L10

Question 1

Bisphosphonates

Answer 1

synthetic analogs of inorganic pyrophosphate

osteoporosis and osteopenia
pagets disease or osteogenesis imperfecta

Question 2

Antiresportive drugs

Answer 2

RANKL inhibitor

Prolia
Xgeva

out of system in 6 months wait to do surgical ext

Question 3

RANKL binds

Answer 3

rank r to help OSC form

Question 4

Antiangiogenic meds

Answer 4

TK inhibitors and monoclonal antibodies

Target VEGF to stop new vessel formation
cannot remodel and heal without neoangiogenesis
renal cell carcinoma
often in jaw high bone turnover + thin overlying mucosa

Question 5

Asymptoamtic taking oral BP

Answer 5

Sound recommendation still lacking
<4 year–> proceed
< 4 Y + risk factor –> 2 month drug holiday
>4Y –> 2 month drug holiday resume when osseous healing finishing

Question 6

MRONJ Stage 0

Answer 6

No clinical or radiographic evidence of necrotic bone

Non specific symptoms-Dull ache sinus pain altered neursensory funciton

Question 7

MRONJ Stage 1

Answer 7

Asympatic exposed necrotic bone moth eaten without infection
live bone bleed
medial to 3M most offen missed site
Conservative tx- oral antimicrobial rinse. heals on own

Question 8

MRONJ Stage 3

Answer 8

painful infected exposed/nectrotic bone +1 of the following
path fracture
extra-oral fistula
oro nasal communication
osteolysis
Tx surgical debridement

Question 9

MRONJ Stage 2

Answer 9

painful infected exposed/nectrotic bone

Tx oral antibcrobial rinse clip bone

Question 10

Osteo-radio-necrosis ORN

Answer 10

Irradiated bone exposed through skin + no healing 3-6 months

Question 11

ORN pathogenesis

Answer 11

3 Hs
Hypoxia
Hypvascularity
Hypocellularity

Question 12

ORN Stage 1

Answer 12

Superical only cortical bone exposed

Conservative treatment CHX MW

Question 13

ORN Stage 2

Answer 13

Lcoalized cortical and medullary bone
conservative tx- local decried + CHX

hyperbaric oxygen controversial

Question 14

ORN Stage 3

Answer 14

Diffuse inferior border–> pathological fracture ostecutaneous fistula

Surgical resection + reconstruction

Question 15

XRT Oral complication Managment

Answer 15

Before complete tx
During avoid osseous surgery
After- refer if exposed bone

Question 16

Osteomyelitis

Answer 16

Inflammatory process of marrow involving cancellous and cortical bone with progression tendency

Question 17

Osteomyelitis bacteria

Answer 17

marrow inflammation/edema and blood vessel compression–. ischemia–> necrosis

Question 18

Osteomyelitis more in

Answer 18

mandible than maxilla

Question 19

Osteomyelitis predisposing facotre

Answer 19

immune compromised
DM
Alcholism
myeloproliferative diseae
chemotherapy
fracture and odontological infections
osteopetrosis

Question 20

Osteomyelitis signs and symptoms

Answer 20

Pain swelling fever malaise tender
trismus parasthetia
exposed bone

Question 21

Osteomyelitis medical management

Answer 21

clindamycin abx may need hospitalization for IV abx

Question 22

Osteomyelitis surgical

Answer 22

debriefed or segmental resection depending on involvement

Question 23

Serious bone infection

Answer 23

Requires clincaisn with previous experience for management-refer if in doubt

dry socket does not last for >1 week