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. |
— |