Maxillary and mandible contouring in patients with a head and neck area irradiation

Purpose: Dental care is crucial after irradiation of the head and neck. This care may include dental restoration, extractions, and prosthetic implantation or prosthesis adjustment. To perform these procedures safely, dentists need to know the delivered radiation dose delivered to the relevant part of the mandible and/or maxilla. We propose a simple, fast, and useful contouring technique to aid accurate recording of radiation therapy dose to the mandible and maxilla.

Methods and materials: The maxilla and mandible of 2 patients, 1 dentate and 1 edentulous, have been contoured on computed tomography planning scans. The jaw has been divided into sextants (3 segments in both the mandible and maxilla) using bony landmarks.

Results: We have developed a contouring atlas to aid radiation oncologists in delineating the maxilla and mandible allowing accurate recording of dose to each sextant and meaningful communication with their dental colleagues.

Conclusion: Delineation of the maxilla and mandible is important if we are to improve communication between radiation oncologists and dentists regarding radiation and risk to these structures. Our method should not increase the time to delineate the organs at risk and target volumes in the head and neck area and could improve the safety of subsequent dental treatments.