11
MRONJ Management Flow Diagram
Oncologist
Dentist Dental Specialist
6-month
preventative
follow-up
8-week
management
follow-up
Oncologist
Dentist
• Consider continuation vs. discontinuation of BMA therapy in
patients newly diagnosed with MRONJ
• Inform patient of required dental assessments and need for
commitment to oral care
• Refer patient to own family dentist or a dentist that is
identified as liaison to cancer program
• Reinforce modifiable risk factors: invasive dental procedure,
diabetes, periodontal disease, denture use, smoking
• Provide the dentist with the patients' medical diagnosis,
antiresorptive and angiogenic inhibitor profile
• Indicate if patient has already commenced therapy and
duration
Oncologist
Dentist
• Send dental diagnosis and treatment plan to oncologist
• Coordinate with oncologist if oral surgery is necessary
• Identify any modifiable risk factors: invasive dental procedure,
diabetes, periodontal disease, denture use, smoking
