Options Following XLA

Question 1

35-year old male w/ UR1 required XLA. Generally F+W but smokes 15/ day.
What information need prior to tx plan?

Answer 1

MH
DH
SH
Dietary hx

Question 2

What examination carry out before deciding tx plan?

Answer 2

EO
IO
Special investigations: study models/ RADs/ sensibility test adjacent teeth

Question 3

What is purpose of BW?

Answer 3

Detect both proximal and occlusal caries
Look at bone loss

Question 4

What is purpose of PA?

Answer 4

Assess periodontal and periodical status of tooth

Question 5

What is purpose of OPG?

Answer 5

Limited use as doesn’t show caries or PA lesions are clearly as IO films

Question 6

What are risks of smoking on oral health?

Answer 6

RF in development and progression of periodontal disease
Compromise socket healing post XLA
Increased risk of cancer

Question 7

What happens on microscopic level bc of smoking?

Answer 7

Reduction in gingival blood flow, white cell malfunction, increase inflammatory cytokines inhancing tissue breakdown

Question 8

How does smoking affect XLA?

Answer 8

Pt should be advised not to smoke after XLA to reduce risk of dry socket and delayed healing

Question 9

Does smoking affect tooth replacement options?

Answer 9

Yes, smoking is relative CI for implants as reduces chance of osseointegration

Question 10

What are immediate replacement options following XLA?

Answer 10

No replacement - best for gingiva health
Immediate denture
Immediate bridge
Pt own XLA tooth
Immediate implant

Question 11

Requirements for immediate implant?

Answer 11

Good supporting bone
Atraumatic XLA technique for bone preservation