The results pointed towards the irradiation-induced bone changes in the canine mandible and the long-term changes in human mandibular bone after radiotherapy. The main conclusions of the present study were:
1. Microscopic and cellular changes around dental implants in the irradiated mandible were demonstrated in the canine models.
Bone-to-implant contact (BIC) percentage, the diameter of the Haversian canal, and the number of veins within the lamellar bone were decreased in the irradiated bone. Despite the alterations in the irradiated bone microstructure, optimal osseointegration with stable implants provided a basis for future clinical studies.
2. Biochemical compositional changes such as the increase in carbonate, carbonate substitution and decrease in phosphate mineral and mineral-to-matrix ratio were observed in the irradiated human cortical bone. Such changes can affect bone quality,
mechanical competence and increase the risk of implant failure or fracture in the long term.
3. The Haversian system that plays a vital role in bone homeostasis is disturbed in the irradiated mandible. The diameter and number of osteons, Haversian canals are decreased, affecting the cortical structure. The osteocytes and their dendrites are reduced in the irradiated and ORN bone, affecting the LCN. These underlying structural and cellular changes can contribute to radiation-induced bone damage or to the pathogenesis of ORN, years after
radiotherapy.
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