Creating customized oral stents for head and neck radiotherapy using 3D scanning and printing
Posted on 2019-08-20 - 12:01
Abstract Background To evaluate and establish a digital workflow for the custom designing and 3D printing of mouth opening tongue-depressing (MOTD) stents for patients receiving radiotherapy for head and neck cancer. Methods We retrospectively identified 3 patients who received radiation therapy (RT) for primary head and neck cancers with MOTD stents. We compared two methods for obtaining the digital impressions of patients’ teeth. The first method involved segmentation from computed tomography (CT) scans, as previously established by our group, and the second method used 3D scanning of the patients’ articulated stone models that were made during the conventional stent fabrication process. Three independent observers repeated the process to obtain digital impressions which provided data to design customized MOTD stents. For each method, we evaluated the time efficiency, dice similarity coefficient (DSC) for reproducibility, and the 3D printed stents’ accuracy. For the 3D scanning method, we evaluated the registration process using manual and automatic approaches. Results For all patients, the 3D scanning method demonstrated a significant advantage over the CT scanning method in terms of time efficiency with over 60% reduction in time consumed (p < 0.0001) and reproducibility with significantly higher DSC (p < 0.001). The printed stents were tested over the articulated dental stone models, and the trueness of fit and accuracy of dental anatomy was found to be significantly better for MOTD stents made using the 3D scanning method. The automated registration showed higher accuracy with errors < 0.001 mm compared to manual registration. Conclusions We developed an efficient workflow for custom designing and 3D-printing MOTD radiation stents. This workflow represents a considerable improvement over the CT-derived segmentation method. The application of this rapid and efficient digital workflow into radiation oncology practices can expand the use of these toxicity sparing devices to practices that do not currently have the support to make them.
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Zaid, Mohamed; Bajaj, Nimit; Burrows, Hannah; Mathew, Ryan; Dai, Annie; Wilke, Christopher; et al. (2019). Creating customized oral stents for head and neck radiotherapy using 3D scanning and printing. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.4634612.v1
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AUTHORS (20)
MZ
Mohamed Zaid
NB
Nimit Bajaj
HB
Hannah Burrows
RM
Ryan Mathew
AD
Annie Dai
CW
Christopher Wilke
SP
Stephen Palasi
RH
Ryan Hergenrother
CC
Caroline Chung
CF
Clifton Fuller
JP
Jack Phan
GG
G. Gunn
WM
William Morrison
AG
Adam Garden
SF
Steven Frank
DR
David Rosenthal
MA
Michael Andersen
AO
Adegbenga Otun
MC
Mark Chambers
EK
Eugene Koay