Medical History Update for Oral Surgery and Dental Implants
Medication: Coumadin Plavix Pradaxa Xarelto Eliquis Aspirin Antineoplastics any blood thinners including garlic
Diseases: Liver diseases
Conditions: Clotting issues
Smoker? Dry Mouth? Birth control?
Diseases: Diabetes Renal Disease COPD Congestive heart failure HIV
Connective Tissue Diseases like RA Sjogren’s Syndrome
History of: Multiple myeloma, Bone metastasist, osteoporosis, radiation therapy in head or neck, chemotherapy, organ transplant.
Allergic to any Medication? Penicillin?
Bone healing or strengthening pills or shots = Bisphosphates? taken for osteoporosis, Paget’s disease, multiple myeloma, hypercalcemia, and metastatic breast cancer and prostate cancer
- Alendronate (Fosamax, Alendro)
- Risedronate (Actonel)
- Ibandronate (Boniva)
- Atelvia Skelid (tiludronate) This one OK
- Tiludronate (Skelid) This one OK
- Pamidronate (Aredia, Pamisol) worst
- Zolendronic acid (Zometa, Reclast) worst
- Ibandronate (Boniva IV)
- Clodronate (Bonefos) This one OK
- Denosumab monoclonal Ig Ab (Prolia, XGEVA=like IV). Prolia patients should be treated the way we treat ORAL Bisphosphonate patients as their risk is very low, likely less than .5% Watts 2019 JCEM. Xgeva patients should be treated the way we treat IV Bisphosphonate Patients.
History of cancer? What type? Do you know what treatments you were given?
Immunosuppressive drugs? Enbrel Humira
Antiangiogenic agent? Cancer and macular degeneration like Sunitinib (Sutent) Bevacizumab (Avastin)
Congential heart defects?
History of C. diff. infection?
FYI Bisphosphonates can be classified into 2 categories: non-nitrogen containing and nitrogen containing bisphosphonates. Nitrogen-containing bisphosphonates are the only compounds that cause BP-related osteonecrosis. Reference
Treatment of BP patient OS and implant