A direct method for fabricating tongue-shielding stent

Wang, Russell R.; Olmsted, Levona W.

doi:10.1016/s0022-3913(05)80182-9

Cited by 22 publications

(20 citation statements)

References 12 publications

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“…The backscatter dose enhancement and its prevention are of clinical interest and have been extensively studied. (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) Here, we focus on those restorations which may come into contact with the oral mucosa. Farahani et al (1) performed experiments to measure the effects of various dental restoration materials on dose distribution: 18-karat gold alloy, Ag-Hg amalgam, Ni-Cr alloy, human tooth tissue, and soft-tissue-simulating polymer.…”

Section: Introductionmentioning

confidence: 99%

Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study

Chin

Treister

Friedland

et al. 2009

J Applied Clin Med Phys

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Dental restorations, fixed prosthodontics, and implants affect dose distribution in head and neck radiation therapy due to the high atomic number of the materials utilized. The backscatter of electrons from metallic materials due to the impinging treatment x‐ray results in localized dose enhancements. These dose enhancements cause localized mucositis in patients who have dental work, a significant clinical complication. We investigated the backscatter effect of 23 configurations of dental work using the EGS4nrc Monte Carlo (MC) simulation system. We found that all‐metal fixed partial dentures caused the highest amount of dose enhancement – up to 33% – while amalgam restorations did not cause a significant amount. Restorations with a ceramic veneer caused up to 8% enhancement. Between 3 mm and 5 mm of water‐equivalent material almost completely absorbed the backscatter. MC simulations provide an accurate estimate of backscatter dose, and may provide patient‐specific estimates in future.

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Section: Introductionmentioning

confidence: 99%

Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study

Chin

Treister

Friedland

et al. 2009

J Applied Clin Med Phys

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“…Clinical reports have described the fabrication of repositioning stents using acrylic resin . Only 2 studies have attempted to assess the influence of an intraoral repositioning stent on reproducibility of patient positioning; however, unlike the current study, in that study, intraoral stents were attached to extraoral frameworks .…”

mentioning

confidence: 96%

“…Some radiation oncologists believe that patients’ movements and daily variations in positioning are unavoidable, and oncologists compensate by widening the planning target volume to a field large enough to ensure adequate irradiation of the tumor while accepting the damage to a wider area of normal adjacent tissues. The potential oral complications from therapeutic irradiation include xerostomia, trismus, dysgeusia, dysphagia, osteoradionecrosis, and mucositis …”

mentioning

confidence: 99%

“…The potential oral complications from therapeutic irradiation include xerostomia, trismus, dysgeusia, dysphagia, osteoradionecrosis, and mucositis. 8 In an attempt to minimize these complications, others have tried to stabilize the mandible through the use of repositioning stents (referred to by radiation oncologists as bite blocks) made of materials with questionable durability such as wax and cork. 9 At British Columbia Cancer (BCC), it has become the standard of care to use a stent when treating certain tumor sites, including nasal cavity, sinus, or oral cavity tumors.…”

mentioning

confidence: 99%

“…Clinical reports have described the fabrication of repositioning stents using acrylic resin. 5,8,[10][11][12][13] Only 2 studies have attempted to assess the influence of an intraoral repositioning stent on reproducibility of patient positioning; however, unlike the current study, in that study, intraoral stents were attached to extraoral frameworks. 14,15 As a result, the current feasibility study was conducted to determine if a newly proposed stent design can provide clinically acceptable stability of patient po-…”

mentioning

confidence: 99%

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The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

Lee

Nguyen

2019

Journal of Prosthodontics

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Purpose Radiotherapy is one of the main treatment modalities for head and neck cancers. To minimize damage to normal tissues during radiotherapy, various methods of stabilization have been used, including thermoplastic facemasks and repositioning stents. The goal is to assess the effect of using a customized oral repositioning stent on patient positioning during the course of radiotherapy. Materials and Methods Ten consecutive patients scheduled to undergo intensity modulated radiation therapy (IMRT) for cancers of the maxillary sinus, nasal cavity, or oral cavity were recruited to participate in the study (ST group). These patients were matched to 2 retrospective cohorts, one using the original repositioning stent design (OB group), and the other with no stabilization stent (NB group). Hard baseplate wax was used to create a customized wax pattern of the proposed acrylic stent chairside, and processed in heat‐cured clear hard acrylic. Relative stability of the daily patient setup was assessed by comparing measurements from surrogate bony landmarks to radiation isocentres obtained from the initial reconstructed planning computed tomograph (CT) to each daily KeV image. Results There was no stent fracture or distortion throughout treatments, and no patients’ treatments were required to be aborted, delayed, or replanned. Mean 3D deviations for the ST, OB, and NB groups were 0.29 ± 0.10 cm, 0.32 ± 0.14 cm, and 0.31 ± 0.13 cm, respectively. The ANOVA test revealed no significant difference in triangulated variations between the treatment groups (F = 0.18, p = 0.84). Patient stability data demonstrated mean vertical, longitudinal, and lateral variations that did not appear different when compared to 2 retrospective cohorts. Although the deviations were not statistically significant between matched cohorts, the added durability of the stent and comfort for patients, without affecting IMRT timeline, are considered clinically significant. Conclusion By using a customized repositioning stent, it is possible to maintain patient stability comparable to prior protocols and within the range of clinical guidelines, while providing superior comfort and ease of insertion to the patients.

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A new, simple maxillary‐sparing tongue depressor for external mandibular radiotherapy: A case report

et al. 2009

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A direct method for fabricating tongue-shielding stent

Cited by 22 publications

References 12 publications

Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study

Effect of dental restorations and prostheses on radiotherapy dose distribution: a Monte Carlo study

The Fabrication of an Acrylic Repositioning Stent for Use During Intensity Modulated Radiation Therapy: A Feasibility Study

A new, simple maxillary‐sparing tongue depressor for external mandibular radiotherapy: A case report

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