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Radiation Biology

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Siddhesh Kokane
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3 views47 pages

Radiation Biology

Uploaded by

Siddhesh Kokane
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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RADIATION

BIOLOGY
DR. SUNIL S. MISHRA
Professor & Head
Oral Medicine and Radiology
Learning Objectives

• By the end of the session the 3rd year BDS students shall be able to-
• Define radiation biology

• Understand the direct and indirect effect of radiation on living systems

• Differentiate between stochastic and deterministic effects of radiation

• Enumerate the different cells according to their radiosensitivity

• Understand the rationale of radiotherapy

• Enumerate the radiation effects on oral tissues


Definition
Radiobiology is the study of the effects of
ionizing radiation on living systems
photon
e-
p+

Initial interaction – Changes at molecular level Changes at cellular level Permanent change in organism
10-13 secs (Secs to hours) (hours) (decades-generations)

CHANGE

Injury Death
Radiation Chemistry

Direct effect Indirect effect


4 4
nm nm
H2O X-ray
X-ray
.
RH + H → R + H2
.
RH + OH → R
RH + X-ray → R + H+ + e- + H2O
2 2
nm nm
Indirect effect

H2O X-ray

H
. OH
.

Radiolysis
of Water

HO
. .
(+HO ) → H O + O2
2 2 2 2
Indirect effect

4 nm

H2O X-ray

H
. OH
.

RH RH
.
R +H .
2 R +H O 2

2 nm
Radiation Chemistry

Direct effect Indirect effect


4 4
nm nm
H2O X-ray
X-ray
.
RH + H → R + H2
.
RH + OH → R
RH + X-ray → R + H+ + e- + H2O
2 2
nm nm
Radiation Chemistry
.
RH + H → R + H2
RH + X-ray → R + H+ + e- .
RH + OH → R + H2O

Dissociation: R → X + Y .

.
Cross-Linking: R + S → RS
CHANGES IN DEOXYRIBONUCLEIC ACID (DNA)
4 nm

Cell death

X-ray Genetic Mutation

Carcinogenesis
2 nm
CHANGES IN DEOXYRIBONUCLEIC ACID (DNA)

4 nm

2 nm
Radiotherapy in
the Oral Cavity
RADIATION EFFECT ON ORAL TISSUES

• Oral Mucous Membrane


• Taste Buds
• Salivary Glands
• Teeth
• Radiation Caries
• Bone
RADIATION CARIES
EFFECTS ON BONE
OSTEORADIONECROSIS

• Osteoradionecrosis refers to an inflammatory condition of bone (osteomyelitis) that occurs


after the bone has been exposed to therapeutic doses of radiation usually given for a
malignancy of the head and neck region.

• It is characterized by the presence of exposed bone for a period of at least 3 months


occurring at any time after the delivery of the radiation therapy.

• Doses above 50 Gy usually are required to cause this irreversible damage. Bone that has
been irradiated is hypocellular and hypovascular.

• The lack of sufficient vascularity results in a hypoxic environment in which adequate


healing of bone is compromised.
OSTEORADIONECROSIS

• Although infection may be a contributing factor, it is not necessarily the primary insult after
the radiation damage has occurred.

• In many cases dental extraction and denture trauma after radiation therapy have been
implicated as etiologic factors.

• Secondary infection is common, further fomenting the inflammatory reaction.

• Because of the difficulty of management, this serious complication of radiation therapy


carries a high morbidity rate.
Clinical Features
• The mandible is much more commonly affected than the maxilla is. This is

likely due to the microanatomy and comparatively less vasculature of this

bone.

• The posterior mandible is affected more often than the anterior portion. The

posterior body of the mandible is more frequently in the direct field of the

radiation treatment because primary tumors and metastatic lesions in lymph

nodes being treated are commonly adjacent to this part of the mandible.
Clinical Features
• Loss of mucosal covering and exposure of bone is
the hallmark of osteoradionecrosis.

• The exposed bone becomes necrotic as a result of loss


of vascularity from the periosteum and subsequently
sequestrates, often leading to exposure of more bone.

• Pain may or may not be present. Intense pain may


occur, with intermittent swelling and drainage extraorally.
However, many patients feel no pain with bone
exposure.

• Pathologic fracture also may occur.


THANK YOU

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