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Oral Surgery · single question

A 40-year-old patient has pain on tooth #18 with ~30% bone loss and a questionable prognosis. The patient starts chemotherapy next week. What is the best treatment to minimize complications?

  1. Root canal treatment
  2. Scaling and root planing
  3. Composite restoration
  4. Extraction
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Correct answer: D. Extraction

  • A. RCT on a tooth with questionable prognosis (significant bone loss) would be a poor investment; the tooth remains infected and at risk during immunosuppression.
  • B. SRP alone cannot adequately address a tooth with questionable prognosis in a patient about to undergo chemotherapy.
  • C. Composite restoration does not address the periodontal disease or bone loss.
  • D. Before chemotherapy, teeth with questionable or poor prognosis must be extracted. Chemotherapy causes severe immunosuppression and mucositis, making post-chemo infections potentially life-threatening. Removing a compromised tooth BEFORE the chemo window is the standard of care.

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