Theodore V Tso1, Martina Hurwitz2, Danielle N Margalit3, Sang J Lee4, Christopher L Williams5, Evan B Rosen6. 1. Graduate student, Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Mass. 2. Physicist, Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Mass. 3. Assistant Professor, Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Mass. 4. Assistant Professor, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass. 5. Instructor, Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Mass; Dana-Farber Cancer Institute, Boston, Mass; Harvard Medical School, Boston, Mass. 6. Lecturer, Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass; Assistant Attending, Dental Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: rosene@mskcc.org.
Abstract
STATEMENT OF PROBLEM: Electron backscatter radiation from dental materials can contribute to soft tissue injury in patients undergoing head and neck radiation therapy. PURPOSE: The dose enhancement from the materials used for prosthodontic restoration of the dentition has not been well quantified. This study reports the magnitude of backscatter dose from the contemporary dental materials lithium disilicate and zirconia as compared with high-noble alloy and investigates the role of a spacer material in mitigating this effect. MATERIAL AND METHODS: Three flat slabs of dental materials high-noble alloy, lithium disilicate, and zirconia with thicknesses of 1.5 and 3 mm were irradiated with 6-MV photons from a clinical linear accelerator. Measurements were made using a thin-window parallel-plate ionization chamber placed at 0, 1, 3, and 5 mm from the material. One millimeter of poly(methyl methacrylate) or thermoplastic material was used to cover the dental material and measure the effect on the adjacent dose enhancement. RESULTS: Dose enhancements between 8% and 50% were recorded adjacent to the dental restoration materials. The largest enhancements occurred for the material of the highest density, the high-noble alloy. Dose enhancement was substantially lower for lithium disilicate (8%) and zirconia (30%). The thickness of the restoration material did not significantly affect dose enhancement. The dose enhancement decreased with distance from the material, dropping to <10% for all materials at 3 mm. CONCLUSIONS: Contemporary dental restorations enhance the backscatter dose. The presence of dental restorations may warrant the use of a stent to create separation from these materials as this can mitigate the effect.
STATEMENT OF PROBLEM: Electron backscatter radiation from dental materials can contribute to soft tissue injury in patients undergoing head and neck radiation therapy. PURPOSE: The dose enhancement from the materials used for prosthodontic restoration of the dentition has not been well quantified. This study reports the magnitude of backscatter dose from the contemporary dental materials lithium disilicate and zirconia as compared with high-noble alloy and investigates the role of a spacer material in mitigating this effect. MATERIAL AND METHODS: Three flat slabs of dental materials high-noble alloy, lithium disilicate, and zirconia with thicknesses of 1.5 and 3 mm were irradiated with 6-MV photons from a clinical linear accelerator. Measurements were made using a thin-window parallel-plate ionization chamber placed at 0, 1, 3, and 5 mm from the material. One millimeter of poly(methyl methacrylate) or thermoplastic material was used to cover the dental material and measure the effect on the adjacent dose enhancement. RESULTS: Dose enhancements between 8% and 50% were recorded adjacent to the dental restoration materials. The largest enhancements occurred for the material of the highest density, the high-noble alloy. Dose enhancement was substantially lower for lithium disilicate (8%) and zirconia (30%). The thickness of the restoration material did not significantly affect dose enhancement. The dose enhancement decreased with distance from the material, dropping to <10% for all materials at 3 mm. CONCLUSIONS: Contemporary dental restorations enhance the backscatter dose. The presence of dental restorations may warrant the use of a stent to create separation from these materials as this can mitigate the effect.