Micromorphology of the dental pulp is highly preserved in cancer patients who underwent head and neck radiotherapy

J Endod. 2014 Oct;40(10):1553-9. doi: 10.1016/j.joen.2014.07.006. Epub 2014 Aug 20.

Abstract

Introduction: 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.

Keywords: Cancer; dental pulp; radiation caries; radiotherapy; side effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Actins / analysis
  • Adolescent
  • Adult
  • Antigens, CD34 / analysis
  • CD56 Antigen / analysis
  • Coloring Agents
  • Dental Caries / etiology
  • Dental Enamel / radiation effects
  • Dental Pulp / blood supply
  • Dental Pulp / cytology
  • Dental Pulp / innervation
  • Dental Pulp / radiation effects*
  • Dentin / radiation effects
  • Extracellular Matrix / radiation effects
  • Female
  • Fibroblasts / radiation effects
  • Fluorescent Dyes
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Intermediate Filaments / chemistry
  • Male
  • Microvessels / radiation effects
  • Middle Aged
  • Nerve Fibers / radiation effects
  • Neural Cell Adhesion Molecules / analysis
  • Radiotherapy Dosage
  • S100 Proteins / analysis
  • Vimentin / analysis

Substances

  • Actins
  • Antigens, CD34
  • CD56 Antigen
  • Coloring Agents
  • Fluorescent Dyes
  • NCAM1 protein, human
  • Neural Cell Adhesion Molecules
  • S100 Proteins
  • Vimentin