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Hospital Dentistry - ABGD Oral Boards > Psych/Cancer/Implants > Flashcards

Psych/Cancer/Implants Flashcards

1
Q

What are the 2 most common places for Tumor/Oral Cancer Location/?

A
  • Tongue
  • Tonsil
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2
Q

What are some risk factors for oral cancer?

A
  • Tobacco
  • Alcohol
  • Age
  • Sex
  • Viral
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3
Q

What are 2 viral risk factors for oral cancer?

A

Ebstein Barr Virus (Mono)

  • Positively linked ot nasopharyngeal cancer

HPV (16, 18, 31, 32)

  • Positively linked to oral cancer
  • Better prognosis
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4
Q

What does TNM stand for?

A
  • T: Tumor Size
  • N: Nodal Involvement
  • M: Distant Metastasis
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5
Q

For Tumor Size, describe Tx through T4…

A
  • Tx: Primary tumor cannot be assessed
  • TO: No evidence of primary tumor
  • T1: Tumor < 2 cm
  • T2: Tumor > 2 cm, but < 4 cm
  • T3: Tumor > 4 cm
  • T4: Tumor of any size that invades adjacent structures
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6
Q

Describe Nodal involvement from NO to N3…

A
  • NO: No palpable node
  • N1: Single, homolateral node < 3 cm
  • N2: Single, homolateral node 3 - 6 cm, or multiple homolateal nodes, none > 6 cm
  • N3: Single or multiple homolateral nodes with one > 6 cm or bilateral nodes or contralateral nodes
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7
Q

For Distant Metastasis, describe MX to M1…

A
  • Mx: Presence of distant spread cannot be assessed
  • M0: No distant spread
  • M1: Cancer has spread to distant sites outstide the head and neck region
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8
Q

What nodes can you palpate on the head and neck?

A
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9
Q

What is the first choice treatment for most oral cancers?

A

Surgery

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10
Q

What is the limiting factor to surgery when removing oral cancer?

A
  • Crtical strucutres of the head and neck
  • Can include neck dissection
  • Ranges from small excision to large resection
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11
Q

How do Chemotherapy drugs affects cells?

A

Interfere with mitosis

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12
Q

How is Chemotherapy administered?

A

IV infusion

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13
Q

What are 3 side effects of Chemotherapy?

A
  • Mucositis
  • Leukopenia
  • Nausea
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14
Q

What are the 4 types of external beams associated with Radiation Therapy?

A
  1. Gamma Rays
  2. X-Rays
  3. Protons
  4. Electrons
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15
Q

What are 3 side effects of Radiation Therapy?

A
  • Xerostomia
  • Mucositis
  • Muscle Fibrosis
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16
Q

What are the 3 side effects of a radiated mandible after extractions??

A
  • Hypoxic
  • Hypocellular
  • Hypovascular
17
Q

When you have a total dose > ____ CGy, you would consider ____________ _____________ therapy…

A
  • 6000 CGy
  • Hyperbaric Oxygen Therapy
18
Q

How much does Hyperbaric Oxygen Therapy reduce incidence of ORN in the mandible?

A

30% to 5%

19
Q

What is the dive scheudle for Hyperbaric Oxygen Therapy if total dose > 6000 CGy

A
  • 20 pre-op dives
  • 10 post-op dives
20
Q

What types of disease render Antiresorptive Therapy?

A
  • Osteoporosis
  • Pagets Disease
  • Bone metastasis of malignancies
  • Multiple Myeloma
21
Q

What are 3 examples of oral BIsphosphonates?

A
  • Fosamax (Alendronate)
  • Actonel (Risdronate)
  • Boniva (Ibandronate)
22
Q

What are 4 examples of IV Bisphosphonates?

A
  • Aredia (Pamidronate)
  • Boniva (Ibandronate)
  • Zometa (Zolendronic Acid)
  • Reclast (Zelendronic Acid)
23
Q

What is Denosumab used to treat?

A

Antiresorptive Therapy

24
Q

What does a Cathepsin K inhibitor do like Odanacatib?

A
25
Q

What 3 elements MUST YOU HAVE to diagnosis MRONJ?

A
  1. Current or previous treament with antiresorptive or antiangiogenic
  2. Exposed bone or bone that can be probed through an intra/extraoral fistula in the maxillofacial region that has persisted for more than 8 weeks
  3. No history of radiation therapy to the jaws or obvious mets to bone
26
Q

What is the percentage of of people getting MRONJ after Osteoporosis treatment?

A
  • AS high as 0.1% spontaneous
  • 0.34% following dental extraction
27
Q

What is the risk of a Cancer patient taking Denosumab (Xgeva) of getting MRONJ?

A

As high as 13% seen in literature

28
Q

How do you treat a pt who is clinically normal, asymtomatic who have received antiresorptive therapy?

A
  • Mp treatment beyond routine dental care
  • Patient education
29
Q

How would you treat a patient who is Stage 0 for ARONJ who has no clincal evidence of exposed bone, but presence of non-specific symptoms or clinical and/or radiographic abnormalities?

A
  • Conservative local treatment measures
  • Analgesics and antibiotics as indicated
  • Communication with prescribing physician
30
Q

How would you treat a ARONJ Stage 1 pt who has exposed and necrotic bone in patients who are asymptomatic and have no evidence of infection?

A
  • Antimicrobial mouth rinse
  • Smooth sharp bone to relieve soft tissue irritation, remove loose sequestra
  • Analgesics and antibiotics as indicated
  • Clinical follow-up every 3 - 6 months
  • Review indications for continued anti-resorptive therapy with prescribing physician
31
Q

How would you treat a Stager 2 ARONJ pt who has exposed and necrotic bone associated with pain and/or signs of infection in the region of bone exposure with or without purulent drainage?

A
32
Q

How would you treat a Stage 3 pt with ARONJ who has exposed and necrotic bone with pain, infection, and at least one of the following: exosure and necrosis extending beyond the local alveolar tissues; radiographic evidence of osteolysis extending to the inferior mandibular border or the maxillary sinus floor; pathologic fracture; oro-antral, oro-nasal or oro-cutaneous communication?

A
33
Q

According to the ADA/AAOS - what can you consider in regards to antibiotic prophylaxis for total prosthetic hip and knee repalcements?

A

You may consider discontinuing the practice of antibiotics prophylaxis for total prostehtic hip and knee joints undergoing routine dental procedures

34
Q

If you are going to prescribe antibitoics prior to a dental procedure for a patient who has had a Total Joint Replacement, what would you prescribe?

A

2 gram one hour prior to procedure

  • Amoxicillin
  • Cephalexin (Keflex)
  • Cephradine(Velosef)

Hospital Dentistry - ABGD Oral Boards (10 decks)

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