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SDCEP > MRONJ > Flashcards

MRONJ Flashcards

1
Q

what increases risk of MRONJ - give 3

A

previous diagnosis of MRONJ

currently taking bisphosphonate and has taken for more than five years

takes bisphosphonates and systemic glucocorticoid

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2
Q

what is MRONJ

A

medication related osteonecrosis of jaw
side effect of anti-resorptive andante-angiogenic drugs
exposure of bone

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3
Q

signs and symptoms of MRONJ

A

delayed healing following dental extraction/ surgery - 8 weeks

pain

soft tissue infection

swelling

numbness

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4
Q

medical history of pt with MRONJ

A

anti-resorptive or anti-angiodenic drugs

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5
Q

how do anti-resoroptive drugs function

A

inhibit osteoclast differentiation and function

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6
Q

why is the jaw adversely affected by action of anti-resorptive drugs

A

increased remodelling rate compared to other skeletal sites

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7
Q

two ant-resorptive drugs associated with MRONJ

A

bisphosphonates
denosumab

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8
Q

how do bisphonsphonates function

A

inhibit enzymes for formation recruitment and function of osteoclasts

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9
Q

half life of alendronate (bisphosphonate)

A

10 years

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10
Q

how does denosumab function

A

inhibits osteoclast function by binding to RANKL

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11
Q

what is bisphosphonates used to treat

A

osteoporosis
pagets disease
osteogenesis imperfecta

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12
Q

how do anti-angiogenic drugs function

A

inhibit new blood vessel formation - used in cancer treatment to limit tumour vascularisation

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13
Q

biggest risk factor for MRONJ

A

medical condition
cancer greater risk than osteoporosis

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14
Q

how does time taking bisphonsphonates influence risk of MRONJ

A

pt taking bisphosphonates for more than 5 years are at higher risk of MRONJ than patients taking for less time

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15
Q

why is taking break in bisphosphonates not effective in reducing MRONJ risk

A

can persist in skeletal tissue for years

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16
Q

what information do you need to assess MRONJ risk

A

medical condition
type and duration of drug therapy

17
Q

MRONJ low risk patients

A

bisphosphonates for less than 5 years

17
Q

higher risk of MRONJ patients

A

bisphosphonates for more than 5 years

patients being treated with bisphosphonates for any time alongside systemic glucocorticoids

anti-resorptive or anti-angiogenic drugs as part of cancer treatment

previous MRONJ

18
Q

when is there risk of MRONJ with denosumab

A

if currently taking or taken in last 9 months - low risk

if taking with glucocorticoid then high risk

19
Q

you have extracted a tooth from a patient taking bisphosphonate. in 8 weeks time the socket still has not healed. what do you suspect and what do you do

A

MRONJ
refer to oral surgery/SCD

20
Q

2 examples of bisphonsphonate

A

alendronic acid
zoledronic acid

21
Q

how long does exposed bone need to persist before MRONJ diagnosis

A

8 weeks - arrange 8 week review

SDCEP (8 decks)

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