D004730:Endothelium, Vascular / Q000528:radiation effects; D005355:Fibrosis; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D006940:Hyperemia / Q000473:pathology; D008336:Mandibular Diseases / Q000473:pathology*; D055806:Microvessels / Q000528:radiation effects; D010025:Osteoradionecrosis / Q000473:pathology*; D010519:Periodontium / Q000528:radiation effects*; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000379:methods; D013927:Thrombosis / Q000473:pathology
chemical_list: D018952:Antigens, CD34