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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Hauptverfasser: Herpel, Christopher (VerfasserIn) , Held, Thomas (VerfasserIn) , Labis, Christos (VerfasserIn) , Christ, Leo (VerfasserIn) , Uzun-Lang, Kristin (VerfasserIn) , Regnery, Sebastian (VerfasserIn) , Eichkorn, Tanja (VerfasserIn) , Hommertgen, Adriane (VerfasserIn) , Jäkel, Cornelia (VerfasserIn) , Moratin, Julius (VerfasserIn) , Semmelmayer, Karl (VerfasserIn) , Moutsis, Tracy Thecla (VerfasserIn) , Plath, Karim (VerfasserIn) , Ristow, Oliver (VerfasserIn) , Freudlsperger, Christian (VerfasserIn) , Adeberg, Sebastian (VerfasserIn) , Debus, Jürgen (VerfasserIn) , Rammelsberg, Peter (VerfasserIn) , Schwindling, Franz Sebastian (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 9 April 2023
In: Journal of Clinical Medicine
Year: 2023, Jahrgang: 12, Heft: 8, Pages: 1-13
ISSN:2077-0383
DOI:10.3390/jcm12082789
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm12082789
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/12/8/2789
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Verfasserangaben:Christopher Herpel, Thomas Held, Christos Labis, Leo Christ, Kristin Lang, Sebastian Regnery, Tanja Eichkorn, Adriane Lentz-Hommertgen, Cornelia Jaekel, Julius Moratin, Karl Semmelmayer, Tracy Thecla Moutsis, Karim Plath, Oliver Ristow, Christian Freudlsperger, Sebastian Adeberg, Jürgen Debus, Peter Rammelsberg and Franz Sebastian Schwindling

MARC

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245 1 0 |a Oral sequelae after head and neck radiotherapy  |b RCT comparing 3D-printed tissue retraction devices with conventional dental splints  |c Christopher Herpel, Thomas Held, Christos Labis, Leo Christ, Kristin Lang, Sebastian Regnery, Tanja Eichkorn, Adriane Lentz-Hommertgen, Cornelia Jaekel, Julius Moratin, Karl Semmelmayer, Tracy Thecla Moutsis, Karim Plath, Oliver Ristow, Christian Freudlsperger, Sebastian Adeberg, Jürgen Debus, Peter Rammelsberg and Franz Sebastian Schwindling 
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520 |a 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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