Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

Kitamori, Hideki; Sumida, Iori; Tsujimoto, Tokuzou; Shiba, Hiroaki; Murakami, Shumei; Ohki, Masafumi

doi:10.1016/j.ejmp.2019.02.002

Cited by 28 publications

(26 citation statements)

References 19 publications

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“…According to different origins of HNC, depressors or elevators were used to reduce incidental exposure of the tongue and healthy structures during RT [20]. These kinds of 3D printed bite blocks were manufactured recently, and their clinical use is still being investigated and evaluated [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

et al. 2020

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Conventional methods that have been developed to immobilize the mouth and tongue for radiotherapy (RT) in head and neck cancer (HNC) treatment have been unsatisfactory. We, therefore, developed three-dimensional (3D), customizable, silicone bite blocks and examined their clinical feasibility. For HNC patients, before RT, the 3D printed bite blocks were fabricated based on primary computed tomography (CT) simulation images. The placement of the 3D bite blocks was followed by a secondary CT simulation before RT planning was finalized. Dosimetric parameters and positioning verification achieved with the propose bite blocks were compared with conventional universal oral corks. The 3D printed bite blocks were conformal to the occlusal surface, ensuring immobilization of the tongue without eliciting a gag reflex, and an elastic and firm texture that supports opening of the mouth, with a smooth surface with tolerable intraoral tactility. The dosimetry of patients using the proposed bite blocks showed better coverage of the planning target volume and surface of a tumour bed along with reduction in normal tissue doses. Good concordance of positioning by 3D printed bite blocks during the RT course was verified. The 3D printed bite blocks with silicone might be a customizable, safe, and practical advanced technology in RT for HNC.

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

et al. 2020

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“…The results of the experimental study of the synthesized samples demonstrated high sound absorption efficiency. Kitamori et al [17] developed a biocompatible class VI resin polyjet photopolymer mouthpiece using polyjet printing, which was used as a fixation device for head and neck radiotherapy patients. Hong et al [18] developed a computer tomography (CT) image-based 3D-printed model of thyroid cancer using various kinds of 3D printers including polyjet printers and compared their accuracies and other aspects regarding facilitating this patient-physician communication.…”

Section: Polyjet Printingmentioning

confidence: 99%

Additive Manufacturing of Polymer Materials: Progress, Promise and Challenges

et al. 2021

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The use of additive manufacturing (AM) has moved well beyond prototyping and has been established as a highly versatile manufacturing method with demonstrated potential to completely transform traditional manufacturing in the future. In this paper, a comprehensive review and critical analyses of the recent advances and achievements in the field of different AM processes for polymers, their composites and nanocomposites, elastomers and multi materials, shape memory polymers and thermo-responsive materials are presented. Moreover, their applications in different fields such as bio-medical, electronics, textiles, and aerospace industries are also discussed. We conclude the article with an account of further research needs and future perspectives of AM process with polymeric materials.

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“…A significant decrease in radiation dose to the tongue was demonstrated using 3D-printed devices (10). Kitamori et al suggested advantages of 3D-printed TRDs in terms of dose distribution with reduction of the integral dose to the surrounding normal tissue (11). Additionally, scattered radiation by dental restorative metals might be effectively absorbed by 3D-printing resin (11).…”

Section: Introductionmentioning

confidence: 99%

“…Given an adequate design, 3D-printed TRDs might support the accurate interfractional patient setup by using the remaining dentition for a rigid inter-jaw fixation, thus providing a defined position of the lower jaw in relation to the upper jaw. This might reduce longitudinal deviations in maxillomandibular relation ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Individualized 3D-Printed Tissue Retraction Devices for Head and Neck Radiotherapy

et al. 2021

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BackgroundRadiotherapy for head and neck cancer may cause various oral sequelae, such as radiation-induced mucositis. To protect healthy tissue from irradiation, intraoral devices can be used. Current tissue retraction devices (TRDs) have to be either individually manufactured at considerable cost and time expenditure or they are limited in their variability. In this context, a 3D-printed, tooth-borne TRD might further facilitate clinical use.MethodsA novel approach for the manufacturing of TRDs is described and its clinical application is analysed retrospectively. The devices were virtually designed for fabrication by 3D-printing technology, enabling—in only a single printing design—caudal or bi-lateral tongue displacement, as well as stabilization of a tongue-out position. For a total of 10 patients undergoing radiotherapy of head and neck tumors, the devices were individually adapted after pre-fabrication. Technical and clinical feasibility was assessed along with patient adherence. Tissue spacing was calculated by volumetric analysis of tongue retraction. In one exemplary case, radiotherapy treatment plans before and after tissue displacement were generated and compared. The reproducibility of maxillomandibular relation at device re-positioning was quantified by repeated intraoral optical scanning in a voluntary participant.Results3D-printing was useful for the simplification of TRD manufacture, resulting in a total patient treatment time of less than 30 min. The devices were tolerated well by all tested patients over the entire radiation treatment period. No technical complications occurred with the devices. The TRDs caused an effective spacing of the healthy adjacent tissue, e.g., the tongue. Position changes of maxillomandibular relation were limited to a mean value of 98.1 µm ± 29.4 µm root mean square deviation between initial reference and follow-up positions.ConclusionsThe presented method allows a resource-efficient fabrication of individualized, tooth-bourne TRDs. A high reproducibility of maxillomandibular relation was found and the first clinical experiences underline the high potential of such devices for radiotherapy in the head and neck area.

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Evaluation of mouthpiece fixation devices for head and neck radiotherapy patients fabricated in PolyJet photopolymer by a 3D printer

Cited by 28 publications

References 19 publications

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

Three-Dimensional Printed Silicone Bite Blocks for Radiotherapy of Head and Neck Cancer—A Preliminary Study

Additive Manufacturing of Polymer Materials: Progress, Promise and Challenges

Individualized 3D-Printed Tissue Retraction Devices for Head and Neck Radiotherapy

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