Ionizing radiation and bone quality: time-dependent effects

Limirio, Pedro Henrique Justino Oliveira; Soares, Priscilla Barbosa Ferreira; Emi, Eduardo Tadashi Pinto; Rocha, Flaviana Soares; Batista, Jonas Dantas; Rabelo, Gustavo Davi; Dechichi, Paula

doi:10.1186/s13014-019-1219-y

Cited by 22 publications

(24 citation statements)

References 36 publications

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“…Some studies have shown that irradiation increases plastic deformation in bone tissue by releasing free radicals via radiolysis of water molecules, degrading collagen molecules and restricting fibrillary sliding mechanisms, 29 , 30 which affect the proper molecular arrangement for the biomineralization process to occur. 16 In addition, irradiation may affect the activity of osteoblasts in terms of normal deposition and development of hydroxyapatite crystals from the inorganic matrix. 29 , 30 The secondary effect caused by ionizing radiation is related to the implant composition, and we agree that the implant composition is decisive for the bone response.…”

Section: Discussionmentioning

confidence: 99%

“…Radiotherapy is one of the most common treatments for head and neck cancer patients, 4 , 13 and ionizing radiation can reduce bone healing capacity through the progressive fibrosis of blood vessels and soft tissue, 14 loss of osteoblast function 15 and damage to the collagen arrangement. 16 These effects can also negatively influence bone/implant integration. 5 , 10 Studies have been carried out to evaluate implant survival in previously irradiated areas, 2 , 3 , 5 but there are limited data on the effect of backscattered radiation on the osseointegration process of implants placed before ionizing radiation.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Soares

Limirio

et al. 2020

J. Appl. Oral Sci.

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Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant Objective: This study analyzed the effect of ionizing radiation on bone microarchitecture and biomechanical properties in the bone tissue surrounding a dental implant. Methodology: Twenty rabbits received three dental morse taper junction implants: one in the left tibia and two in the right tibia. The animals were randomized into two groups: the nonirradiated group (control group) and the irradiated group, which received 30 Gy in a single dose 2 weeks after the implant procedure. Four weeks after the implant procedure, the animals were sacrificed, and the implant/bone specimens were used for each experiment. The specimens (n=10) of the right tibia were examined by microcomputed tomography to measure the cortical volume (CtV, mm 3), cortical thickness (CtTh, mm) and porosity (CtPo, %). The other specimens (n=10) were examined by dynamic indentation to measure the elastic modulus (E, GPa) and Vickers hardness (VHN, N/mm 2) in the bone. The specimens of the left tibia (n=10) were subjected to pull-out tests to calculate the failure load (N), displacement (mm) up to the failure point and interface stiffness (N/mm). In the irradiated group, two measurements were performed: close, at 1 mm surrounding the implant surface, and distant, at 2.5 mm from the external limit of the first measurement. Data were analyzed using one-way ANOVA, Tukey's test and Student's t-test (α=0.05). Results: The irradiated bone closer to the implant surface had lower elastic modulus (E), Vickers hardness (VHN), Ct.Th, and Ct.V values and a higher Ct.Po value than the bone distant to the implant (P<0.04). The irradiated bone that was distant from the implant surface had lower E, VHN, and Ct.Th values and a higher Ct.Po value than the nonirradiated bone (P<0.04). The nonirradiated bone had higher failure loads, displacements and stiffness values than the irradiated bone (P<0.02). Conclusion: Ionizing radiation in dental implants resulted in negative effects on the microarchitecture and biomechanical properties of bone tissue, mainly near the surface of the implant.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Soares

Limirio

et al. 2020

J. Appl. Oral Sci.

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“…Limirio et al, [15] Ionising radiation and bone quality: time dependent effects Bartlow et al, [16] Limited field radiation therapy results in decreased bone fracture toughness in a murine model Wright et al, [17] Single-limb irradiation induces local and systemic bone loss in a murine model Barbosa et al, [18] Effect of ionising radiation after-therapy interval on bone: histomorphometry and biomechanical characteristics Oest et al, [19] Longitudinal effects of single hindlimb radiation therapy on bone strength and morphology at local and contralateral sites Sullivan et al, [20] A mouse model for skeletal structure and function changes caused by radiation therapy and oestrogen deficiency Lima et al, [21] Exposure to low-dose X-ray radiation alters bone progenitor cells and bone microarchitecture Zhai et al, [22] Influence of radiation exposure pattern on the bone injury and osteoclastogenesis in a rat model volume and microarchitecture using μCT. The right hindlimb represents the irradiation sides compared to the left hindlimb (contralateral-shielded bone) and control bone.…”

Section: Author Years Titlesmentioning

confidence: 98%

Systematic Review on Multilevel Analysis of Radiation Effects on Bone Microarchitecture

Bakar

Mohamad

Mahmud

et al. 2022

BioMed Research International

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Introduction. Modern radiation therapy has become an effective method to treat and monitor tumour growth in cancer patients. It has proved to be a successful way to minimise mortality rates. However, the adverse effects of radiation have been historical evidence in the clinical environment involving diminishing the quality and density of bone and causing fragility fracture to the bone in the long run. This systematic review was aimed at identifying and evaluating the effects of irradiation on morphology and mechanical properties of murine model bone in previous publications. Methods. A systematic literature review was undertaken following the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) guidelines. A comprehensive literature search was performed using Scopus, Web of Science, and Science Direct databases (English only studies published between 2015 and 2020). The selected studies were evaluated according to three criteria: (1) criteria for study sample selection; (2) criteria for methodological procedures; and (3) criteria for detection and evaluation. Results. The initial search strategy identified 1408 related studies, 8 of were included based on inclusion and exclusion criteria. This review revealed an association between bone destruction and the magnitude of time and dose postirradiation. We agreed that the effect of radiation on bone morphology and strength primarily is a later stage event but noticeable in both low (1 Gy) and high dose (30 Gy) radiation. Trabecular and cortical bone microstructures were significantly altered at irradiation and contralateral sites. Besides, the mechanical strength was significantly impacted in both shorter and longer periods. Conclusion. Overall, the radiotherapy altered bone microstructures and substantially decreases bone mechanical properties. The alteration was related to quantity and the activity of the osteoblast and osteoclast. Early detection of those most at risk for radiation-induced bone alterations could lead to better prophylactic intervention decisions.

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“…These injuries lead to impairment in bone repair properties that could progress to complications, such as infections, healing delay and osterradionecrosis (3). Previous publicatios from our group showed the effects of RT on cortical bone that revealed modification on the morphology of bone channels network (4), decreased anisotropy and increased bone fragility (5), also with deficity in bone quality, with decrease of stiffness, more evident in later time points after radiation (6).…”

Section: Introductionmentioning

confidence: 94%

Cortical Bone Modifications after Radiotherapy: Cortex Porosity and Osteonal Changes Evaluated Over Time

et al. 2021

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Aiming to evaluate cortical bone microarchitecture and osteonal morphology after irradiation, twelve male New Zealand rabbits were used. The animals were divided: control group (no radiation-NIr); and 3 irradiated groups, sacrificed after: 7 (Ir7d); 14 (Ir14d) and 21 (Ir21d) days. A single radiation dose of 30 Gy was used. Computed microtomography analyzed the cortical microarchitecture: cortical thickness (CtTh), bone volume (BV), total porosity (Ct.Po), intracortical porosity (CtPo-cl), channel/pore number (Po.N), fractal dimension (FD) and degree of anisotropy (Ct.DA). After scan, osteonal morphology was histologically assessed by means: area and perimeter of the osteons (O.Ar; O.p) and of the Haversian canals (C.Ar; C.p). Microtomographic analysis were performed by ANOVA, followed by Tukey and Dunnet tests. Osteon morphology analyses were performed by Kruskal-Wallis, and test Dunn’s. Cortical thickness was significant difference (p<0.010) between the NIr and irradiated groups, with thicker cortex at Ir7d (1.15±0.09). The intracortical porosity revealed significant difference (p<0.001) between irradiated groups and NIr, with lower value for Ir7d (0.29±0.09). Bone volume was lower in Ir14d compared to control. Area and perimeter of the osteons were statistically different (p<0.0001) between NIr and Ir7d. Haversian canals also revealed lower values (p<0.0001) in Ir7d (80.57±9.3; 31.63±6.5) compared to NIr and irradiated groups. Cortical microarchitecture was affected by radiation, and the effects appear to be time-dependent, mostly regarding the osteons morphology at the initial days. Cortex structure in Ir21d revealed similarities to control suggesting that microarchitecture resembles normal condition after a period.

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Ionizing radiation and bone quality: time-dependent effects

Cited by 22 publications

References 36 publications

Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant

Systematic Review on Multilevel Analysis of Radiation Effects on Bone Microarchitecture

Cortical Bone Modifications after Radiotherapy: Cortex Porosity and Osteonal Changes Evaluated Over Time

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