Radiation Effects in the Lower Jaw
Dentist Hannah Dekker conducted research on the effects of radiation in the lower jaw. People with oral cancer often undergo radiation therapy. Radiation helps to kill cancer cells, but it can also cause problems. For example, it can damage the bone in the jaw. Sometimes, irradiated bone dies. The bone then no longer contains living cells, causing it to be exposed in the mouth and become inflamed. This condition is called osteoradionecrosis (ORN). It occurs more frequently in the lower jaw than in the upper jaw. We do not yet fully understand why this happens.
Bone Formation and Breakdown
Dekker examined the bone of irradiated patients. This bone was available after the placement of implants in the lower jaw. Dekker observed various changes in the irradiated bone. For instance, there were fewer cells that build and break down bone. There were also fewer blood vessels, especially fewer small blood vessels. Additionally, there were more fat cells in the bone marrow. This indicates that the stem cells have changed their function.
Bone Cells After Radiation
Some of these changes are related to the amount of radiation. We believe that ORN develops because the different bone cells 'communicate' differently with each other after radiation. As a result, the bone becomes brittle and less able to heal. This increases the risk of infection and necrosis, especially if the surrounding tissue is also damaged. This new knowledge helps us better understand ORN and may assist us in finding better ways to prevent and treat ORN.
More information on the thesis