MRONJ Risk — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHuman Disease & Dental ManagementMRONJ RiskORE Part 1

A 55-year-old woman attends for a routine dental examination. She has a history of breast cancer treated with tamoxifen and is receiving denosumab for bone protection. Which medication-related complication is the principal dental concern?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Medication-related osteonecrosis of the jaw

The correct answer is D. Denosumab is an anti-resorptive medicine associated with MRONJ; this is the key dental implication, particularly when considering extraction or other procedures involving bone. SDCEP advises dentists to assess and document MRONJ risk according to the indication for therapy, drug exposure and additional risk factors. Oral candidiasis and xerostomia may occur with some medicines or cancer therapies, but neither is the defining dental concern created by denosumab. Gingival enlargement is classically linked to medicines such as calcium-channel blockers, ciclosporin and phenytoin. Denosumab does not directly cause dental caries. The history of breast cancer may increase the importance of clarifying whether denosumab is being used in a cancer-related high-dose regimen, but it does not change the single best answer.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw, reviewed March 2024 and extant. https://www.sdcep.org.uk/media/5cnbsel5/sdcep-mronj-guidance-extant-2024.pdf