MRONJ Risk Classification — ORE Part 1 MCQ

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

ModerateHuman Disease & Dental ManagementMRONJ Risk ClassificationORE Part 1

A 50-year-old woman takes alendronic acid 70 mg once weekly for osteoporosis. She has taken it continuously for 7 years and has no history of cancer, systemic glucocorticoid therapy or MRONJ. According to SDCEP guidance, which MRONJ risk category should be recorded?

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

Reveal the answer and explanation

Correct answer: E — Higher risk

The correct answer is E, higher risk. SDCEP states that a patient initially classified as low risk who continues bisphosphonate treatment after the five-year medication review should be reclassified as higher risk. This patient has used oral alendronic acid continuously for 7 years, so duration alone determines the classification in the information given. Low risk would apply before this duration-based reclassification and is therefore incorrect. No risk is wrong because bisphosphonates are associated with MRONJ. Intermediate risk is not an SDCEP MRONJ category, and the history provided is sufficient to classify her; therefore unclassifiable risk is incorrect.

Reference: Scottish Dental Clinical Effectiveness Programme. Oral Health Management of Patients at Risk of Medication-related Osteonecrosis of the Jaw – Guidance in Brief, Risk Assessment, March 2017 (extant 2024). https://www.sdcep.org.uk/media/xzffda1g/sdcep-mronj-guidance-in-brief-extant-2024.pdf