Thyroidectomy: Precautions to Take Before Placing Implants?
Dr. G. asks:
I have a patient who recently had his thyroid removed because it was cancerous. Fortunately, the cancer did not metastasize because of the thick connective tissue sheath around the thyroid. He is scheduled for placement of 2 dental implants. He is taking synthroid to compensate for loss of his thyroid and it is well controlled. Are there any precautions I should take for the implant surgery? Should I wait 6 months post-op to place the implants or is it safe to place them now? What is the worst problem I could expect?
4 Comments on Thyroidectomy: Precautions to Take Before Placing Implants?
New comments are currently closed for this post.
ali fatemi
9/16/2008
Synth. is not a concern, but other medications that patient is taking might be. Is he/she taking any bisphonates? Is the patient undergoing any chemotherapy post removal of the mass?
If all the answers are negative and patient is OK and is just you and I, then place the implants, otherwise, you need to think twice if patient is undergoing chemotherapy or radiation theraypy or have been given IV Bisphosphonate. You do not want to have BON
Dr. Ozzo
9/16/2008
Specifically, hormone levels should be normal before surgery. If your patient receives or received radioactive iodine therapy, he will spread radiation around for some days or weeks depending on the dosage given. That would require to set a limit to social life and relationships for a given time by his consultant. You may have to postpone the surgery. Such an irradiation may cause decrease in saliva flow but general adverse effects are known to be limited. You do not have to wait for 6 months where timing will vary on the individual basis.
Also remember such patients may come up with malaise and depressive mood, which may be erased with all other possible complaints following proper drug usage.
Generally, in such rare medical conditions we face, it seems wiser to consult the doc responsible for the treatment and/or maintenance of the patient. We use consultation form which describes the situation and asks the doc for the evaluation of the patient in order to confirm an oral surgery which involves bone under local anaesthesia. After we receive the paper back as signed and stamped by the responsible doctor, we explain the patient which step we plan to take.
I hope to have been helpful.
kem
9/16/2008
RAI treatment for Thyroid cancer is a common cause for xerostomia and parotid/submandibular salivary problems... be aware that this relative xerostomia may impact long-term implant maintanence....
Harvey Meade, DMD
2/10/2009
I have a patient who completed radiation therapy of her thyroid gland in March of 2008. She has now developed rampant caries of her lower teeth which need to be extracted. We a considering replacing her teeth with a fixed dental prosthesis supported by multiple dental implants. Do you know if the prognosis of the implants on a such a patient will be compromised? Thanks!
