SDCEP MRONJ

Question 1

MRONJ
No risk
Low risk
Higher risk

Answer 1

No - nothing
Low - taking denosumab/ has in last 9 months or took biphosphonate for <5 years

High -
Previous MRONJ diagnosis
Being treated for cancer
Biphosphonates >5 years
Being treated with a concurrent glucocorticoid

Question 2

MRONJ risk patient management

Answer 2

Get patient dentally fit, ideally before starting drug

Extract teeth as normal but inform patient of risk (try to not extract - try to avoid bone manipulation) and get them to contact you if they experience any numbness, altered sensation, swelling, unexpected pain

Suspected spontaneous MRONJ, refer

Review healing after extraction. If not healed at 8 weeks and you suspect MRONJ - refer to OS/Special Care Dentistry

With all MRONJ cases, the risk is small and should never preclude dental treatment

Question 3

MRONJ risk

Answer 3

0-0.1% risk in osteoporosis
1% risk in cancer patients

Question 4

MRONJ what it is

Answer 4

Exposed bone for greater than 8 weeks through an intraoral or extraoral fistula that is present in a patient taking an anti-resorptive or anti-angiogenic drug

The drugs slow down bone resorption