Implant Contraindications — ORE Part 1 MCQ
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Correct answer: A — Current intravenous bisphosphonate therapy for malignancy
Explanation lettering: E = shown as B · B = shown as C · C = shown as D · D = shown as E
The correct answer is A. Although the RCS notes there are strictly no medical conditions that absolutely contraindicate implants, current UK practice (SDCEP guidance) advises avoiding implant placement in patients receiving high-dose intravenous bisphosphonates for malignancy due to substantially elevated risk of medication-related osteonecrosis of the jaw (MRONJ). International consensus endorses this approach. Options B–E are not absolute contraindications: controlled diabetes does not impair implant survival; treated periodontitis with good maintenance demonstrates compliance and oral health; a single missing tooth is a standard restorative indication; and oral alendronate for mild osteoporosis carries low MRONJ risk and is not contraindicated. The distinction between IV-BP in cancer (contraindicated) and oral-BP in osteoporosis (permissible) tests discriminating knowledge of risk stratification in implant planning.
Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Dental implants guidance (prevention and management of medication-related osteonecrosis of the jaw). Available at: https://companion.sdcep.org.uk/prevention-of-medication-related-osteonecrosis-of-the-jaw/continuing-management/dental-implants/. Accessed July 2026.