114 Chapter 5 Table 2 - Number of removed teeth per location Region No. of extracted teeth Dmean<40Gy n (%) Dmean≥40Gy n (%) Dmax<40Gy n (%) Dmax≥40Gy n (%) Larynx 217 209 (96) 8 (4) 204 (94) 13 (6) Hypopharynx 163 145 (89) 18 (11) 127 (78) 36 (22) Parotid region 94 81 (86) 13 (14) 72 (77) 22 (23) Oropharynx 667 480 (72) 187 (28) 383 (57) 284 (43) Oral cavity 378 177 (47) 201 (53) 139 (37) 239 (63) Maxillary complex 87 52 (60) 35 (40) 43 (49) 44 (51) Nasopharynx 72 62 (86) 10 (14) 54 (75) 18 (25) Other 81 68 (84) 13 (16) 58 (72) 23 (28) Total 1759 1274 (72) 485 (28) 1080 (61) 679 (39) Abbreviation: n, number; Dmax, maximum dose; Dmean, mean dose The highest percentages of redundantly removed teeth were found in the patients with tumors in the laryngeal (94-96%), hypopharyngeal (78-89%) and ‘parotid region’ (77-86%) (Table 2). In all but one of these 132 patients, the regions that received a dose of ≥40Gy were the mandibular molar and mandibular second premolar regions on both sides in the hypopharyngeal and laryngeal group. In patients from the ‘parotid region’ group, this affected only the ipsilateral side. Detailed information on the doses for each tooth and the number and percentage of redundantly removed teeth can be found in Supplementary Tables 2A1-2H2. In patients with an oropharyngeal tumor the percentages of redundantly removed teeth were 57-72%, with the areas of the four incisors, the two canines and the two contralateral premolars of the maxilla all exposed to a RT dose <40Gy. For other regions of the maxilla and for the entire mandible, the radiation dose for each tooth varied widely, resulting in percentages of redundantly removed teeth from 0% to 100% (Supplementary Tables 2D1-2D2). In the ‘oral cavity group’ the number of redundantly removed teeth was the lowest. Eleven percent of the mandibular teeth on the ipsilateral side and 40% on the contralateral side were extracted redundantly due to a Dmean of <40Gy. Considering the Dmax of <40Gy, 5% of the ipsilateral and 23% of the contralateral mandibular teeth were redundantly extracted. For maxillary teeth it was 89% and 81% for Dmean and Dmax <40Gy, respectively (Supplementary Tables 2E1-2E2).
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