Bio

Bio


Dr. Crystal Chang is a Hospital Dentist and Clinical Instructor in Dental Oncology and Dental Medicine & Surgery. She focuses on maintaining oral health through the management of infection, trauma and secondary comorbidities to the dentition and its supporting structures. She performs medically necessary dental extractions in the context of cardiac disease, orthopedic surgery, cancer therapy and organ transplants.

Clinical Focus:
Hospital Dentistry
Dental Surgery
Dental Oncology

Clinical Focus


  • Dentistry
  • Dental Oncology
  • Orofacial Trauma

Academic Appointments


Professional Education


  • Residency, Veterans Affairs, Palo Alto Healthcare System, Hospital Dentistry (2016)
  • DDS, University of California, San Francisco, Dentistry (2015)
  • BA, Harvard University, Molecular and Cellular Biology

Publications

All Publications


  • Oral Squamous Cell Carcinoma Mimicking Peri-Implantitis. Clinical advances in periodontics Chainani-Wu, N., Chang, C., Sim, C., Wu, T. C., Cox, D., Sirjani, D., Silverman, S. 2016; 6 (2): 83–88

    Abstract

    Peri-implantitis is inflammation and alveolar bone loss around a dental implant. Published case reports have described squamous cell carcinoma (SCC) development around dental implants.A 60-year-old female presented with two small fistulas on the alveolar ridge of missing tooth #18. The mucosa around the fistulas appeared normal otherwise, with no hyperplasia, erythema, or keratotic changes. The patient had a 14-year history of recurrent erythroleukoplakia (with microscopic dysplasia) on the left tongue that had been managed by surgical removal (scalpel and carbon dioxide laser), biopsies, and close follow-up. She had no other medical conditions. She reported that she had an implant placed to replace tooth #18 4 years ago that had been removed without flap reflection, curettage, or biopsy 1 year previously as a result of peri-implantitis. Periapical radiographs showed that the peri-implant radiolucency in the region of tooth #18 was unchanged in dimensions from the time of implant removal 1 year ago. Curettage and biopsy of the area were performed and showed the presence of a well-differentiated SCC.This is a case of peri-implant SCC development in a patient at high risk for oral SCC. The carcinoma was present within the alveolar defect in the area of a failed implant that had been removed 1 year previously. The overlying surface mucosa did not show the clinical changes typically seen in carcinoma. This case and others demonstrate the importance of periodic oral and radiographic examination after implant placement. Although rare, neoplasia must be considered in the evaluation of peri-implant pathology.

    View details for DOI 10.1902/cap.2015.150041

    View details for PubMedID 31535489

  • Oropharyngeal carcinoma arising after methotrexate and etanercept therapy for rheumatoid arthritis ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY Chainani-Wu, N., Chang, C., Gross, A. J., Yom, S. S., Silverman, S. 2014; 117 (3): E261-E263

    Abstract

    Etanercept is an anti-tumor necrosis factor α receptor agent used to treat inflammatory conditions. Previous reports described rapid development of skin squamous cell carcinoma (SCC) after etanercept use. This report describes a novel case of oropharyngeal SCC associated with the use of etanercept. A 45-year-old man with rheumatoid arthritis developed oropharyngeal pain within 2 months after the start of etanercept therapy and was diagnosed with tonsillar carcinoma. This patient had other exposures that increase the risk of oropharyngeal cancer, such as tobacco and alcohol use. However, owing to the timing of onset of his initial symptoms, etanercept should be considered as a possible factor in the etiology or progression of his tumor, especially in the context of reported skin SCC after etanercept therapy in patients at risk for SCC. Clinicians should be alert to signs of malignancy in patients on etanercept, particularly those at high risk for skin or head and neck cancers.

    View details for DOI 10.1016/j.oooo.2013.11.499

    View details for Web of Science ID 000331062700006

    View details for PubMedID 24528797