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Dentistry · Oral and maxillofacial surgery: osteoradionecrosis
Sample itemA man who had 66 Gy radiotherapy for tonsillar cancer has a lower molar extracted and develops a non-healing exposed necrotic bone area over 3 months. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Osteoradionecrosis
Osteoradionecrosis follows irradiation, which causes hypovascular, hypocellular and hypoxic bone, and is triggered by trauma such as extraction. Prevention uses pre-radiotherapy dental clearance and careful atraumatic technique.
Option by option
A. Dry socket
Dry socket heals within weeks and has no radiation history.
B. Osteosarcoma
Osteosarcoma would show a mass and sunray periosteal reaction.
C. Osteoradionecrosis (correct)
Correct. Irradiated bone with exposed necrosis after extraction fits osteoradionecrosis.
D. Bisphosphonate-related osteonecrosis
Bisphosphonate necrosis needs a history of antiresorptive drugs.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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