Stereotactic radiosurgery with an upper partial denture.

Area of Science:

• Neurosurgery
• Oncology
• Medical Imaging

Background:

• Stereotactic radiosurgery (SRS) for brain tumors typically uses biteplates for head immobilization.
• Patients with significant maxillary tooth loss pose a challenge for traditional biteplate fixation.
• Accurate head positioning is critical for effective SRS delivery.

Observation:

• A modified biteplate technique was developed for a patient with a metastatic brain tumor and partial dentures.
• The maxillary denture was secured to the biteplate using autopolymerizing resin.
• The lower jaw's rest-occlusal position was also registered on the biteplate.

Findings:

• Measurements confirmed the reproducibility and stability of the modified biteplate fixation.
• The technique successfully ensured accurate radiotherapy planning and delivery.
• A significant increase in positional error was noted when the biteplate was removed.

Implications:

• This modified biteplate technique offers a viable solution for SRS in edentulous or partially edentulous patients.
• It enhances the safety and efficacy of radiosurgery for brain metastases in challenging dental cases.
• Further research could explore wider applications of this denture-based immobilization method.