Denosumab Osteoporosis Low Risk — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementDenosumab Osteoporosis Low RiskORE Part 1

A 65-year-old woman is receiving denosumab 60 mg subcutaneously every 6 months for osteoporosis. She is not taking systemic glucocorticoids and requires a straightforward dental extraction. According to SDCEP, how should her risk of medication-related osteonecrosis of the jaw be categorised?

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Correct answer: E — Low risk

The correct answer is **A. Low risk**. SDCEP explicitly categorises patients treated with denosumab for osteoporosis or another non-malignant bone disease as low risk when they are not receiving systemic glucocorticoids. The six-monthly 60 mg regimen supports that the indication is osteoporosis rather than metastatic malignancy. **B** is incorrect because higher risk applies to patients with relevant additional risk factors or higher-risk treatment contexts, particularly malignancy-related therapy. **C** is incorrect because SDCEP risk assessment uses low-risk and higher-risk categories, not an intermediate category. **D** is incorrect because MRONJ risk is small, not absent. **E** is incorrect because the stem supplies the decisive SDCEP risk-classification factors.

Reference: Scottish Dental Clinical Effectiveness Programme. Prevention of Medication-related Osteonecrosis of the Jaw: Risk categories. Guidance published 2017; reviewed and extant March 2024. https://companion.sdcep.org.uk/prevention-of-medication-related-osteonecrosis-of-the-jaw/assessing-patient-risk/risk-categories/