Construction and clinical evaluation of a new customized bite block used in radiotherapy of head and neck cancer

Abstract

PurposeIn the present study we constructed a new customized bite block and evaluated its effect on dosimetric and clinical features in radiotherapy. Materials and methodsThe key point of this method is using the oral stent and silicon rubber through a procedure of making fine intraoral impressions. For type I customized bite block, only the upper and lower alveoli of the oral stent are coated with silicone rubber and impressions of the teeth can be obtained. For type II customized bite block, all parts of the oral stent are coated with silicone rubber to make sure impressions of the teeth, tongue and other intraoral tissues can be obtained. Sixty patients undergoing radiotherapy of nasal cavity, paranasal sinuses and oromaxillofacial area were evaluated. For each patient, intensity-modulated radiotherapy plans created with and without customized bite block were compared and data were collected on radiation-induced complications. ResultsThe total fabricating time was approximately 20minutes, and the cost was approximately 10 US dollars. Type I customized bite block is applicable to cancer of sinuses and nasal cavity. Type II customized bite block is applicable to cancer of the oral cavity, salivary glands, especially tongue cancer. The use of the customized bite block showed promising results in decreasing the radiation dose to organs at risk during intensity-modulated radiotherapy. No patients had oral mucositis (grade 3 or above), taste dysfunction, or xerostomia during and post radiotherapy. ConclusionA customized bite block is easy-made and worthy of clinical use.