Contouring and dose extraction of the maxilla, mandible and teeth on head and neck cancer radiotherapy planning scans

Abstract

Background and Purpose

Despite their vulnerability to radiation-induced damage, the maxilla and dentition are not routinely contoured in head and neck (HN) radiotherapy (RT), preventing accurate dose assessment and establishment of dose-effect relationships. This literature review aimed to: (1) identify published dentofacial contouring approaches, (2) synthesise current methods, and (3) where feasible, compare practices in paediatric and adult RT.

Materials and Methods

MEDLINE and Embase were searched for studies that contoured the maxilla, mandible, or teeth in HN RT. Reference lists were manually screened.

Results

Thirty-one (2003–2025) papers met inclusion criteria. Manual contouring predominated (77.4%), with substantial heterogeneity across all structures. Only seven studies (22.6%) contoured the maxilla. Tooth contouring varied from individual segmentation to variable groupings. Eight studies (25.8%) reported dental professional involvement.

Conclusion

Dentofacial contouring lacks standardisation and predominantly relies on manual techniques. This variability impedes dose assessment and cross-study comparisons. Standardised international guidelines for the contouring of the maxilla, mandible and teeth are necessary to ensure uniformity and enable comparability between studies.