Table 3.
Possibility of dental procedures in the prechemotherapy phase.
Procedure | Considerations and restrictions | Time before the start of CT |
---|---|---|
Type I | ||
Exam | ||
Clinical Radiographic Hygiene instructions |
No restrictions. | — |
Molding | Elective procedure, postpone | — |
Type II | ||
Simple restorations (ART) Prophylaxis and supragingival scaling |
No restrictions. | — |
Orthodontics | Elective treatment, postpone. Consider removing orthodontic appliances. |
— |
Type III | ||
More complex restorations | Solely for adequacy of the oral environment. Consider use of provisional restorative materials (e.g., glass ionomer). |
— |
Scaling and root planning (subgingival) | Invasive procedure of high-risk carried out carefully. To evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. |
— |
Endodontics | ||
Symptomatic tooth | Evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. Consider extraction if endodontics fail. |
At least 1 week [1] |
Asymptomatic tooth | Postpone (tricresol formalin) OR Evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. |
At least 1 week [1] |
Type IV | ||
Simple extractions | Invasive procedure of high-risk. Evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. |
3 weeks; minimum 10–14 days [5] 2 weeks; minimum 7–10 days [1] |
Curettage (gingivoplasty) | Elective procedure, invasive and high-risk. Postpone. |
— |
Type V | ||
Multiple extractions | If for adequacy of the oral environment, evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. If elective, postpone. |
3 weeks; minimum 10–14 days [5] 2 weeks; minimum 7–10 days [1] |
Flap surgery/gingivectomy Extraction of impacted tooth Apicoectomy Single implant placement |
Elective procedure, invasive and high-risk. Postpone. |
— |
Type VI | ||
Extraction of an entire arch or both | If adequacy of the oral environment, evaluate hematological indices of platelets and neutrophils. Need for antibiotic prophylaxis. If elective, postpone. |
3 weeks; minimum 10–14 days [5] 2 weeks; minimum 7–10 days [1] |
Extraction of multiple impacted teeth Flap surgery Orthognathic surgery Placement of multiple implants |
Elective procedure, invasive and high-risk. Postpone. |
— |