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Oral Surgery · single question

A patient on IV bisphosphonate (Zometa) has a non-restorable tooth that also carries an RPD clasp. The safest management is to:

  1. Perform a surgical extraction with a flap
  2. Extract and perform alveoloplasty
  3. Do endodontic treatment + coronectomy and remove/cut the clasp
  4. Extract and place an immediate implant
Show answer and explanation

Correct answer: C. Do endodontic treatment + coronectomy and remove/cut the clasp

  • A. Surgical extraction exposes bone and raises MRONJ risk.
  • B. Alveoloplasty adds bone trauma, increasing MRONJ risk.
  • C. Correct. Endo + coronectomy (decoronation) avoids removing bone, and the clasp is cut/removed since the tooth can no longer serve as an abutment.
  • D. Implant placement involves osteotomy and is contraindicated in this setting.

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