GB2432767A - Radiotherapy bite block - Google Patents
Radiotherapy bite block Download PDFInfo
- Publication number
- GB2432767A GB2432767A GB0523874A GB0523874A GB2432767A GB 2432767 A GB2432767 A GB 2432767A GB 0523874 A GB0523874 A GB 0523874A GB 0523874 A GB0523874 A GB 0523874A GB 2432767 A GB2432767 A GB 2432767A
- Authority
- GB
- United Kingdom
- Prior art keywords
- patient
- bite block
- portion arranged
- labia
- frame according
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
- 238000001959 radiotherapy Methods 0.000 title claims abstract description 13
- 239000000463 material Substances 0.000 claims abstract description 24
- 210000000214 mouth Anatomy 0.000 claims abstract description 22
- 241001313288 Labia Species 0.000 claims abstract description 15
- 210000004373 mandible Anatomy 0.000 claims abstract description 8
- 210000002050 maxilla Anatomy 0.000 claims abstract description 7
- 238000004519 manufacturing process Methods 0.000 claims description 4
- 238000010438 heat treatment Methods 0.000 claims description 3
- 239000012815 thermoplastic material Substances 0.000 claims description 2
- 229920001169 thermoplastic Polymers 0.000 abstract description 2
- 239000004416 thermosoftening plastic Substances 0.000 abstract description 2
- 210000001847 jaw Anatomy 0.000 description 4
- 210000001519 tissue Anatomy 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 210000003128 head Anatomy 0.000 description 3
- 239000004033 plastic Substances 0.000 description 3
- 230000005855 radiation Effects 0.000 description 3
- 230000008901 benefit Effects 0.000 description 2
- WERYXYBDKMZEQL-UHFFFAOYSA-N butane-1,4-diol Chemical compound OCCCCO WERYXYBDKMZEQL-UHFFFAOYSA-N 0.000 description 2
- 230000001934 delay Effects 0.000 description 2
- 208000002925 dental caries Diseases 0.000 description 2
- 206010013781 dry mouth Diseases 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 241000167880 Hirundinidae Species 0.000 description 1
- 206010061218 Inflammation Diseases 0.000 description 1
- 208000003445 Mouth Neoplasms Diseases 0.000 description 1
- 206010028116 Mucosal inflammation Diseases 0.000 description 1
- 201000010927 Mucositis Diseases 0.000 description 1
- 208000005946 Xerostomia Diseases 0.000 description 1
- 238000007792 addition Methods 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 230000003444 anaesthetic effect Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 201000010536 head and neck cancer Diseases 0.000 description 1
- 208000014829 head and neck neoplasm Diseases 0.000 description 1
- 230000004054 inflammatory process Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 210000003097 mucus Anatomy 0.000 description 1
- 239000008188 pellet Substances 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 229920001296 polysiloxane Polymers 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000009747 swallowing Effects 0.000 description 1
- XLYOFNOQVPJJNP-UHFFFAOYSA-N water Substances O XLYOFNOQVPJJNP-UHFFFAOYSA-N 0.000 description 1
- PAPBSGBWRJIAAV-UHFFFAOYSA-N ε-Caprolactone Chemical compound O=C1CCCCCO1 PAPBSGBWRJIAAV-UHFFFAOYSA-N 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
- A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
- A61B6/51—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for dentistry
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
- A61B90/16—Bite blocks
-
- A61B6/14—
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B90/14—Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B13/00—Instruments for depressing the tongue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/10—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis
- A61B2090/101—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges for stereotaxic surgery, e.g. frame-based stereotaxis for stereotaxic radiosurgery
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Surgery (AREA)
- Pathology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Radiology & Medical Imaging (AREA)
- Neurosurgery (AREA)
- Dentistry (AREA)
- Physics & Mathematics (AREA)
- Biophysics (AREA)
- High Energy & Nuclear Physics (AREA)
- Optics & Photonics (AREA)
- Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
Abstract
This invention relates to the field of applying external beam radiotherapy to the oral cavity. The bite block provides a top portion arranged to support the maxilla of a patient and having a front portion arranged to extend outside the patient's upper labia and a rear portion arranged to fit inside the patient's upper dentals; a bottom portion arranged to fit inside patient's mandible and having a front portion arranged to extend outside the patient's lower labia and a rear portion arranged to fit inside the patient's lower dentals; and a bridging portion to be positioned outside the patient's mouth and extending between the maxilla and mandible to the front of the labia such that the top portion and bottom portion are spaced apart by the bridging portion. The bite block is made from a radio-translucent material. It may also be made of a thermo-plastic which becomes malleable when warm and can be bitten into the correct shape. It may further comprise a tongue depresser.
Description
<p>-1-2432767</p>
<p>RADIOTHERAPY BITE BLOCK</p>
<p>BACKGROUND</p>
<p>a. Field of the Invention</p>
<p>This invention relates to the field of applying external beam radiotherapy to the oral cavity.</p>
<p>The aim of planning a course of radiotherapy treatment is to deliver a homogeneous dose of radiation accurately to a target area, and to minimise the effect on the surrounding tissues.</p>
<p>Radiotherapy treatment around the oral cavity can cause inflammation of the mucus of the mouth (mucositis) and dry mouth (xerostomia). If the patient can be accurately positioned for repeat sessions of radiotherapy then such side effects can be minimised. Benefits will also include the reduction of dental decay (caries) caused by radiation and death of the bone tissue as a late side effect of radiation (ostiorad ionecroses).</p>
<p>In planning treatment for head and neck cancers it is necessary to perform each session of radio therapy with the patient in an identical position (as far as is possible) for each session. This can be problematic for treatment of the head area, in particular for the oral cavity as the patient's lower jaw and tongue are inclined to change position even when the head is held securely.</p>
<p>b. Related Art In the treatment of oral cancers a face mask is used in conjunction with a bite block to open the jaws and depress the tongue. This helps to ensure a repeatable position during each session. There are various prior art bite blocks. One simple type uses a silicone putty or impression material which is inserted into the patient's mouth with a tube inserted through to allow the patient to breath. The tube may include a flap which serves to depress the tongue. This simple bite block is uncomfortable for the patient to use and does not position the tissues accurately enough to allow reproducible radiotherapy. Hence the set up margins of the treatment must take this inaccurate positioning into account.</p>
<p>A more complex version uses oral impressions to make a custom made bite block.</p>
<p>However, the bite block must be made and fitted prior to treatment, and consequently delays to the treatment may be incurred.</p>
<p>Prior art mouth props in the field of human and veterinary dentistry are also known. However, such devices are relatively complex due to the need to prop open the patient's mouth whilst also allowing access to the patient's oral cavity by the dentist, and repeatable positioning of the patient's perioral tissues is not really an issue.</p>
<p>Therefore, it is desirable to provide a bite block which is simple to manufacture, which will ensure reproducible positioning of the patient's oral tissues and which can be simply customised for each patient without incurring treatment delays.</p>
<p>SUMMARY OF THE INVENTION</p>
<p>According to the invention there is provided a bite block frame for use in oral radiotherapy comprising: a top portion arranged to support the maxilla of a patient and having a front portion arranged to extend outside the patient's upper labia and a rear portion arranged to fit inside the patient's upper dentals; a bottom portion arranged to fit inside patient's mandible and having a front portion arranged to extend outside the patient's lower labia and a rear portion arranged to fit inside the patient's lower dentals; and a bridging portion to be positioned outside the patient's mouth and extending between the maxilla and mandible to the front of the labia such that the top portion and bottom portion are spaced apart by the bridging portion.</p>
<p>It is an advantage if the top portion and the bottom portion each have a stop portion arranged to rest on the patient's upper and lower labia respectively such that the bite block frame is prevented from entering the patient's oral cavity for example during swallowing, or while the patient is under anaesthetic.</p>
<p>Preferably the frame further comprises curves to accommodate the patient's labia, and/or a tongue depressor and/or channels to accommodate a patient's teeth.</p>
<p>In the preferred embodiment the bite block frame comprises a single strip of radio translucent material which makes the frame extremely simple to manufacture.</p>
<p>Preferably the strip is substantially 2mm thick and 12mm wide.</p>
<p>A customised bite block may be created by using such a frame together with an impression material bonded to an inner surface of the bite block frame to bond the top portion to the bottom portion and to give a fixed separation. It is also possible to incorporate such impression material into any tooth channels.</p>
<p>According to another aspect of the invention there is also provided a method of manufacturing a bite block comprising the steps of: heating a radio translucent thermo plastic material and forming the material on a jig to form a bite block frame as described above; inserting a malleable impression material between the top and bottom portions of the frame; inserting the frame and the malleable impression material into the mouth of a patient; removing the bite block once the malleable impression material is hardened.</p>
<p>BRIEF DESCRIPTION OF THE DRAWINGS</p>
<p>The invention will now be described, by way of example only, with reference to the accompanying drawings in which: Figure 1 illustrates a perspective view of a bite block according to the present invention; Figure 2 illustrates the bite block of Figure 1 with a radio translucent material insert; and Figure 3 illustrates a side view of the bite block of Figure 1.</p>
<p>DETAILED DESCRIPTION</p>
<p>Referring now to Figure 1, a bite block frame I is formed from a single piece of radio translucent plastic and comprises a top portion 20 a bottom portion 30 and a bridging portion 10.</p>
<p>The plastic is formed to the desired frame shape by heating the material and forming it to a preformed jig. In the preferred embodiment the plastic is 2mm thick and 12mm wide.</p>
<p>The top portion 20 fits under the top jaw (maxilla) of the patient, the bottom portion fits above the bottom jaw (mandible) of the patient and the bridging portion 10 serves to keep the jaws of the patient apart in a fixed separation.</p>
<p>The top portion 20 has a stop means 4a, and the bottom portion 30 has a corresponding stop means 4b. The stop means 4a, 4b serve to prevent the bite block from entering the patient's mouth, for example when the patient swallows.</p>
<p>The top portion 20 has a curve 3a for the patient's upper lip (labia), and the bottom portion 30 has a corresponding curve 3b for the patient's lower lip (labia).</p>
<p>The top portion 20 has a channel 2a for the patient's upper dental, and the bottom portion 30 has a channel 2b for the patient's lower dental.</p>
<p>The bottom portion 30 optionally has a tongue depressor 5 which serves to hold the patient's tongue against the bottom of the patient's mouth (mandible) whilst the radiotherapy is in progress. The tongue depressor could be shaped other than shown in the Figures.</p>
<p>Referring now to Figure 2, a radio translucent impression material such as Aquaplast RTTM Thermoplastic which comprises 2-Oxepanone, polymer with 1,4-butanediol (also know as Adapt-itTM which come in the form of pellets) is immersed within water at 70 degrees centigrade to form a malleable compound and inserted in the space between the top portion 20 and the bottom portion 30 in order to bond the top portion and the bottom portion together. Impression material may also be inserted into the channels 2a and 2b to gain an impression of the patient's teeth.</p>
<p>The bite block is located in the patient's mouth and the patient inserts their teeth into the channels 2a and 2b, forming dental impressions within the impression material (if used). The patient ensures that the tongue is under the tongue depressor 5 and that the teeth are located correctly in the grooves 2a and 2b.</p>
<p>The radio translucent material 6 hardens, the device is removed from the patient's mouth, and any excess material is cleaned from the bite block.</p>
<p>This method provides a simple customised bite block thus allowing repeatable radiotherapy to be performed in subsequent sessions.</p>
<p>Once the mouth prop has been customised the bridging portion may be attached to a face mask for keeping the patient's head in a fixed position in order to facilitate repeatability of the positioning of the patient's oral cavity.</p>
<p>It will be understood that various alterations, modifications, and/or additions may be introduced into the constructions and arrangements of parts described above without departing from scope of the present invention as defined in the appended claims.</p>
Claims (1)
- <p>CLAIMS</p><p>1. A bite block frame for use in oral radiotherapy comprising: a top portion arranged to support the maxilla of a patient and having a front portion arranged to extend outside the patient's upper labia and a rear portion arranged to fit inside the patient's upper dentals; a bottom portion arranged to fit inside patient's mandible and having a front portion arranged to extend outside the patient's lower labia and a rear portion arranged to fit inside the patient's lower dentals; and a bridging portion to be positioned outside the patient's mouth and extending between the maxilla and mandible to the front of the labia such that the top portion and bottom portion are spaced apart by the bridging portion.</p><p>2. A bite block frame according to claim 1, in which the top portion and the bottom portion each have a stop portion arranged to rest on the patient's upper and lower labia respectively such that the bite block frame is prevented from entering the patient's oral cavity.</p><p>3. A bite block frame according to any one of the preceding claims, in which the frame further comprises curves to accommodate a patient's labia.</p><p>4. A bite block frame according to any one of the preceding claims further J comprising a tongue depressor. /</p><p>5. A bite block frame according to any one of the preceding claims, in which the frame further comprises channels to accommodate a patient's teeth.</p><p>6. A bite block frame according to any one of the preceding claims, in which the frame comprises a single strip of radio translucent material.</p><p>7. A bite block frame according to claim 6, in which the single piece of radio translucent material comprises a strip which is substantially 2mm thick and substantially 12mm wide.</p><p>8. A customisable bite block comprising a frame according to any one of the preceding claims and an impression material suitable for bonding to an inner surface of the bite block frame to fix the position of the top portion relative to the bottom portion.</p><p>9. A bite block comprising a bite block frame according to claim 5, and further comprising an impression material suitable for inserting in said grooves.</p><p>10. A method of manufacturing a bite block comprising the steps of: heating a radio translucent thermo plastic material and forming the material on a jig to form a bite block frame according to any one of claims I to 7; inserting a malleable impression material between the top and bottom portions of the frame; inserting the frame and the malleable impression material into the mouth of a patient; removing the bite block once the malleable impression material is hardened.</p>
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB0523874A GB2432767A (en) | 2005-11-24 | 2005-11-24 | Radiotherapy bite block |
| PCT/GB2006/003975 WO2007060388A1 (en) | 2005-11-24 | 2006-10-25 | Radiotherapy bite block |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB0523874A GB2432767A (en) | 2005-11-24 | 2005-11-24 | Radiotherapy bite block |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| GB0523874D0 GB0523874D0 (en) | 2006-01-04 |
| GB2432767A true GB2432767A (en) | 2007-05-30 |
Family
ID=35601078
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| GB0523874A Pending GB2432767A (en) | 2005-11-24 | 2005-11-24 | Radiotherapy bite block |
Country Status (2)
| Country | Link |
|---|---|
| GB (1) | GB2432767A (en) |
| WO (1) | WO2007060388A1 (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7963286B2 (en) * | 2007-08-10 | 2011-06-21 | Infohealthnetwork, Inc. | Combination bite block, tongue depressor/retractor and airway |
| US8251069B2 (en) | 2007-08-10 | 2012-08-28 | Infohealthnetwork, Inc. | Combination bite block, tongue depressor/retractor and airway |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108939315B (en) * | 2017-05-18 | 2021-06-18 | 胡漫 | Method for manufacturing buccal device suitable for radiotherapy of head and neck tumor and buccal device |
| CN109125950A (en) * | 2018-06-29 | 2019-01-04 | 哈尔滨医科大学 | A kind of oral cavity radiotherapy mouth containing device bracket and production method |
| CN109663222B (en) * | 2018-11-30 | 2024-05-17 | 中国人民解放军总医院 | Head and neck fixing device for radiotherapy |
| CN109646818B (en) * | 2018-12-10 | 2020-12-25 | 上海交通大学医学院附属第九人民医院 | Oral radiotherapy support |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5730745A (en) * | 1993-11-02 | 1998-03-24 | Loma Linda University Medical Center | Vacuum-assisted fixation apparatus |
| US6096048A (en) * | 1994-04-20 | 2000-08-01 | Howard, Iii; Matthew A. | Noninvasive, reattachable skull fiducial marker system |
| US6223067B1 (en) * | 1997-04-11 | 2001-04-24 | Brainlab Med. Computersysteme Gmbh | Referencing device including mouthpiece |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4304227A (en) * | 1978-03-03 | 1981-12-08 | Samelson Charles F | Device for treatment of snoring, bruxism or for avoidance of sleep apnea |
| GB2173105A (en) * | 1985-04-04 | 1986-10-08 | Neil Christopher Barnes | Mouthpiece |
| DE3530234A1 (en) * | 1985-08-23 | 1987-02-26 | Siemens Ag | DENTAL X-RAY DIAGNOSTIC DEVICE |
| SE462737B (en) * | 1989-05-10 | 1990-08-27 | Fixster Instr Ab | DEVICE FOR REPEATABLE POSITIONING OF A REFERENCE ELEMENT AT THE HEAD OF A PEOPLE |
| DE19619761C2 (en) * | 1995-05-18 | 1999-12-09 | Michael Vogele | Device and method for fixing the human head |
| US6877513B2 (en) * | 2000-01-21 | 2005-04-12 | Respironics, Inc. | Intraoral apparatus for enhancing airway patency |
| US7448388B2 (en) * | 2003-08-07 | 2008-11-11 | Halstrom Leonard W | Mandible positioning devices |
-
2005
- 2005-11-24 GB GB0523874A patent/GB2432767A/en active Pending
-
2006
- 2006-10-25 WO PCT/GB2006/003975 patent/WO2007060388A1/en active Application Filing
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5730745A (en) * | 1993-11-02 | 1998-03-24 | Loma Linda University Medical Center | Vacuum-assisted fixation apparatus |
| US6096048A (en) * | 1994-04-20 | 2000-08-01 | Howard, Iii; Matthew A. | Noninvasive, reattachable skull fiducial marker system |
| US6223067B1 (en) * | 1997-04-11 | 2001-04-24 | Brainlab Med. Computersysteme Gmbh | Referencing device including mouthpiece |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7963286B2 (en) * | 2007-08-10 | 2011-06-21 | Infohealthnetwork, Inc. | Combination bite block, tongue depressor/retractor and airway |
| US8251069B2 (en) | 2007-08-10 | 2012-08-28 | Infohealthnetwork, Inc. | Combination bite block, tongue depressor/retractor and airway |
Also Published As
| Publication number | Publication date |
|---|---|
| GB0523874D0 (en) | 2006-01-04 |
| WO2007060388A1 (en) | 2007-05-31 |
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