How do you approach teeth extractions for head and neck cancer patients getting radiation?
We have seen a lot of patients referred to oral surgeons who insist all their teeth are in poor shape, leaving these patients edentulous.
What do you quote patients as to the risk of ORN?
Does your decision to refer a patient for extractions depend on the doses received to the mandible?
What is your opinion on dental implants requiring a post? What do you tell patients regarding how long following irradiation to wait before getting procedures done, and is there a time frame after which the risks stabilize?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · University of Michigan
Answered on
Here is what my oral surgeon, who deals with ORN, told me:
“We do implants in fields of high does radiation. The risk of immediate and long term failure is higher but often the risk/benefit still weighs in favor. I have two patients that have devoleped ORN (one immediate and one late) after implants...
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Mednet MemberInvited Expert
Radiation Oncology · University of Texas MD Anderson Cancer Center
Answered on
Our experience shows a risk of ORN of ~ 7%. Of course that has to be taken into context of all grades, from conservative management to aggressive surgical management
We our fortunate as a cancer center to have in house dental oncologists who see the patients up front and are involved in the decisi...
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