Dental treatment in patients with leukemia.
Dental treatment in patients with leukemia.
Zimmermann C, Meurer MI, Grando LJ, Gonzaga Del Moral JÂ, da Silva Rath IB, Schaefer Tavares S.
PMID: 25784937
Neutrophil and platelet counts play a major hematologic index in predicting bleeding, infection risk, and whether to perform dental procedures. There are no internationally accepted protocols, but several recommendations have been published. (Table 2) Generally, antibiotic prophylaxis is required when the neutrophil count is less than 1,000 cells / mm3, and transfusion is recommended when the platelet count is 40,000-60,000 cells / mm3.
Dental procedures can be divided into six groups according to the degree of invasiveness. Types I and II are noninvasive procedures, and patients can be enrolled at any time before, during, and after chemotherapy. In this case, the patient is in the transchemotherapy group because of the fact that the consolidation therapy will be started immediately after the induction therapy 2 weeks after the induction therapy. In this case, the dental intervention is the emergency situation . Type III is a high risk factor in the transchemotherapy stage and should be determined by considering the hematologic index and recommending the use of prophylactic antibiotics. Type IV, V, and VI are more invasive procedures and recommend postpone, as well as type III restriction, as well as emergency situations.
Type I includes oral exam, oral hygiene instruction, and molding. Type II includes simple restoration and supragingival scaling. Type III is a non-surgical procedure that involves more complex restorations, subgingival scaling, and endodontics. However, it involves simple extractions, curettage (gingivoplasty) for type IV, multiple extractions for flap surgery / gingivectomy Of impacted tooth, apicoectomy, single implant placement, and type VI are extracted from an entire arch or both, extraction of multiple impacted teeth, flap surgery, orthognathic surgery, and placement of multiple implants. If the patient has all four wisdom teeth and more than one wisdom tooth is desired, multiple extraction, or type V procedure, should be performed. In this case, the author recommends that leukemia be elective before the diagnosis and treatment begins, but should be completed after successful completion of antineoplastic treatment if treatment has already begun.
Therefore, the above recommendations suggest that the patient should be deferred until all anticancer therapy has been completed, and if necessary, low risk scaling may be performed, if necessary, while maintaining oral hygiene care.
Zimmermann C, Meurer MI, Grando LJ, Gonzaga Del Moral JÂ, da Silva Rath IB, Schaefer Tavares S.
PMID: 25784937
Neutrophil and platelet counts play a major hematologic index in predicting bleeding, infection risk, and whether to perform dental procedures. There are no internationally accepted protocols, but several recommendations have been published. (Table 2) Generally, antibiotic prophylaxis is required when the neutrophil count is less than 1,000 cells / mm3, and transfusion is recommended when the platelet count is 40,000-60,000 cells / mm3.
Dental procedures can be divided into six groups according to the degree of invasiveness. Types I and II are noninvasive procedures, and patients can be enrolled at any time before, during, and after chemotherapy. In this case, the patient is in the transchemotherapy group because of the fact that the consolidation therapy will be started immediately after the induction therapy 2 weeks after the induction therapy. In this case, the dental intervention is the emergency situation . Type III is a high risk factor in the transchemotherapy stage and should be determined by considering the hematologic index and recommending the use of prophylactic antibiotics. Type IV, V, and VI are more invasive procedures and recommend postpone, as well as type III restriction, as well as emergency situations.
Type I includes oral exam, oral hygiene instruction, and molding. Type II includes simple restoration and supragingival scaling. Type III is a non-surgical procedure that involves more complex restorations, subgingival scaling, and endodontics. However, it involves simple extractions, curettage (gingivoplasty) for type IV, multiple extractions for flap surgery / gingivectomy Of impacted tooth, apicoectomy, single implant placement, and type VI are extracted from an entire arch or both, extraction of multiple impacted teeth, flap surgery, orthognathic surgery, and placement of multiple implants. If the patient has all four wisdom teeth and more than one wisdom tooth is desired, multiple extraction, or type V procedure, should be performed. In this case, the author recommends that leukemia be elective before the diagnosis and treatment begins, but should be completed after successful completion of antineoplastic treatment if treatment has already begun.
Therefore, the above recommendations suggest that the patient should be deferred until all anticancer therapy has been completed, and if necessary, low risk scaling may be performed, if necessary, while maintaining oral hygiene care.
