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Oral Surgery · single question

A patient taking Fosamax (alendronate) for 6 months has a retained root tip. What do you do?

  1. Tell the patient to stop Fosamax 15 days before
  2. Immediately refer to oral surgeon
  3. Extract and inform the patient of MRONJ risk
  4. Tell the patient to decrease the dose
Show answer and explanation

Correct answer: C. Extract and inform the patient of MRONJ risk

  • A. ❌ Drug holidays from bisphosphonates are only considered for long-term use (>4 years). At 6 months, a drug holiday is not indicated.
  • B. ❌ At 6 months of bisphosphonate use, immediate specialist referral is not necessary without additional risk factors.
  • C. ✅ Correct. For short-term bisphosphonate use (<4 years) with no additional risk factors, extraction is safe but the patient must be informed of MRONJ risk, counseled on wound care, and monitored closely.
  • D. ❌ Modifying bisphosphonate dose is the prescribing physician's decision and is not evidence-based for 6-month exposure.

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