Treatment Plane & Seminar

8/13/2019 Treatment Plane & Seminar

1/17

AHMED IMAD 2 91 458

HASSAN KAIS 2 92 519


2/17

72 year old lady presented to dentist seeking theextraction of the few teeth in her mouth in order

to get a set of full dentures , Her medical historyrevealed breast cancer with metastasis shereceived radiotherapy , chemotherapy 2 years agoand since then she is on Zometa .


3/17

To improve the quality of live for patientswith malignant disease, who are receivingcancer therapy that has implications for oralcomfort and function, by promotingconsistent high standards of oral carethrough a coordinated team approach


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5/17

Prevent recurrenceRecommended (after surgery) when :

cancer larger than 5 cm cancer is found in the lymph nodes

Radiotherapy can be given in 2 main ways :External beam radiationBrachytherapy ( internal radiation)

Mechanism :Destroy cancer cells and normal cells as well

Fraction : (5 days/week (Monday to Friday) for about 5 to 6 weeks)


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Dermatitismucosal changesCandidiasisloss of tastesalivary gland dysfunctionradiation caries

soft-tissue necrosisscar tissue formationosteoradionecrosis.


7/17

Chemotherapy -The word chemotherapy means the use of anydrug (such as aspirin or penicillin) to treat any disease, but tomost people chemotherapy refers to drugs used for cancer

treatment.

Shortened as Chemo

Medically Antineoplastic (anti-cancer) Cytotoxic (cell-killing) .


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The most common chemo drugs used for breast cancer : The anthracyclines (doxorubicin/Adriamycin&

epirubicin/Ellence )The taxanes ( paclitaxel/Taxol & docetaxel/Taxotere )

Many other chemo drugs are useful in treating women with breast cancer, suchas:Platinum agents (cisplatin, carboplatin)Vinorelbine (Navelbine )Capecitabine (Xeloda )Liposomal doxorubicin (Doxil )

Gemcitabine (Gemzar

)MitoxantroneIxabepilone (Ixempra )Albumin-bound paclitaxel (Abraxane )Eribulin (Halaven )

May be used in combination


9/17

Bone Marrow Suppression

Thrombocytopenia

Anemia

Nausea

Vomiting

Alopecia


10/17

Mucositis

Infections

Dental Alterations

Xerostomia

Bleeding

Osteonecrosis


11/17

Drug Type : Zoledronic acid or zoledronate is a bisphosphonate derivativeWhat Zometa Is Used For :

Hypercalcemia (HCM)multiple myelomaOsteoporosisprevious hip fracture

How Zometa Is Given : IV (Dose 4.5 mg/5 ml IV injection)No pillAmount :

General health or other health problems,type of cancer or condition being treated

How Zometa Works : lowers high blood calcium levelsslowing the breakdown of your bones

ZOMETA is not an anti-cancer therapy.


12/17

Adverse effect on kidneysBone/ joint / muscle pain

Nausea & vomitingNumbnessFatigueFeverEye related SEHeadache

Not all SE Predictable

Reversible Prevention

No Relationship Not to confused with

HCM


13/17

Osteonecrosis of the Jaw (ONJ) Mucositis

InfectionsTaste changesDry mouthPainTooth decayGum diseaseSores inside your mouth.


14/17

Medical team communication ( Dentist, Physicianand Oncologist )

Extraction and full denture NOT Recommended .Why ?

Slight chance of ONJ VS Bone metastasis

(Weigh the alternatives !!!)Zometa affect !Preventive Rx


15/17

Alternative RX :

RPDFill in spaces of missing teethFunctionStop unwanted movement of remaining teethSpeech

Esthetics

Overdenture??


16/17

Adjunct RX :Fluoride rinseMouth wash / difflamSaliva substituteSalivary gland protectionFrequent oral hygiene recalls

Topical antifungal medicationDenture hygiene instructionDietary advice

Simple, functional and acceptable )


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Documents

Treatment Plane & Seminar