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Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints
Objectives: To evaluate oral sequelae after head and neck radiotherapy (RT) when using two different types of intraoral appliances. Thermoplastic dental splints (active control) protect against backscattered radiation from dental structures. Semi-individualized, 3D-printed tissue retraction devices...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146966/ https://www.ncbi.nlm.nih.gov/pubmed/37109126 http://dx.doi.org/10.3390/jcm12082789 |
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author | Herpel, Christopher Held, Thomas Labis, Christos Christ, Leo Lang, Kristin Regnery, Sebastian Eichkorn, Tanja Lentz-Hommertgen, Adriane Jaekel, Cornelia Moratin, Julius Semmelmayer, Karl Moutsis, Tracy Thecla Plath, Karim Ristow, Oliver Freudlsperger, Christian Adeberg, Sebastian Debus, Jürgen Rammelsberg, Peter Schwindling, Franz Sebastian |
author_facet | Herpel, Christopher Held, Thomas Labis, Christos Christ, Leo Lang, Kristin Regnery, Sebastian Eichkorn, Tanja Lentz-Hommertgen, Adriane Jaekel, Cornelia Moratin, Julius Semmelmayer, Karl Moutsis, Tracy Thecla Plath, Karim Ristow, Oliver Freudlsperger, Christian Adeberg, Sebastian Debus, Jürgen Rammelsberg, Peter Schwindling, Franz Sebastian |
author_sort | Herpel, Christopher |
collection | PubMed |
description | Objectives: To evaluate oral sequelae after head and neck radiotherapy (RT) when using two different types of intraoral appliances. Thermoplastic dental splints (active control) protect against backscattered radiation from dental structures. Semi-individualized, 3D-printed tissue retraction devices (TRDs, study group) additionally spare healthy tissue from irradiation. Materials and Methods: A total of 29 patients with head and neck cancer were enrolled in a randomized controlled pilot trial and allocated to receive TRDs (n = 15) or conventional splints (n = 14). Saliva quality and quantity (Saliva-Check, GC), taste perception (Taste strips, Burghart-Messtechnik), and oral disability (JFLS-8, OHIP-14, maximum mouth opening) were recorded before and 3 months after RT start. Radiotherapy target volume, modality, total dose, fractionation, and imaging guidance were case-dependent. To evaluate intra-group developments between baseline and follow-up, nonparametric Wilcoxon tests were performed. Mann-Whitney-U tests were applied for inter-group comparisons. Results: At follow-up, taste perception was unimpaired (median difference in the total score; TRDs: 0, control: 0). No significant changes were found regarding oral disability. Saliva quantity (stimulated flow) was significantly reduced with conventional splints (median −4 mL, p = 0.016), while it decreased insignificantly with TRDs (median −2 mL, p = 0.07). Follow-up was attended by 9/15 study group participants (control 13/14). Inter-group comparisons showed no significant differences but a tendency towards a better outcome for disability and saliva quality in the intervention group. Conclusion: Due to the small cohort size and the heterogeneity of the sample, the results must be interpreted with reservation. Further research must confirm the positive trends of TRD application. Negative side-effects of TRD application seem improbable. |
format | Online Article Text |
id | pubmed-10146966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101469662023-04-29 Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints Herpel, Christopher Held, Thomas Labis, Christos Christ, Leo Lang, Kristin Regnery, Sebastian Eichkorn, Tanja Lentz-Hommertgen, Adriane Jaekel, Cornelia Moratin, Julius Semmelmayer, Karl Moutsis, Tracy Thecla Plath, Karim Ristow, Oliver Freudlsperger, Christian Adeberg, Sebastian Debus, Jürgen Rammelsberg, Peter Schwindling, Franz Sebastian J Clin Med Article Objectives: To evaluate oral sequelae after head and neck radiotherapy (RT) when using two different types of intraoral appliances. Thermoplastic dental splints (active control) protect against backscattered radiation from dental structures. Semi-individualized, 3D-printed tissue retraction devices (TRDs, study group) additionally spare healthy tissue from irradiation. Materials and Methods: A total of 29 patients with head and neck cancer were enrolled in a randomized controlled pilot trial and allocated to receive TRDs (n = 15) or conventional splints (n = 14). Saliva quality and quantity (Saliva-Check, GC), taste perception (Taste strips, Burghart-Messtechnik), and oral disability (JFLS-8, OHIP-14, maximum mouth opening) were recorded before and 3 months after RT start. Radiotherapy target volume, modality, total dose, fractionation, and imaging guidance were case-dependent. To evaluate intra-group developments between baseline and follow-up, nonparametric Wilcoxon tests were performed. Mann-Whitney-U tests were applied for inter-group comparisons. Results: At follow-up, taste perception was unimpaired (median difference in the total score; TRDs: 0, control: 0). No significant changes were found regarding oral disability. Saliva quantity (stimulated flow) was significantly reduced with conventional splints (median −4 mL, p = 0.016), while it decreased insignificantly with TRDs (median −2 mL, p = 0.07). Follow-up was attended by 9/15 study group participants (control 13/14). Inter-group comparisons showed no significant differences but a tendency towards a better outcome for disability and saliva quality in the intervention group. Conclusion: Due to the small cohort size and the heterogeneity of the sample, the results must be interpreted with reservation. Further research must confirm the positive trends of TRD application. Negative side-effects of TRD application seem improbable. MDPI 2023-04-09 /pmc/articles/PMC10146966/ /pubmed/37109126 http://dx.doi.org/10.3390/jcm12082789 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Herpel, Christopher Held, Thomas Labis, Christos Christ, Leo Lang, Kristin Regnery, Sebastian Eichkorn, Tanja Lentz-Hommertgen, Adriane Jaekel, Cornelia Moratin, Julius Semmelmayer, Karl Moutsis, Tracy Thecla Plath, Karim Ristow, Oliver Freudlsperger, Christian Adeberg, Sebastian Debus, Jürgen Rammelsberg, Peter Schwindling, Franz Sebastian Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title | Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title_full | Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title_fullStr | Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title_full_unstemmed | Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title_short | Oral Sequelae after Head and Neck Radiotherapy: RCT Comparing 3D-Printed Tissue Retraction Devices with Conventional Dental Splints |
title_sort | oral sequelae after head and neck radiotherapy: rct comparing 3d-printed tissue retraction devices with conventional dental splints |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10146966/ https://www.ncbi.nlm.nih.gov/pubmed/37109126 http://dx.doi.org/10.3390/jcm12082789 |
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