Is the degree of facial swelling after dental extraction sufficient to justify the current delays to radiotherapy mask production? A pilot evaluation of postextraction swelling using 3D photography

Abstract

Background Concern that facial swelling after dental extractions will spoil the fit of radiotherapy masks in head and neck cancer patients leads to the current practice of delay making of mask production (and therefore the start of radiotherapy) for several days or longer. However, there is little data on how extensive facial swelling is after dental extraction. Aim To assess the degree of facial swelling in a group of adult patients attending Newcastle Dental School for routine dental extractions. Materials and Methods Seventeen dental extraction patients underwent three‐dimensional photography using the 3dMDFace® system at 1‐week preop, immediately preop, and at 48‐h postop. We recorded demographic data, teeth extracted, and methods. Facial volume change was assessed using 3dMD Vultus® software. Two reviewers ran the data through the 3dMD Vultus® software independently. We used Student's t ‐test to assess significance. Results Twelve patients were included in the final analysis. There was no significant difference in the difference between the two preoperative measurements and the preoperative versus postoperative difference (Wilcoxon signed‐rank test: Reviewer 1: p = .31. and Reviewer 2: p = .10). Thus, mean facial swelling was less than the threshold for significant swelling which was deemed to be 15 cm 3 . Conclusion Facial swelling following dental extraction may not be sufficient in itself to justify the current delays in mask production and subsequent delivery of radiotherapy. Further definitive studies are needed to optimize how dental extractions should be timed within head and neck cancer care pathways.

A randomized controlled trial comparing conventional and piezosurgery methods in mandibular bone block harvesting from the retromolar region

“…Comprehensive future studies are necessary to establish equivalency and investigate factors influencing operation time and complication rates. Additionally, the exploration of advanced 3D measurement techniques for assessing postoperative edema and swelling could provide a more nuanced understanding of surgical outcomes [ 32 ].…”

“…Patients were asked to distinguish between the number of contacts on the oral mucosa and skin while their eyes were closed. If two points could be distinguished at less than 7 mm, it was considered normal; at a distance between 7 and 11 mm, it was considered slightly aberrant; and if it could only be distinguished at a distance greater than 11 mm, sensitivity was considered impaired [ 32 ]. The graft was considered successful when there was no infection or graft loss.…”

Photographic Parameters in Three-Dimensional Facial Image Acquisition. A Scoping Review

“…Despite the considerable quantity of image acquisition systems presently employed for 3D photography, research use for this type of imaging is limited to a handful of devices, of which 2 are the most extensively utilized. First, we found that the most used system was the 3dMD, 10,[12][13][14][15][16][17][18][19][20][21][22][23][24] which consists of 2 groups of 3 cameras, each located at 45 degrees to the right and left side target, and was used by 52% of the authors, followed by the Vectra M3, [25][26][27][28][29][30][31][32] which consists of a device composed of 3 groups of 2 cameras each and was used by 28% of the authors. In contrast, some other systems were used by some authors.…”

“…In contrast, most of the authors used chairs with high backs to improve back support, reducing variations due to mobility or changes in body posture. [12][13][14][15][16]18,19,25,[27][28][29][30][31][32][33]36,37,41 Head Posture Riml et al (2011) 42 showed the influence of head position on facial analysis, noting that different postures yield different results in measurements on facial photographs. In this study, most authors describe the positioning of the head for image acquisition as: "natural head position," (NHP) noting that this is a reproducible and proven position, described as "the head positioned in a relaxed manner while the person observes a fixed point on the horizon."…”

“…In this study, some authors agree that the facial expression should be neutral and relaxed, with the lips gently closed. 10,12,14,16,19,21,22,27,29,[31][32][33]38 However, no study refers to those individuals with forced lip closure, lip separation at rest, and lip incompetence. Due to the influence of expressions on facial measurements and the difficulty in defining the concept of "neutral facial expression," we consider this parameter to be the most inconsistent in standardizing the image.…”