Will you wait to simulate, or resimulate, a patient after teeth extractions in preparation for HN cancer treatment?
If only a few teeth, do you still wait to simulate until after the dental work?
Answer from: Radiation Oncologist at Academic Institution
The answer is, it depends.
I do not have a specific policy, and it depends refers to which and how many teeth need to be extracted.
The main questions to answer this question are:
Will the extractions alter the set up?
And as a corollary, will the extractions alter the use of an intraoral devi...
Answer from: Radiation Oncologist at Academic Institution
If the patient has dental extractions done between initial RT simulation and RT start date, I rely on the cone beam CT done during the first fraction to decide whether or not I need to do a re-simulation.
In case the anatomy is lining up well on the CBCT, which is usually the case, I go ahead ...
Answer from: Radiation Oncologist at Academic Institution
If the extractions are extensive, I typically wait.
But in a practical sense, it's often not until the patient has been seen by dentistry/oral surgery before I know what the extent will be, so I wait more often than not so as to ensure as reproducible a setup as possible.