Contraindications Absolute contraindications Site has been previously heavily irradiated (extraction could precipitate osteoradionecrosis) Site is in proximity to an area of infection or malignancy (extraction may spread the disease) Adjacent structure is fractured (the tooth may be stabilizing the fracture) Relative contraindications Patients receiving injectable bisphosphonate or RANK-ligand (receptor activator of nuclear factor-kappa B-ligand) inhibitor therapy (eg, for cancer): Extraction could precipitate osteonecrosis.