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MRONJ — NDEB AFK MCQ

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ModerateOral MedicineMRONJNDEB AFK

A patient on intravenous zoledronic acid for metastatic breast cancer develops exposed necrotic bone in the mandible following a tooth extraction. What is the most likely diagnosis?

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Correct answer: E — Medication-related osteonecrosis of the jaw (MRONJ)

MRONJ is defined as exposed bone or bone that can be probed through an intraoral or extraoral fistula in the maxillofacial region persisting for more than 8 weeks, in a patient currently or previously treated with antiresorptive or antiangiogenic agents, and with no history of radiation therapy to the jaws. Zoledronic acid (IV bisphosphonate) carries the highest risk. Canadian guidelines recommend dental assessment before initiating antiresorptive therapy.

Reference: CDA – Position Statement on MRONJ, 2020; AAOMS – Position Paper on MRONJ, 2022