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Oral Surgery · single question

A patient on IV zoledronate (Zometa) has an abutment tooth (RPD clasp) with grade III mobility, ~5 mm probing depth, gingival hyperplasia and a deep carious lesion. The safest management is:

  1. Simple extraction
  2. Surgical extraction with a flap
  3. Endodontic treatment plus coronectomy, avoiding extraction
  4. No treatment at all
Show answer and explanation

Correct answer: C. Endodontic treatment plus coronectomy, avoiding extraction

  • A. Any extraction risks medication-related osteonecrosis of the jaw (MRONJ) in an IV-bisphosphonate patient.
  • B. Flap surgery exposes more bone and increases MRONJ risk.
  • C. Correct. Endo + coronectomy retains the root and avoids bone trauma, minimizing MRONJ risk.
  • D. Leaving active infection/caries untreated is not acceptable.

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