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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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