World Journal of Dentistry

Register      Login

VOLUME 12 , ISSUE 6 ( November-December, 2021 ) > List of Articles


Efficacy of Low-cost Intraoral Prosthesis in the Era of Modern Radiation Therapy in Oral Cancer Patients

Shivani S Desai, Adnan Calcuttawala, Dipti Patil, Nilesh Deshmane, Sharad Desai

Keywords : Intraoral prosthesis, Oral cancer, Radiation therapy, Radiation-induced oral mucositis

Citation Information : Desai SS, Calcuttawala A, Patil D, Deshmane N, Desai S. Efficacy of Low-cost Intraoral Prosthesis in the Era of Modern Radiation Therapy in Oral Cancer Patients. World J Dent 2021; 12 (6):463-468.

DOI: 10.5005/jp-journals-10015-1880

License: CC BY-NC 4.0

Published Online: 24-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: To fabricate a customized intraoral prosthesis (IOP) and determine its dosimetric, clinical, and economic impact in oral cancer patients undergoing radiation therapy (RT). Materials and methods: Intraoral prosthesis was made using routine chairside and laboratory techniques using alginate, dental stone, and heat cure acrylic resin. Modifications in the IOP were made according to the specific case. Six patients with head and neck cancers (HNC) involving either of the jaws, planned to receive either adjuvant or definitive RT with the presence of one or more risk factors of developing severe acute radiation-induced toxicities were enrolled in this study. Results: With the use of a customized IOP during radiation treatment, an improvement in radiation-induced oral mucositis (RIOM) was observed from grade III to grade I. There was a significant reduction in the radiation dose received by normally involved structures of the oral cavity. The minimal cost of the fabrication of IOP negates the cost involved in the management of severe grade RIOM and its complications. Conclusion: Fabrication of a low-cost customized IOP in oral cancer patients undergoing RT is feasible and its use with modern techniques of RT planning and delivery can reduce the doses to the normal tissues in the oral cavity, thereby reducing the severity of RIOM in patients with cancers of the oral cavity. Clinical significance: Radiation therapy has significant acute side effects like mucositis, oral ulceration, and impaired taste, which increases morbidity leading to multiple breaks in the treatment. Also, the negative psychological impact of these side effects causes them to discontinue the treatment, thus worsening the disease outcome. We present a study on the fabrication of a custom-made, and affordable IOP and its efficacy in decreasing the severity of acute side effects of RT.

  1. Sharma S, Satyanarayana L, Asthana S, et al. Oral cancer statistics in India on the basis of first report of 29 population-based cancer registries. J Oral Maxillofac Pathol: JOMFP 2018;22(1):18. DOI: 10.4103/jomfp.JOMFP_77_20.
  2. Day TA, Davis BK, Gillespie MB, et al. Oral cancer treatment. Curr Treatm Opt Oncol 2003;4(1):27–33. DOI: 10.1007/s11864-003-0029-4.
  3. Mathur P, Sathishkumar K, Chaturvedi M, et al., ICMR-NCDIR-NCRP Investigator Group Cancer statistics, 2020: report from national cancer registry programme, India. JCO Global Oncology 2020;6(6):1063–1075. DOI: 10.1200/GO.20.00122.
  4. Palaskar J, Mody ZS, Mohile SS, et al. Different types of radiation prosthesis to minimise radiation side effects. Int J Curr Res 2016;8:33575–33578.
  5. Deng H, Sambrook PJ, Logan RM. The treatment of oral cancer: an overview for dental professionals. Aust Dent J 2011;56(3):244–252. DOI: 10.1111/j.1834-7819.2011.01349.x.
  6. Taniguchi H. Radiotherapy prostheses. J Med Dent Sci 2000;47(1):12–26.
  7. Elting LS, Cooksley CD, Chambers MS, et al. Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies. Int J Radiat Oncol Biol Phys 2007;68(4):1110–1120. DOI: 10.1016/j.ijrobp.2007.01.053.
  8. Spencer KR, Ferguson JW, Wiesenfeld D. Current concepts in the management of oral squamous cell carcinoma. Aust Dent J 2002;47(4):284–289. DOI: 10.1111/j.1834-7819.2002.tb00539.x.
  9. Schiødt M, Hermund N. Management of oral disease prior to radiation therapy. Support Care Cancer 2002;10(1):40–43. DOI: 10.1007/s005200100284.
  10. Verrone JR, Alves FA, Prado JD, et al. Benefits of an intraoral stent in decreasing the irradiation dose to oral healthy tissue: dosimetric and clinical features. Oral Surg, Oral Med, Oral Pathol Oral Radiol 2014;118(5):573–578. DOI: 10.1016/j.oooo.2014.08.008.
  11. Ferreira JA, Olasolo JJ, Azinovic I, et al. Effect of radiotherapy delay in overall treatment time on local control and survival in head and neck cancer: review of the literature. Rep Pract Oncol Radiothe 2015;20(5):328–339. DOI: 10.1016/j.rpor.2015.05.010.
  12. Maria OM, Eliopoulos N, Muanza T. Radiation-induced oral mucositis. Front Oncol 2017;7:89. DOI: 10.3389/fonc.2017.00089.
  13. Mantri SS, Bhasin AS. Preventive prosthodontics for head and neck radiotherapy. J Clin Diagn Res 2010;4:2958–2962.
  14. Schaaf NG. Maxillofacial prosthetics and the head and neck cancer patient. Cancer 1984;54(S2):2682–2690. DOI: 10.1002/1097-0142(19841201);2-3.
  15. Dewan H, Radiation Prosthesis for Improving the Life of Cancer Patients. 2019. DOI: 10.34297/AJBSR.2019.04.000849.
  16. Gaba N, Goswami R, Agarwal K. Prosthetic carriers for radiation therapy of head and neck. Adv Biomed Bull 2013;1(2):136–146.
  17. Janani T, Suganya R. Clinical demonstration of various radiation stents-an overview. J Pharmaceut Sci Res 2016;8(12):1358.
  18. Verrone JR, Alves FA, Prado JD, et al. Impact of intraoral stent on the side effects of radiotherapy for oral cancer. Head Neck 2013;35(7):E213–E217. DOI: 10.1002/hed.23028.
  19. Shogan JE, Bhatnagar AK, Heron DE, et al. Dosimetric correlation of oral cavity dose with acute mucositis in patients treated with intensity modulated radiation therapy (IMRT) and chemotherapy. Int J Radiat Oncol Biol Phys 2005;63:S74–S75. DOI: 10.1016/j.ijrobp.2005.07.128.
  20. Inoue Y, Yamagata K, Nakamura M, et al. Are intraoral stents effective for reducing the severity of oral mucositis during radiotherapy for maxillary and nasal cavity cancer? J Oral Maxillofac Surg 2020;78(7):1214.e1–1214.e8. DOI: 10.1016/j.joms.2020.02.009.
  21. Russo G, Haddad R, Posner M, et al. Radiation treatment breaks and ulcerative mucositis in head and neck cancer. Oncologist 2008;13(8):886–898. DOI: 10.1634/theoncologist.2008-0024.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.