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Oral Surgery · single question

A patient scheduled to begin head-and-neck radiation in 3 weeks has a non-restorable mandibular molar. What is the best next step?

  1. Extract the tooth immediately without medical consultation
  2. Consult the patient's oncologist and extract at least 2 (ideally 3) weeks prior to radiation start
  3. Defer extraction until after radiation
  4. Place an implant
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Correct answer: B. Consult the patient's oncologist and extract at least 2 (ideally 3) weeks prior to radiation start

Non-restorable teeth in the radiation field must be extracted prior to therapy to minimize the risk of osteoradionecrosis (ORN). Healing time of 2–3 weeks is ideal. Always coordinate with the oncologist. Post-radiation extractions carry high ORN risk; patients with prior radiation may require hyperbaric oxygen therapy if extraction becomes unavoidable.

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