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Oncology

How do you manage a patient undergoing an allogeneic bone marrow transplant?

This question was submitted to us by a general dentist: How should we manage a patient undergoing an allogeneic bone marrow transplant? Dr. Jeff Chadwick, at Princess Margaret Cancer Centre, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question The allogeneic bone marrow transplant (BMT) is a medical procedure that may be employed for the treatment of several hematologic malignancies including, but not limited to, aplastic anemia, myelodysplastic syndrome, acute and chronic leukemias and lymphomas. BMTs typically involve the insertion of a central venous catheter (CVC), high dose chemotherapy and, in some cases, total body irradiation, prior ...

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Is inadequate osseointegration a concern in radiation-treated patients, if implants are treatment planned?

This question was submitted by a general dentist: Is inadequate osseointegration a concern in patients who have received radiation therapy for a head and neck malignancy if implants are treatment planned? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question Yes, however … As with most questions related to this patient population, the answer is: “it depends.” Careful examination is a vital step in determining which restorative/prosthodontic approach best suits the individual. Examination also mandates a thorough review of their cancer diagnosis as well as the constituents and sequence ...

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What are the risk factors for osteoradionecrosis (ORN), in a xerostomic radiation-treated patient, if extractions are required?

This question was submitted to us by a general dentist: If extractions are required, what are the risk factors for osteoradionecrosis (ORN) in a xerostomic patient with rampant decay two years after the successful treatment of their head and neck cancer (radiation, chemotherapy and surgery)? Dr. Jeff Chadwick, at Princess Margaret Hospital, Dental Oncology, Ocular, and Maxillofacial Prosthetics Group, provided a preliminary response to this question:  With the numerous comorbidities associated with head and neck radiation (oral mucositis, radiodermatitis, dysgeusia, dysphagia/odynophagia, trismus, and xerostomia), arises a critical issue with tooth extraction is the altered biology of the maxilla and mandible due ...

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