Simulation of scattering effects of irradiation on surroundings using the example of titanium dental implants: a Monte Carlo approach.

Occasionally, head and neck cancer patients treated with high-energy X-rays and gamma rays have titanium dental implants. The aim of this study was to calculate alterations in the irradiated bone caused by a foreign body, representing a titanium implant in size and physical qualities, using a stochastic (Monte Carlo) simulation. A clinical linear accelerator was simulated using BEAM/EGS4. The calculations showed that the presence of an implant results in differences of the dose distribution all around the implant. Titanium dental implants in the field of irradiation were capable of causing significant radiation scattering. The risk for dose enhancement was notably important for the bone in direct contact with the foreign body. Therapists involved in radiation planning should consider the impact of dental implants on the radiation beam as a putative cause of osteoradionecrosis.