Special patients · Level 3 — Advanced reasoning

Extraction in a patient on IV antiresorptive therapy

Case library

Patient profile (fictional)

Age

Medical history

Breast cancer with bone metastases; IV antiresorptive therapy for 2 years

Dental history

Non-restorable lower molar requiring extraction

Medications

IV antiresorptive agent, tamoxifen, calcium/vitamin D

Findings

No exposed bone; adequate oral hygiene; extraction unavoidable

Procedure / context

Planned extraction with medical coordination

[Image placeholder — non-restorable lower molar]

Step 1

Evidence: High

What does PBM change in the risk assessment?

Step 2

Evidence: Limited

Where might PBM legitimately appear in this plan?

Step 3

Evidence: Moderate

Which additional review is mandatory before application?

Educational content only. These algorithms are educational decision-support tools and never autonomous medical decision-makers. Clinical decisions remain the responsibility of the treating professional. Certification within OHDR Study™ is not a university award unless an authorised institution has been formally configured.