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MRONJ Risk Assessment Questions — NDEB AFK MCQ

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ModerateOral SurgeryMRONJ Risk Assessment QuestionsNDEB AFK

A patient reports a history of bisphosphonate use for osteoporosis but is unsure of the specific medication. Which question is most important to determine MRONJ risk?

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Correct answer: B — Duration and route of bisphosphonate therapy (oral vs intravenous and for how long)

The MRONJ risk varies dramatically based on the route and duration of bisphosphonate administration. IV bisphosphonates (zoledronic acid, pamidronate) used for oncological indications carry a much higher MRONJ risk (1-15%) than oral bisphosphonates (alendronate, risedronate) used for osteoporosis (<0.1%). Duration also matters — oral bisphosphonate use for <4 years has very low risk; >4 years increases risk. Establishing the specific drug, route, and duration is essential for risk stratification before dental surgery.

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