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2022 Catalog: General Courses

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DE0342: IHS Monthly CDE Webinar [co-sponsored by the IHS FAC]: Medication-Related Osteonecrosis of the Jaw [Recorded Webinar]

Date: 10/01/2021 - 9/30/2022
Course Status: Completed
Facility: Online
Location: Online
Director: Visanio Mukes
Level: Advanced
Audience: DHA, Hygienists, Dentists, Assistants
Quota: 5 - 500 students
Tuition: $0.00
Hours: 1.00 (Total CDE); 1.00 (DANB Non-Clinical); 1.00 (AGD - 730)
Joint Sponsorship: No
Lecture icon Question and Answer icon

This one-hour webinar, which was originally offered on June 24, 2020 and co-sponsored by the IHS Field Advisory Committee [FAC], offers an overview and clinical implications of Medication Related Osteonecrosis of the Jaw [MRONJ]. Case presentations will be included in the presentation. MRONJ is a disease process that is relatively new to our profession, which is caused by medications prescribed in our patient populations. These medications are prescribed to treat conditions such as osteoporosis to prevent fractures and cancer. We are still learning more about the extent of this disease process. This webinar will discuss the medications of concern, the disease process, pre-operative management of patients on these medications, surgical management of MRONJ [case presentation], and the future of non-surgical treatment and prevention.

"Could you please explain the process of hyperbaric dive?"

The process of Hyperbaric Oxygen [HBO] Dives can be quite cumbersome for the patient and take a ton of time. Typically, in dentistry, we use this to prevent Radiation Osteonecrosis or to treat soft tissue defects. Marx protocol is 30 pre-op dives and 10 post-op dives at 2.4 atmospheres of pressure. One dive is done per day and each dive can take multiple hours. In the presented case the patient underwent 120 days of HBO therapy, so you can imagine how much time and effort went in to treatment.

The dives are most commonly done in a tube like machine [the chamber], but more recently they have developed rooms that patients can sit in that produce the appropriate pressures to treat the patient. The chambers are tight and can be difficult for a claustrophobic patient.

Here's a link to get an idea of what a chamber looks like:

Learning Objectives:

Upon completion of this webinar, participants should be able to:
1. Understand the pathology of MRONJ
2. Understand different stages of MRONJ and subsequent management
3. Review cases to help understand that appropriate treatment

Speaker / Presenter:

Justin Sikes — Personal Description / Biography not available. For follow-up questions, please contact the speaker at

Lori Snidow — Personal Description / Biography not available. For follow-up questions, please contact the speaker at

Disclosure Policy:

It is the policy of the Indian Health Service, Division of Oral Health, that faculty/planners disclose any financial or other relationships with commercial companies whose products may be discussed in the educational activity. The Indian Health Service, Division of Oral Health, also requires that faculty disclose any unlabeled or investigative use of pharmaceutical products and medical devices. Images that have been falsified or manipulated to misrepresent treatment outcomes are prohibited.

None of the faculty/planners for this activity has a conflict of interest, and there is no use of unlabeled or investigative pharmaceutical products or medical devices. No images have been falsified or manipulated to misrepresent treatment outcomes.The educational objectives, content, and selection of educational methods and instructors are conducted independent of any commercial entity.

The IHS Division of Oral Health is an ADA CERP Recognized Provider

The IHS Division of Oral Health is an accredited sponsor of continuing education under the American Dental Association Continuing Education Recognition Program (CERP). ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the IHS at IHS CDE Coordinator or to the Commission for Continuing Education Provider Recognition at


Open to all IHS, tribal, and urban dental program staff.

Tuition Payment Information:

Please Make Checks Payable to: Indian Health Service.

Tuition Policy:

Tuition must be paid in full 8 weeks prior to the start date of any course. Request for refunds must be received in writing at least two weeks before the course begins. For each refund request, there will be an administrative charge of $100. No refunds will be made to registrants who fail to attend a course. If IHS CDE program cancels a course, then 100% of the tuition will be refunded.