Page 108 - Effects of radiotherapy and hyperbaric oxygen therapy on oral microcirculation Renee Helmers

Chapter 5
in mean buccal FCD was found between control subjects (20±5 cpll/mm2) and irradiated buccal mucosa (19±7 cpll/mm2). MFI was 3 (continuous blood flow present) for both buccal and gingival microcirculation in both groups.
Table 3. Summary of focus depth (Fd) and microcirculation measurement for both control and irradiated tissue (RT). Data is presented in means±SD.
Buccal mucosa
Control
RT
Mandibular gingiva
Control RT
[μm] 197
[cpll/mm2] 20
[AU] 3 ±03 ±03 ±03 ±0 [μm] 14 ± 1 16 ± 3*
MFI microvascular flow index, TCD total capillary density, Øbv blood vessel diameter *p<0.001 vs control.
DISCUSSION
The purpose of this study was to examine the feasibility of a chairside approach in detecting and measuring late microvascular irradiation pathology in the oral mucosa of HNCP. Differences in microcirculatory parameters, such as capillary density and Øbv, between healthy and irradiated tissue can be easily detected using the CC, demonstrating its clinical applicability for chairside patient assessments. The results suggest no altered microvasculature morphology occurred in irradiated mandibular gingiva although a generalized reduction in gingival FCD was present. Despite the close proximity between the gingiva and buccal mucosa, FCD of the buccal mucosa was relatively unhindered despite angiomorphologic differences.
Reduced vascularity due to fibrosis is a known long-term adverse effect after therapeutic RT.3,32 Several techniques (biopsy, transcutaneous oxygen measurement, LDF) have been applied in the past to study this phenomenon in oral and cutaneous tissues, but inconsistent findings were reported. Doll et al. found a decrease of blood flow in irradiated skin of breast cancer patients and a normalization after 36 months compared to control sites using LDF.12 Another study, using cutaneous laser Doppler, reported increased subcutaneous microcirculation associated with thermal stimulation in irradiated breast skin compared to a non-irradiated contralateral side 10; the investigators argue
Fd TCD MFI
Øbv
± 39 157 ± 5 20
± 54* 147 ± 7 68
± 40 ± 19
123 ± 53 34 ± 17*
106