El papel del tiempo de irradiación local en el proceso de osteointegración en implantes
DOI:
https://doi.org/10.33448/rsd-v11i8.29923Palabras clave:
Osteointegración; Radioterapia; Inmunohistoquímica; Torsíon.Resumen
Propósito: El objetivo de este estudio fue evaluar los efectos de la radiación Gamma mediante la simulación de una dosis total de radioterapia convencional para el cáncer de cabeza y cuello en la remodelación ósea y la osteointegración de implantes en fémures de ratas.Materiales y Métodos: Sesenta ratas recibieron implantes roscados de titanio (Ti6Al4V) en ambos fémures. Los animales se dividieron: Sin Irradiación (N-Ir): grupo N-Ir con implante solo, Irradiación Temprana (E-Ir): implante + irradiación después de 24 h; Irradiación tardía (L-Ir): implante + irradiación después de 4 semanas e Irradiación previa (P-Ir): irradiación + implante después de 4 semanas. La irradiación se fraccionó en dos sesiones de 15 Gy cada una, totalizando 30 Gy. Los animales fueron sacrificados a los 3 días, 2 y 7 semanas después del tratamiento. Se utilizaron marcadores inmunohistoquímicos Runx2 y tinción roja de Picrosirius, análisis histomorfométrico (BIC y BAFO) y prueba de torsión inversa para evaluar la interfaz implante/hueso y el hueso circundante. Los datos de Runx-2 (%), tinción roja de picrosirius (%), BIC y BAFO (%) y torque inverso (N/cm) se sometieron a las pruebas de ANOVA y Tukey para la comparación entre grupos, ambas con α=0,05. Resultados: Los resultados mostraron que la expresión de Runx-2 fue diferente en los grupos irradiados en comparación con el grupo N-Ir. En general, los análisis de fibra de colágeno en los grupos irradiados diferían del grupo N-Ir. Con respecto a BIC, BAFO y la prueba de torsión inversa, el grupo L-Ir mostró resultados similares al grupo N-Ir, mientras que los otros grupos se vieron afectados por la radioterapia.Conclusiones: Las radiaciones ionizantes afectan negativamente al remodelado óseo, y su efecto depende del momento de aplicación de la radioterapia, con un retraso de la osteointegración cuando se aplica de forma previa o próxima a la cirugía.
Citas
Adelstein, D. J., Li, Y., Adams, G. L., Wagner, H., Jr, Kish, J. A., Ensley, J. F., Schuller, D. E., & Forastiere, A. A. (2003). An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, 21(1), 92–98. https://doi.org/10.1200/JCO.2003.01.008
Alberga, J. M., Korfage, A., Bonnema, I., Witjes, M., Vissink, A., & Raghoebar, G. M. (2020). Mandibular dental implant placement immediately after teeth removal in head and neck cancer patients. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 28(12), 5911–5918. https://doi.org/10.1007/s00520-020-05431-y. (a)
Alberga, J. M., Vosselman, N., Korfage, A., Delli, K., Witjes, M., Raghoebar, G. M., & Vissink, A. (2021). What is the optimal timing for implant placement in oral cancer patients? A scoping literature review. Oral diseases, 27(1), 94–110. https://doi.org/10.1111/odi.13312.(b)
Aline, D., Laura, B., Stephan, L., Jean-Christophe, B., & Anne-Gaëlle, C. (2020). Assessment of irradiated socket healing in the rabbit's mandible: Experimental study. Research in veterinary science, 133, 226–231. https://doi.org/10.1016/j.rvsc.2020.09.021
Brasseur, M., Brogniez, V., Grégoire, V., Reychler, H., Lengelé, B., D'Hoore, W., & Nyssen-Behets, C. (2006). Effects of irradiation on bone remodelling around mandibular implants: an experimental study in dogs. International journal of oral and maxillofacial surgery, 35(9), 850–855. https://doi.org/10.1016/j.ijom.2006.03.016
Brogniez, V., Nyssen-Behets, C., Grégoire, V., Reychler, H., & Lengelé, B. (2002). Implant osseointegration in the irradiated mandible. A comparative study in dogs with a microradiographic and histologic assessment. Clinical oral implants research, 13(3), 234–242. https://doi.org/10.1034/j.1600-0501.2002.130302.x
Brogniez, V., D'Hoore, W., Grégoire, V., Munting, E., & Reychler, H. (2000). Implants placed in an irradiated dog mandible: a morphometric analysis. The International journal of oral & maxillofacial implants, 15(4), 511–518. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/10960984/
Chambrone, L., Mandia, J., Jr, Shibli, J. A., Romito, G. A., & Abrahao, M. (2013). Dental implants installed in irradiated jaws: a systematic review. Journal of dental research, 92(12 Suppl), 119S–30S. https://doi.org/10.1177/0022034513504947
Cunha, S. S. D., Sarmento, V. A., Ramalho, L. M. P., Freitas, A. C. de, Almeida, D. de, Tavares, M. E., & Costa, N. P. da. (2007). Efeitos da radioterapia no tecido ósseo. Radiologia Brasileira, 40(3), 189–192. 10.1590/s0100-39842007000300011
Claudy, M. P., Miguens, S. A., Jr, Celeste, R. K., Camara Parente, R., Hernandez, P. A., & da Silva, A. N., Jr (2015). Time interval after radiotherapy and dental implant failure: systematic review of observational studies and meta-analysis. Clinical implant dentistry and related research, 17(2), 402–411. https://doi.org/10.1111/cid.12096
da Cruz Vegian, M. R., Costa, B., de Fátima Santana-Melo, G., Godoi, F., Kaminagakura, E., Tango, R. N., do Prado, R. F., de Oliveira, L. D., Federico, C. A., de Oliveira Marco Avelino, S., Neves, R. M., & de Vasconcellos, L. (2020). Systemic and local effects of radiotherapy: an experimental study on implants placed in rats. Clinical oral investigations, 24(2), 785–797. https://doi.org/10.1007/s00784-019-02946-5
de Vasconcellos, L. M., Barbara, M. A., Deco, C. P., Junqueira, J. C., do Prado, R. F., Anbinder, A. L., de Vasconcellos, L. G., Cairo, C. A., & Carvalho, Y. R. (2014). Healing of normal and osteopenic bone with titanium implant and low-level laser therapy (GaAlAs): a histomorphometric study in rats. Lasers in medical science, 29(2), 575–580. https://doi.org/10.1007/s10103-013-1326-1
Dholam, K. P., Chouksey, G. C., & Dugad, J. (2016). Oral health-related quality of life after prosthetic rehabilitation in patients with oral cancer: A longitudinal study with the Liverpool Oral Rehabilitation Questionnaire version 3 and Oral Health Impact Profile-14 questionnaire. Indian journal of cancer, 53(2), 256–260. https://doi.org/10.4103/0019-509X.197716
Doh, R. M., Kim, S., Keum, K. C., Kim, J. W., Shim, J. S., Jung, H. S., Park, K. M., & Chung, M. K. (2016). Postoperative irradiation after implant placement: A pilot study for prosthetic reconstruction. The journal of advanced prosthodontics, 8(5), 363–371. https://doi.org/10.4047/jap.2016.8.5.363
Dos Santos, P. L., de Molon, R. S., Queiroz, T. P., Okamoto, R., de Souza Faloni, A. P., Gulinelli, J. L., Luvizuto, E. R., & Garcia, I. R., Jr (2016). Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia. Journal of periodontal & implant science, 46(3), 176–196. https://doi.org/10.5051/jpis.2016.46.3.176
Dos Santos, P. L., Queiroz, T. P., Margonar, R, Gomes de Souza Carvalho, A. C., Okamoto. R., de Souza Faloni, A. P., & Garcia Júnior, I. R (2013) Guided implant surgery: what is the influence of this new technique on bone cell viability? J Oral Maxillofac Surg 71:505–512. https://doi.org/10.1016/j.joms.2012.10.017
Esteves, J. C., Marcantonio, E., Jr, de Souza Faloni, A. P., Rocha, F. R., Marcantonio, R. A., Wilk, K., & Intini, G. (2013). Dynamics of bone healing after osteotomy with piezosurgery or conventional drilling - histomorphometrical, immunohistochemical, and molecular analysis. Journal of translational medicine, 11, 221. https://doi.org/10.1186/1479-5876-11-221
Fenlon, M. R., Lyons, A., Farrell, S., Bavisha, K., Banerjee, A., & Palmer, R. M. (2012). Factors affecting survival and usefulness of implants placed in vascularized free composite grafts used in post-head and neck cancer reconstruction. Clinical implant dentistry and related research, 14(2), 266–272. https://doi.org/10.1111/j.1708-8208.2009.00250.x
Fareen, H. F., Ashok, V., Rengalakshmi, S., & Subhashree, R. (2021). Dental Implants in Maxillary Anteriors for Young Adults: A Retrospective Study. Journal of long-term effects of medical implants, 31(4), 27–31. https://doi.org/10.1615/JLongTermEffMedImplants.2021038554
Flores-Ruiz, R., Castellanos-Cosano, L., Serrera-Figallo, M. A., Cano-Díaz, E., Torres-Lagares, D., & Gutiérrez-Pérez, J. L. (2018). Implant survival in patients with oral cancer: A 5-year follow-up. Journal of clinical and experimental dentistry, 10(6), e603–e609. https://doi.org/10.4317/jced.54937
Globocan. (2020). Proportions. https://gco.iarc.fr/today/online-analysis
Granstrom, G., Bergstrom, K., Tjellström, A., & Brånemark, P. I. (1994). A detailed study of titanium fixture implants lost in irradiated tissues. Int J Oral Maxillofac Implants 9:653-662.
Granstrom, G. (2003). Radiotherapy, osseointegration and hyperbaric oxygen therapy. Periodontol 2000 33:145-162.
Green, D. E., & Rubin, C. T. (2014). Consequences of irradiation on bone and marrow phenotypes, and its relation to disruption of hematopoietic precursors. Bone, 63, 87–94. https://doi.org/10.1016/j.bone.2014.02.018
Hubenak, J. R., Zhang, Q., Branch, C. D., & Kronowitz, S. J. (2014). Mechanisms of injury to normal tissue after radiotherapy: a review. Plastic and reconstructive surgery, 133(1), 49e–56e. https://doi.org/10.1097/01.prs.0000440818.23647.0b
Ihde, S., Kopp, S., Gundlach, K., & Konstantinović, V. S. (2009). Effects of radiation therapy on craniofacial and dental implants: a review of the literature. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 107(1), 56–65. https://doi.org/10.1016/j.tripleo.2008.06.014
Lucatto, S. C., Guilherme, A., Dib, L. L., Segreto, H. R., Alves, M. T., Gumieiro, E. H., Jahn, R. S., & Leite, R. A. (2011). Effects of ionizing radiation on bone neoformation: histometric study in Wistar rats tibiae. Acta cirurgica brasileira, 26(6), 475–480. https://doi.org/10.1590/s0102-86502011000600012
Lyons, A., & Ghazali, N. (2008). Osteoradionecrosis of the jaws: current understanding of its pathophysiology and treatment. The British journal of oral & maxillofacial surgery, 46(8), 653–660. https://doi.org/10.1016/j.bjoms.2008.04.006
Mancha de la Plata, M., Gías, L. N., Díez, P. M., Muñoz-Guerra, M., González-García, R., Lee, G. Y., Castrejón-Castrejón, S., & Rodríguez-Campo, F. J. (2012). Osseointegrated implant rehabilitation of irradiated oral cancer patients. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 70(5), 1052–1063. https://doi.org/10.1016/j.joms.2011.03.032
Marx, R. E., & Morales, M. J. (1998). The use of implants in the reconstruction of oral cancer patients. Dental clinics of North America, 42(1), 177–202.
Nelson, K., Heberer, S., & Glatzer, C. (2007). Survival analysis and clinical evaluation of implant-retained prostheses in oral cancer resection patients over a mean follow-up period of 10 years. The Journal of prosthetic dentistry, 98(5), 405–410. https://doi.org/10.1016/S0022-3913(07)60125-5
Niimi, A., Ueda, M., Keller, E. E., & Worthington, P. (1998). Experience with osseointegrated implants placed in irradiated tissues in Japan and the United States. The International journal of oral & maxillofacial implants, 13(3), 407–411.
Nunes, C. M. M., Ferreira, C. L., Bernardo, D. V., Lopes, C. C. R., Collino, L., da Silva Lima, V. C., & Jardini, M. A. N. (2020). Evaluation of pulsed electromagnetic field protocols in implant osseointegration: in vivo and in vitro study. Clinical Oral Investigations, 25(5), 2925–2937. doi:10.1007/s00784-020-03612-x
Smith Nobrega, A., Santiago, J. F., Jr, de Faria Almeida, D. A., Dos Santos, D. M., Pellizzer, E. P., & Goiato, M. C. (2016). Irradiated patients and survival rate of dental implants: A systematic review and meta-analysis. The Journal of prosthetic dentistry, 116(6), 858–866. https://doi.org/10.1016/j.prosdent.2016.04.025.
Nooh, N. (2013). Dental implant survival in irradiated oral cancer patients: a systematic review of the literature. The International journal of oral & maxillofacial implants, 28(5), 1233–1242. https://doi.org/10.11607/jomi.3045
Ocaña, R. P., Rabelo, G. D., Sassi, L. M., Rodrigues, V. P., & Alves, F. A. (2017). Implant osseointegration in irradiated bone: an experimental study. Journal of periodontal research, 52(3), 505–511. https://doi.org/10.1111/jre.12416
Ohrnell, L. O., Brånemark, R., Nyman, J., Nilsson, P., & Thomsen, P. (1997). Effects of irradiation on the biomechanics of osseointegration. An experimental in vivo study in rats. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 31(4), 281–293. https://doi.org/10.3109/02844319709008974
Oliveira, J. A., do Amaral Escada, A. L., Alves Rezende, M. C., Mathor, M. B., & Alves Claro, A. P. (2012). Analysis of the effects of irradiation in osseointegrated dental implants. Clinical oral implants research, 23(4), 511–514. https://doi.org/10.1111/j.1600-0501.2010.02149.x
Pace-Balzan, A., Shaw, R. J., & Butterworth, C. (2011). Oral rehabilitation following treatment for oral cancer. Periodontology 2000, 57(1), 102–117. https://doi.org/10.1111/j.1600-0757.2011.00384.x
Percie du Sert, N., Hurst, V., Ahluwalia, A., Alam, S., Avey, M. T., Baker, M., Browne, W. J., Clark, A., Cuthill, I. C., Dirnagl, U., Emerson, M., Garner, P., Holgate, S. T., Howells, D. W., Karp, N. A., Lazic, S. E., Lidster, K., MacCallum, C. J., Macleod, M., Pearl, E. J., & Würbel, H. (2020). The ARRIVE guidelines 2.0: Updated guidelines for reporting animal research. PLoS biology, 18(7), e3000410. https://doi.org/10.1371/journal.pbio.3000410.
Queiroz, T. P., Souza, F. A., Okamoto, R., Margonar, R., Pereira-Filho, V. A., Garcia Júnior, I. R., & Vieira, E. H. (2008). Evaluation of immediate bone-cell viability and of drill wear after implant osteotomies: immunohistochemistry and scanning electron microscopy analysis. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons, 66(6), 1233–1240. https://doi.org/10.1016/j.joms.2007.12.037
Quinn, R. (2005). Comparing rat's to human's age: how old is my rat in people years?. Nutrition (Burbank, Los Angeles County, Calif.), 21(6), 775–777. https://doi.org/10.1016/j.nut.2005.04.002
Quispe, R. A., Cremonesi, A. L., Gonçalves, J. K., Rubira, C., & Santos, P. (2018). Case-control study of oral disease indexes in individuals with head and neck cancer after antineoplastic therapy. Einstein (Sao Paulo, Brazil), 16(3), eAO4245. https://doi.org/10.1590/S1679-45082018AO4245
Schoen, P. J., Raghoebar, G. M., Bouma, J., Reintsema, H., Vissink, A., Sterk, W., & Roodenburg, J. L. (2007). Rehabilitation of oral function in head and neck cancer patients after radiotherapy with implant-retained dentures: effects of hyperbaric oxygen therapy. Oral oncology, 43(4), 379–388. https://doi.org/10.1016/j.oraloncology.2006.04.009
Shugaa-Addin, B., Al-Shamiri, H. M., Al-Maweri, S., & Tarakji, B. (2016). The effect of radiotherapy on survival of dental implants in head and neck cancer patients. Journal of clinical and experimental dentistry, 8(2), e194–e200. https://doi.org/10.4317/jced.52346.
Sroussi, H. Y., Epstein, J. B., Bensadoun, R. J., Saunders, D. P., Lalla, R. V., Migliorati, C. A., Heaivilin, N., & Zumsteg, Z. S. (2017). Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer medicine, 6(12), 2918–2931. https://doi.org/10.1002/cam4.1221
Soares, P., Soares, C. J., Limirio, P., Lara, V. C., Moura, C., & Zanetta-Barbosa, D. (2020). Biomechanical and morphological changes produced by ionizing radiation on bone tissue surrounding dental implant. Journal of applied oral science: revista FOB, 28, e20200191. https://doi.org/10.1590/1678-7757-2020-0191
Tang, W., Li, Y., Osimiri, L., & Zhang, C. (2011). Osteoblast-specific transcription factor Osterix (Osx) is an upstream regulator of Satb2 during bone formation. The Journal of biological chemistry, 286(38), 32995–33002. https://doi.org/10.1074/jbc.M111.244236
Toneatti, D. J., Graf, R. R., Burkhard, J. P., & Schaller, B. (2021). Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis. Clinical oral investigations, 25(10), 5579–5593. https://doi.org/10.1007/s00784-021-04065-6
Vasconcellos, L. M., Oliveira, M. V., Graça, M. L., Vasconcellos, L. G., Cairo, C. A., & Carvalho, Y. R. (2008). Design of dental implants, influence on the osteogenesis and fixation. Journal of materials science. Materials in medicine, 19(8), 2851–2857. https://doi.org/10.1007/s10856-008-3421-6
Verdonck, H. W., Meijer, G. J., Nieman, F. H., Stoll, C., Riediger, D., & de Baat, C. (2008). Quantitative computed tomography bone mineral density measurements in irradiated and non-irradiated minipig alveolar bone: an experimental study. Clinical oral implants research, 19(5), 465–468. https://doi.org/10.1111/j.1600-0501.2007.01496.x
Verdonck, H. W., Meijer, G. J., Laurin, T., Nieman, F. H., Stoll, C., Riediger, D., Stoelinga, P. J., & de Baat, C. (2008). Implant stability during osseointegration in irradiated and non-irradiated minipig alveolar bone: an experimental study. Clinical oral implants research, 19(2), 201–206. https://doi.org/10.1111/j.1600-0501.2007.01457.x
Vissink, A., Jansma, J., Spijkervet, F. K., Burlage, F. R., & Coppes, R. P. (2003). Oral sequelae of head and neck radiotherapy. Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists, 14(3), 199–212. https://doi.org/10.1177/154411130301400305
Vosselman, N., Alberga, J., Witjes, M., Raghoebar, G. M., Reintsema, H., Vissink, A., & Korfage, A. (2021). Prosthodontic rehabilitation of head and neck cancer patients-Challenges and new developments. Oral diseases, 27(1), 64–72. https://doi.org/10.1111/odi.13374
Wagner, W., Esser, E., & Ostkamp, K. (1998). Osseointegration of dental implants in patients with and without radiotherapy. Acta oncologica (Stockholm, Sweden), 37(7-8), 693–696. https://doi.org/10.1080/028418698430061
Wetzels, J., Meijer, G. J., Koole, R., Adang, E. M., Merkx, M., & Speksnijder, C. M. (2017). Costs and clinical outcomes of implant placement during ablative surgery and postponed implant placement in curative oral oncology: a five-year retrospective cohort study. Clinical oral implants research, 28(11), 1433–1442. https://doi.org/10.1111/clr.13008
Williams, H. J., & Davies, A. M. (2006). The effect of X-rays on bone: a pictorial review. European radiology, 16(3), 619–633. https://doi.org/10.1007/s00330-005-0010-7
Woods, B., Schenberg, M., & Chandu, A. (2019). A Comparison of Immediate and Delayed Dental Implant Placement in Head and Neck Surgery Patients. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 77(6), 1156–1164. https://doi.org/10.1016/j.joms.2019.02.007
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2022 Luana Marotta Reis de Vasconcellos; Leonardo Silva Gomes Kamezawa; Bruno César Almeida Costa; Ana Luisa Theodoro; Camila Duarte da Silva; Estela Kaminagakura Tango; Leonardo Alvares Sobral Silva; Claudio Antonio Federico; Rubens Nisie Tango
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los autores que publican en esta revista concuerdan con los siguientes términos:
1) Los autores mantienen los derechos de autor y conceden a la revista el derecho de primera publicación, con el trabajo simultáneamente licenciado bajo la Licencia Creative Commons Attribution que permite el compartir el trabajo con reconocimiento de la autoría y publicación inicial en esta revista.
2) Los autores tienen autorización para asumir contratos adicionales por separado, para distribución no exclusiva de la versión del trabajo publicada en esta revista (por ejemplo, publicar en repositorio institucional o como capítulo de libro), con reconocimiento de autoría y publicación inicial en esta revista.
3) Los autores tienen permiso y son estimulados a publicar y distribuir su trabajo en línea (por ejemplo, en repositorios institucionales o en su página personal) a cualquier punto antes o durante el proceso editorial, ya que esto puede generar cambios productivos, así como aumentar el impacto y la cita del trabajo publicado.
