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Dental disease and extractions; patients with poor oral hygiene and dental disease prior to radiation, including edentulous patients and those with dentures, are more susceptible to developing ORN. [ 3 ] [ 9 ] Diseased teeth near the radiation field may need to be extracted, [ 23 ] and should be evaluated prior to radiation treatment.
Tooth extraction is the major risk factor for development of MRONJ. Prevention including the maintenance of good oral hygiene, comprehensive dental examination and dental treatment including extraction of teeth of poor prognosis and dentoalveolar surgery should completed prior to commencing any medication which is likely to cause osteonecrosis ...
The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
Today, however, the condition is often a hidden infection, due in part to not being visible on most dental X-rays unless there is a substantial loss of bone density. In addition, some schools of dentistry do not recognize "silent" OM of the jaws—occurrence of the condition without visually obvious manifestations—in their curriculum.
This condition arises as a response to dental infections, such as periapical pulp inflammation or low-intensity trauma. The lesion typically appears as a radiopacity in the periapical area due to the sclerotic reaction. While most commonly associated with non-vital teeth, condensing osteitis can also occur in vital teeth following occlusal trauma.
In order to obtain permission from patient for extraction of tooth, the dentist should explain that other treatment options are available, what is involved in the dental extraction procedure, the potential risks of the procedure and the benefits of the procedure. [2] The process of gaining consent should be documented in clinical notes. [2]
ICD-9-CM: Volumes 1 and 2 only. Volume 3 contains Procedure codes: ICD-10: The international standard since about 1998 ICPC-2: Also includes reasons for encounter (RFE), procedure codes and process of care International Classification of Sleep Disorders: NANDA: Diagnostic and Statistical Manual of Mental Disorders: Primarily psychiatric disorders
The 2012 edition of the Dental Claim Form includes fields for diagnosis codes and instructions covering the use of the ICD-9-CM and ICD-10-CM coding systems. In addition to ICD-9-CM and ICD-10-CM there are other dental diagnostic coding systems under consideration, including SNODENT and EZCODES .