Clinical Consideration on Spacer for Interstitial Brachytherapy of Malignancy of Tongue.

  • ARAKIDA Ikuo
    Clinic for Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University
  • MIYAHARA Takao
    Department of Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University
  • HASEGAWA Yutaka
    Department of Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University
  • TANIGUCHI Hisashi
    Clinic for Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University
  • OHYAMA Takashi
    Clinic for Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University Department of Stomatognathic Dysfunction, Faculty of Dentistry, Tokyo Medical and Dental University
  • TAKEDA Masamune
    Department of Dental Radiology, Faculty of Dentistry, Tokyo Medical and Dental University
  • SHIBUYA Hitoshi
    Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University
  • MATSUMOTO Satoru
    Department of Radiology, Faculty of Medicine, Tokyo Medical and Dental University
  • HORIUCHI Junichi
    Department of Radiology, Nippon Medical School

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Other Title
  • 舌癌の小線源治療におけるspacerの臨床

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Abstract

In treatment for malignancy of tongue by interstitial brachytherapy, it is very important to prevent the excessive radiation dose to mandible, that is a cause of osteoradionecrosis. For the purpose, we have applied spacers to the patients. We fabricate spacers following prosthodontic methods. Clinically the detarmination of thickness and area of the lingual side of spacer is the most important factor. In taking impression we use custom tray and investigate the space that we can obtain between tongue and mandible. The method is same as the muscle trimming for impression making of full denture, and the area to cover is carefully concidered. In occlusion resistration we increase the vertical dimension for the space of tongue, because after the implantation edama of tongue often appears. In dentulous cases we occasionally use ball type clasps and in edentulous cases we make a chin cap and the appliance for maxilla to retain the spacer at the correct place. The material for spacers is acrilic resin of clear type, because it is very popular to dentists and it is easy to fit to patients. Usually we did not use the shielding materials as lead, because it produce little effect for the radiation quality and we usually take X-ray photographs for computer dosimetry. Following these method we made spacers more than 100 cases from 1987. In almost all cases we can apply the spacer during treatment period of about one week, and could prevent the osteoradionecrosis and reduce the mucositis of mandible. Thus we can fabricate the spacers cirtainly and safely by the clinical method that we have introduced.

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