Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry

Mélanie Rouers; Fabien Bornert; Pierre Truntzer; Sarah Dubourg; Cyrielle Bourrier; Delphine Antoni; Georges Noël

doi:10.1055/s-0039-1688523

European Journal of Dentistry, Table of Contents

CC BY-NC-ND 4.0 · Eur J Dent 2019; 13(01): 088-094
DOI: 10.1055/s-0039-1688523

Original Article

Dental Investigation Society

Ability to Propose Optimal Prosthetic Rehabilitation can be Improved by Discussion between the Dentist and Radiation Oncologist Regarding Upstream Dosimetry

Mélanie Rouers

¹Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France

,

Fabien Bornert

¹Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France

,

Pierre Truntzer

²University Radiation Department, Centre Paul Strauss, Strasbourg, France

,

Sarah Dubourg

¹Faculty of Dental Medicine, 1 Place de l'Hôpital, Strasbourg, France

,

Cyrielle Bourrier

²University Radiation Department, Centre Paul Strauss, Strasbourg, France

,

Delphine Antoni

²University Radiation Department, Centre Paul Strauss, Strasbourg, France

³Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France

,

Georges Noël

²University Radiation Department, Centre Paul Strauss, Strasbourg, France

³Strasbourg University, Radiobiology Lab, Centre Paul Strauss, Strasbourg, France

› Author Affiliations

Abstract

Objective Improvement of dental rehabilitation for patients who have undergone radiation therapy requires knowledge of the dose in the maxillary and mandible bones.

Materials and Methods Forty-three patients with head and neck cancers underwent evaluation for dental rehabilitation before radiation treatment dosimetry. The delivered dose to the maxilla and mandible was determined. From the dose data in the literature, three levels of risk of implant failure were defined. According to the delivered doses, the authors calculated the percentage of patients who could be fully rehabilitated with an implant, as proposed by the dentist before radiation planning.

Results Before dosimetry calculation, all of the completely edentulous arches and 94 partially edentulous (PESs) sextants could be optimally rehabilitated. After dose calculation, among the 14 arches of 7 patients who were completely edentulous, according to the mean and maximal delivered doses, 11 arches (78.6%) and 7 arches (50%) could receive an optimal prosthesis, respectively. For the three patients, who were PESs but with one arch that was completely edentulous, according to the mean and maximal delivered doses, one arch for each dose condition could receive an optimal prosthesis. Among the 94 PESs sextants, according to the mean and maximal delivered doses, 41 (43.6%) and 24 (25.5%) sextants could receive an optimal prosthesis, respectively.

Conclusion By determining the sites of implantation before dosimetry, the radiation oncologist could shield specified areas, potentially improving the possibilities for dental rehabilitation. The dialogue between the dentist and the radiation oncologist can improve the possibilities for implants and decrease the risk of unsafe implantation.

Keywords

dental care - dental implant - dental prosthesis - head and neck cancer - treatment planning

Full Text

References

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