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Pathology · single question

What is the relationship between chemotherapy and osteonecrosis of the jaw?

  1. Chemotherapy has no bearing on osteonecrosis risk
  2. Certain chemotherapeutic and antiangiogenic agents (and impaired healing from cytotoxic drugs generally) can increase the risk of osteonecrosis, particularly when combined with antiresorptive (bisphosphonate/denosumab) therapy
  3. Chemotherapy actually prevents osteonecrosis
  4. This relationship is only relevant in pediatric oncology patients
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Correct answer: B. Certain chemotherapeutic and antiangiogenic agents (and impaired healing from cytotoxic drugs generally) can increase the risk of osteonecrosis, particularly when combined with antiresorptive (bisphosphonate/denosumab) therapy

Cytotoxic chemotherapy impairs wound healing and immune response, and certain agents (antiangiogenics like bevacizumab, mTOR inhibitors) are independently associated with MRONJ. The risk is compounded when chemotherapy is combined with bone-modifying agents — a key reason dental clearance/treatment is ideally completed before starting these therapies when possible.

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