1. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Dental Protector ® The perfect protection for tele- and brachytherapy of head and neck tumors HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, www.hibrand.li

2. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Problem No exact repeatable positioning of facial soft parts (tongue, lips, cheeks) No exact repeatable mouth opening

3. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li OUR SOLUTION - DENTAL PROTECTOR ® exact repetition of lower jaw and soft part position reduction of radiation side effects optimizing of the radiation target volume Upper jaw Tongue mould Lower jaw Lip mould

4. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li DENTAL PROTECTOR ® individually produced for each patient independent of patient‘s denture takes into account patient‘s anatomy adaptable to special therapy requirements fulfils all GEC-ESTRO recommendations patented (pat. no. HI8903/09 169 625.2) CE- certified procedure Upper jaw Tongue mould Lower jaw Lip mould

5. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li DENTAL PROTECTOR ® daily exact repeatable: mouth opening tongue position lip position cheek position Upper jaw Tongue mould Lower jaw Lip mould

6. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Field of applications  Protection of facial soft parts (tongue, lips, cheeks) by Teletherapy Brachytherapy  Tumors of the floor  Oropharyngeal tumors  Nasopharyngeal tumors  Tumors of the nasal cavity and the paranasal sinuses of

7. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li 63 years, female, squamous cell- and tongue carcinoma, cT4 cN0 M0 G2; neoadjuvante RTX 50 Gy, Mitomycin C, 5-FU Radiation of (floor of mouth) squamous cell- tongue carcinoma EXAMPLE 1: Extensive radical radiation therapy under maximum protection of the lawer jaw and upper jaw by using a tongue- and lip shield. THERAPY-GOAL: Clinical experiences Upper jaw Lip moud

8. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Operation: ypT0; no radiation side effects on the lower lip and upper jaw RESULT: Planning- CT with isodosedistribution: lower lip outside of high dosage area (arrow) End of radiotherapy: no radiation side effects in lower lip Clinical experiences => aim of therapy accomplished!

9. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Clinical experiences displacement of lips and labial angles EXAMPLE 2: Hibrand Dental Protector ® with laterally accentuated lower and upper lip mould for anterior displacement of the labial angles. Hibrand Dental Protector ® in situ with formation of a “duck’s bill”, thereby dis- placement of the lips and labial angles out of the lateral radiation fields. Radioopaque marking for better demarcation of the tongue (arrow) in the planning CT scan. Upper series: Lower series:

10. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Clinical experiences anterior tongue displacement EXAMPLE 3: Hibrand Dental Protector ® with double tongue moulds (arrows) for active anterior displacement of the tongue. Hibrand Dental Protector ® in situ with clinical active anterior displacement of the mobile tongue (arrows) moved out of radiation field. Upper series: Lower series:

11. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Clinical experiences cheek and tongue displacement EXAMPLE 4: Hibrand Dental Protector ® with a lateral mould for cheek (arrow) and tongue displacement each (black arrow). Hibrand Dental Protector ® in situ in the planning CT-scan: cheek (arrow) and tongue displacement (black arrow), displacement out of high dosage area. Upper series: Lower series:

12. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li Clinical experiences brachytherapy – detachable lead shielding EXAMPLE 5: Hibrand Dental Protector ® on a stone cast: Without and with detachable lead shielding. Daily repeatable positioning of both jaws and the lead shielding (fulfils all GEC-ESTRO recommendations 2009).

13. HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan, Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.li HIBRAND Establishment, Im alten Riet 121, LI-9494 Schaan Tel. +41 78 6041348, E-Mail: oh@hibrand.li, www.hibrand.lioh@hibrand.li