IBRUTINIB - Dental implant surgery

[misterbee]

Question for CLL’ers being treated with IBRUTINIB and needing DENTAL WORK/IMPLANT:

I’ve been on Obinutuzumab/Ibrutinib clinical trial for two years - and I’m doing well. I am Trisomy 12, unmutated and Notch positive. I need to have a tooth extracted. My DDS insists I use an oral surgeon. Yes, I understand the risk of bleeding/blood thinning. My CLL specialist recommended holding Ibrutinib for 3 days before and 3 days after the extraction. The oral surgeon also wants to install an implant - meaning drilling into bone and adding bone graft material. Hopefully all this stuff will work and heal properly??? Ibrutinib (and Diabetes) seems to substantially increase healing time although I’ve been free of infections so far. Any thoughts or experiences that you can share? Yes, a bridge may be a ‘less invasive’, cheaper, and possible safer solution. THANKS!

[2016Longevity]

First get that tooth extracted (by oral surgeon) -adding bone graft material may be needed / advised but then go for the bridge option. Saves you a lot of headache, pain, costs, time (takes a year altogether). Yes, a bridge is ‘less invasive’, cheaper, and much safer solution.

Good luck with that tooth extraction ! make certain you' get it done by a good oral surgeon (good reviews etc.)

[misterbee in reply to 2016Longevity]

THANKS!

[country76]

I was avoiding an implant and had a bridge. Now I may have to have the bridge removed and have the implant too.

[stevesmith1964]

HiI am in a similar situation. I was diagnosed in November, stage 4 so when straight to Obinatuzamab and Ibrutinib.... 6 cycles , now in remission and on acalabrutinib

I have 3 extractions planned in prep for implants. I will be off acalabrutinib for 5 days before and 5 days after , plus antibiotics 2 days before and 5 days after.

I am doing one extractions first to see how I heal. I am 57.

[Eucalyptus22]

I am in the same position. I need one tooth surgically removed and an implant done. A bridge wouldn't work for me. I am on Acalabrutinib and will be off 5 days before and 5 days after and will have extra blood tests done by the hospital before any work is done. My dentist has a very good reputation for surgical extractions and implants - private and expensive!! He is planning to put me on antibiotics following the extraction in October. I am planning to discuss with him having the extraction done seperately from the implant to see how I heal.

[francc]

I am on ibrutinib now 98 months. I do not have diabetes. I have had a total of 3 implants on 2 different days. No IBRU total of 7 days. No problems whatsoever. Had I known 20 years earlier what a problem the teeth were going to be due to my weak immune system , I would have done it then.

[newyork8]

I would consider holding off for more than 3 days...I believe 7 days before and after is recommended for surgeries and I believe the mouth is subject to easy bleeding. I held off 7 days before before a colonoscopy because I sensed polyps would be removed. Most docs are unfamiliar with Ibr. Also stop aspirin and fish oil.

[waer88]

I just had skin cancer surgery and I was told to stop Ibrutinib three days before and three days after by Dana Farber