Paget Disease — ORE Part 1 MCQ

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HardHuman Disease & Dental ManagementPaget DiseaseORE Part 1

A patient has Paget disease of bone affecting the maxilla and requires extraction of an upper molar. They are not taking anti-resorptive or anti-angiogenic medication. Which is the principal extraction-related concern?

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Correct answer: A — Difficult extraction with increased operative bleeding

Explanation lettering: D = shown as C · E = shown as D · C = shown as E

Pagetic bone has abnormal remodelling and increased vascularity. In the jaws this can make extraction technically difficult and can increase operative bleeding; dental evidence reports greater extraction difficulty and more post-extraction complications in people with Paget disease. B is incorrect because MRONJ is medication-related: it is associated with anti-resorptive or anti-angiogenic drugs, not with Paget disease alone. The stem explicitly excludes such treatment. Pathological fracture and sarcomatous transformation are recognised but uncommon skeletal complications and are not the principal concern for routine molar extraction in the maxilla. An oroantral communication is a possible general complication of upper molar extraction, but Paget disease does not make it the characteristic key concern.

Reference: Sofaer JA. Dental extractions in Paget's disease of bone. International Journal of Oral Surgery. 1984. https://pubmed.ncbi.nlm.nih.gov/6235197/