Abstract
Intensity modulated radiation therapy (IMRT) is useful in the treatment of head and neck cancer. IMRT planning requires outline setup of the target in CT images and CT value for calculating the distribution of radiation dose. However, dental metal artifacts often interfere with correct CT images and CT values. In this paper, we report a case series of patients who underwent removal of dental metal prior to IMRT.
Five patients with head and neck cancer were referred to our department for removal of all of their dental metal. Primary lesions were the oropharynx in two cases, the tongue in one, the larynx in one, and the hypopharynx in one. CT images of their head and neck showed metal artifacts in the tongue, parotid grand, oropharynx and upper neck. They had 12 to 19 teeth that had dental metal that needed to be removed. The removal required 6 to 13 days (2 to 5 visits per patient). All dental metal was replaced by acrylic resin crowns or resin fillings. After the procedures, metal artifacts disappeared and normal CT values appeared in the IMRT planning CT images. None of the patients had any problem with their chewing ability. Thus, it is better to remove dental metal prior to IMRT.
