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Oral Surgery · single question

A 56-year-old (type 2 diabetes, INR 2.4 on warfarin, on bisphosphonates, prostate cancer 2 years ago) needs a non-restorable tooth removed. The factor most relevant to extraction risk is the:

  1. Bisphosphonate therapy (MRONJ risk)
  2. Type 2 diabetes
  3. Hypertension medication
  4. INR of 2.4
Show answer and explanation

Correct answer: A. Bisphosphonate therapy (MRONJ risk)

  • A. Correct – bisphosphonates carry a risk of medication-related osteonecrosis of the jaw after extraction; this is the key consideration to discuss/manage.
  • B. Incorrect – manageable with controlled glucose; not the limiting factor.
  • C. Incorrect – not a contraindication to extraction.
  • D. Incorrect – an INR ≤3.5 generally allows simple extraction WITHOUT stopping warfarin.

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