Heterogeneity of Necrotic Changes between Cortical and Cancellous Bone in Mandibular Osteoradionecrosis: A Histopathological Analysis of Resection Margin after Segmental Mandibulectomy

Figure 3

Clinical and histopathological images of a representative case (patient number 9). (a) A resected bone specimen. Mental foramen (). (b) A sagittal section. The most advanced area of bone destruction (white box). indicates mandibular canal. (c) Anterior margin. Mental nerve (). (d) Viable cancellous bone at the anterior margin. Mental nerve (). (e) Necrotic cortical bone near the inferior border of the mandible. (d′ and e′) Enlarged views. (f) Posterior margin. (g) Cancellous bone and (h) cortical bone near the inferior border of the mandible. Inferior alveolar nerve (). (g′) Enlarged view showing viable bone evident with osteocyte nuclei within lacunae. (h′) Enlarged view showing blood vessels within Haversian canals. However, a mixture of viable and necrotic bones was found. Therefore, the classification is “heterogeneously necrotic.” (i) Cancellous bone near the most advanced area of bone destruction shown in white box in (b). (i′) Enlarged view showing viable bone evident with osteocyte nuclei within lacunae. Inferior alveolar nerve (). All specimens were stained with hematoxylin and eosin, original magnification ×4.