Radiation Biology Important Notes
- The action of radiation can be direct or indirect
- Direct effect occurs when the energy of a photon is transferred directly to biological molecules.
- The indirect effect occurs when a photon is absorbed by water and from free radicals which in turn reacts with biological macromolecules.
- About two-thirds of radiation-induced biological damage results from indirect effects.
- The order of tissue susceptibility affected by radiation are:
- Spermatozoa and oogonia (most susceptible)
- Bone marrow with immature cells including lymphocytes
- Intestinal mucosa
- Epithelium of skin
- Muscle cells
- Nerves
- For osteoradionecrosis to occur, three factors should be present. They are:
- Radiation at the site
- Injury at the site and
- Infection at the site
- Susceptibility of different tissues to radiation-induced cancer
- Linear Energy Transfer (LET): The rate of loss of energy from a particle as it moves through the irradiated material is called LET.
- The dose required to produce a certain biological effect is reduced as the Linear Energy Transfer (LET) of the radiation is increased.
- The amount of radiation necessary to produce a noticeable skin reaction is called an Erythema dose.
- The skin erythema dose is 300 – 400R.
Read And Learn More: Oral Radiology Question and Answers
Radiation Biology Long Essays
Question 1. Enumerate hazards of radiation. Discuss the effects of radiation on oral tissues.
Or
What is ionizing radiation? Describe the biological effects of excessive radiation on orofacial tissues.
Or
What are the effects of radiation in the oral cavity? Write in detail about osteo-radionecrosis.
Or
Describe in detail the effects of radiation on the oral cavity.
Answer.
Ionizing Radiation:
- It is defined as radiation that is capable of producing ions by removing or adding electrons to an atom
Hazards Of Radiation:
- Biologic changes
- Changes in DNA:
- Change in base
- Disruption of hydrogen bonds
- Breakage of DNA strands
- Cross-linking of DNA strands
- Proteins:
- Denaturation of proteins
- Changes in DNA:
- Cellular changes:
- Nuclear changes
- Chromosome aberration
- Cytoplasmic changes
- Tissue changes:
- Non stochastic Effects
- Stochastic Effects
Radiation Effects On Oral Tissues:
- Oral Mucous Membrance:
- Mucositis
- Desquamation of epithelial layer
- Infection of the oral cavity
- Candidiasis
- Atrophic mucosa
- Ulceration
- Radiation necrosis
- Taste buds:
- Degeneration
- Loss of taste sensation
- Salivary glands:
- Xerostomia
- Loss of salivary secretion
- Difficult & painful swallowing
- Decreased buffering capacity
- Susceptibility to radiation caries
- Teeth:
- Retards growth of teeth
- Inhibit cellular differentiation
- Premature eruption
- Retard root formation
- Fibroatrophy of pulp
Radiation Caries:
Pathogenesis:
Types:
-
- Superficial
- Involving cervical region
- Dark pigmentation
- Bone:
- Osteoradionecrosis
- Hypocellularity
- Hypoxia
- Hypovascularity
Osteoradionecrosis:
- It is a radiation-induced pathologic process characterized by chronic and painful infection and necrosis is accompanied by late sequestration and sometimes permanent deformity.
- This is one of the most serious complications of radiation to the head and neck seen frequently
Factors Leading To Osteoradionecrosis:
- Irradiation of an area of previous surgery before adequate healing has taken place
- Irradiation of lesion near the bone
- Poor oral hygiene and continued use of irritants
- Poor patient cooperation in managing irradiated tissue
- Surgery in the irradiated area
- Failure to prevent trauma to the irradiated area
Clinical Features:
- Nonhealing dead bone
- The bone becomes hypovascular, hypocellular, and hypomineralized
- Mandible is more effected than maxilla
Treatment:
- Debridement of necrotic tissue should be done along with the removal of the sequestrum
- Administration of intravenous antibiotics and hyperbaric oxygen therapy
- Maintenance of oral hygiene is necessary
Radiation Biology Short Essays
Question 1. Osteoradionecrosis
Answer.
Osteoradionecrosis
- It is a radiation-induced pathologic process characterized by chronic and painful infection and necrosis is accompanied by late sequestration and sometimes permanent deformity.
- This is one of the most serious complications of radiation to the head and neck seen frequently
Factors Leading To Osteoradionecrosis
- Irradiation of an area of previous surgery before adequate healing has taken place
- Irradiation of lesion near the bone
- Poor oral hygiene and continued use of irritants
- Poor patient cooperation in managing irradiated tissue
- Surgery in the irradiated area
- Failure to prevent trauma to the irradiated area
Osteoradionecrosis Clinical Features:
- Nonhealing dead bone
- The bone becomes hypovascular, hypocellular, and hypomineralized
- Mandible is more effected than maxilla
Osteoradionecrosis Treatment:
- Debridement of necrotic tissue should be done along with the removal of the sequestrum
- Administration of intravenous antibiotics and hyperbaric oxygen therapy
- Maintenance of oral hygiene is necessary
Question 2. Effects of radiation
Or
Hazards of radiation.
Answer.
Effects of radiation
- Biological effects:
- Nucleic acids
- X-ray damages the DNA molecules causing cellular death by the following changes
- Change in the base
- Disruption of H+ bond
- Breakage of DNA strand
- Crosslinking of the DNA Strands
- Proteins
- Causes
- Breakage of hydrogen bonds
- Denaturation of proteins
- Crosslinking
- Nucleic acids
- Cellular effects:
-
- Effects at tissue and organ level
- Non – stochastic effects
- It has specific damaging effects on the body of the person exposed to the high dose of radiation
- Ex: reddening of skin, cataract
- Stochastic effects
- It refers to the radiation that may/may not affect the person
- Non – stochastic effects
- Short term effects
- It depends on the radiosensitivity of cells
- More injury occurs to the proliferating tissues
- Ex: bone marrow
- While less proliferating cells have no sign of injury
- Ex: muscles
- Long term effects
- Depends on the radiosensitivity of cells
- Proliferating tissues are more affected compared to that of less proliferating tissues
- Example: more injury occurs to bone marrow as compared to that of muscles
- Effects at tissue and organ level
Question 3. Effects of radiation on oral tissues.
Answer.
- Oral Mucous Membrance
- Mucositis
- Desquamation of epithelial layer
- Infection of the oral cavity
- Candidiasis
- Atrophic mucosa
- Ulceration
- Radiation necrosis
- Taste buds:
- Degeneration
- Loss of taste sensation
- Salivary glands:
- Xerostomia
- Loss of salivary secretion
- Difficult & painful swallowing
- Decreased buffering capacity
- Susceptibility to radiation caries
- Teeth:
- Retards growth of teeth
- Inhibit cellular differentiation
- Premature eruption
- Retard root formation
- Fibroatrophy of pulp
Types:
-
- Superficial
- Involving cervical region
- Dark pigmentation
- Bone:
- Osteoradionecrosis
- Hypocellularity
- Hypoxia
- Hypovascularity
Question 4. Radiotherapy
Answer.
Radiotherapy
- It is the treatment of the disease using ionizing radiation
Principle:
- Rapidly proliferating cells are more sensitive to ionizing as compared to normal cells
Advantages:
- No function loss
- Cosmetic
- Protect adjacent uninvolved area
- Possible to treat in inaccessible areas
Disadvantages:
- Development of secondary tumours
- Mucositis
- Dysguea
- Xerostomia
Types Of Therapy:
- Curative
- It permanently eradicates the disease
- Palliative
- It leads to a temporary improvement in the patient’s condition
Types Of Radiation:
- External radiation
- Internal radiation
- Brachytherapy
Question 5. Radiation hazards of jaws.
Answer.
Radiation hazards of jaws
- The marrow is replaced by fatty marrow and fibrous connective tissue
- The endosteum becomes atrophic
- The bone becomes hypovascular, hypocellular, and hypomineralized
- The complication following irradiation i.e. “Osteoradionecrosis”
- Necrosis of bone may result in nonhealing ulcers which may occur after tooth extraction
- Lack of osteoblastic and osteoclastic activity in endosteum
- Mandible is more commonly affected than maxilla
- On the radiograph, osteoradionecrosis does not show any periosteal reaction as that seen in the case of osteomyelitis
Radiation Biology Short Answers
Question 1. Effects of radiation on developing tooth.
Answer.
Effects of radiation on developing tooth
Question 2. Radiation mucositis.
Answer.
Radiation mucositis
- The oral mucous membrane contains the basal layer of differentiating intermitotic cells which are highly radiosensitive at the end of the second week of therapy the mucous membrane begins to show areas of redness and inflammation, this state is called “Mucositis”
- As the therapy continues the mucous membrane breaks down with the formation of white or yellow pseudo-membrane
- At the end of the therapy, the mucositis is severe, leading to difficulty in talking, eating, and swallowing
- After termination of therapy, the healing may be complete after about two months, but the mucous membrane tends to become thin, atrophic, and relatively avascular
- Secondary infection by candida albicans is a prevalent complication
- The patient is usually prone to oral ulcerations and unable to tolerate dentures
Question 3. Types of radiation caries.
Answer.
Types of radiation caries
- Primarily involving cementum and dentin in the cervical areas
- This lesion progresses around the teeth circumference and ultimately results in amputation of the crown
- Generalized superficial lesions attacking the Buccal, occlusal, incisal, and palatal surfaces of the teeth
- Dark pigmentation of the crown
Question 4. Acute radiation syndrome.
Answer.
Acute radiation syndrome
Collective signs and symptoms occurring after whole-body radiation exposure
Question 5. Units of radiation
Answer.
Units of radiation
- Exposure:
- It refers to the measurement of ionization in air produced by X-rays
- The unit of exposure is roentgen [R]
- One roentgen is the quantity of gamma radiation that produces an electrical charge of 2.58 x 10-4coulombs in a kilogram of air at standard temperature and pressure
- It is also defined as the amount of gamma radiation that will be produced in 1 cc of air
- It is used to measure the intensity of radiation to which an object is exposed
1R = 2.58 x 10-4 C/kg
1C/kg = 3.88 x 103 R
- Absorbed dose:
- It is the amount of energy absorbed by a tissue
- Radiation absorbed dose or rad is the unit of dose
- It is equal to the deposition of 100 ergs of energy per gram of tissue
- In the SI system, the unit of measurement of dose is Gray (GY)
1Gy = 1 joule/kg or 100 rads
1 rad = 100 ergs/g of absorber
- Dose equivalent:
- It is used to compare the biological effects of different types of radiation
- Its unit is roentgen equivalent – man, rem
- In the SI system, the unit of dose-equivalent is the Sievert {Sv}
1 rem = 0.01 Sv
- Quality factor:
- It refers to its biological effect relative to standard exposure to X-ray
- Relative biological effectiveness:
- It is similar to the quality factor
- Radioactivity:
- It refers to the decay rate of a sample of radioactive material
- Its traditional unit of radioactivity is curie [Ci]
- SI unit is Becquerel [Bq]
1 mCi = 37 mega Bq
1 Bq = 2.7 x 10-11 Ci
Radiation Biology Viva Voce
- The unit of measurement of radiation exposed to the patients during dental X-ray procedures is Roentgen
- SI unit of measuring radioactivity is BecquerelThe most radio-susceptible organ for radiation cancer is the stomach
- The tissue most susceptible to radiation is blood-forming cells
- The most sensitive period in humans for inducing developmental abnormalities is during the period of organogenesis (18 – 45 days of gestation)
- The sensitive sites within the nucleus are DNA and chromosomes
- The order of the cell cycle is G1 S G2 M
- If the radiation exposure occurs after DNA synthesis [i.e. in G2 or late S], only one arm of the affected chromo will be broken.
- If the radiation exposure occurs before DNA replication [i.e. in G1 or early S], the damage occurs in both arms.
- The most sensitive phase to radiation is the G2 phase while the least sensitive phase is the ‘S’ phase
- The mean exposure to radiation from one IOPA is 300 mR
- Mean exposure from dental X-ray can be reduced to as low as 1 – 10 mR by using improved techniques
- The mean exposure of radiation to gonads from one IOPA is 1/1000 x 300 mR = 0.03 mR
- In the treatment of oral cancers, the fraction of the total dose given in each appointment is in the range of 150 rads.