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

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.