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普通牙科医生对药物相关性颌骨坏死(MRONJ)的认知。

Awareness of medication related osteonecrosis of the jaws (MRONJ) amongst general dental practitioners.

作者信息

Tanna N, Steel C, Stagnell S, Bailey E

机构信息

Eastman Dental Hospital - UCLH, 256 Grays Inn Road, Kings Cross, London, WC1X 8LD.

Salisbury District General, Odstock Road, Salisbury, SP2 8BJ.

出版信息

Br Dent J. 2017 Jan 27;222(2):121-125. doi: 10.1038/sj.bdj.2017.79.

Abstract

Background Recent evidence suggests that medication-related osteonecrosis of the jaw (MRONJ) can be caused by a number of anti-resorptive and anti-angiongenic agents not limited to bisphosphonates. A working knowledge of these medications is important for dental practitioners.Methods A total of 129 general dental practitioners (GDPs) were surveyed regarding their awareness of MRONJ and its causes.Results More than 90% of the GDPs sampled were unaware of anti-resorptive and anti-angiogenic medications other than bisphosphonates that had the potential to cause MRONJ. Just over 40% of the sampled GDPs were confident to treat patients on oral bisphosphonates in primary care. Much of the reluctance to manage these patients was due to lack of accessible guidelines and unclear protocols.Conclusions The results demonstrate GDP attitudes to patients taking bisphosphonates and highlight how further education is needed to increase confidence to perform simple exodontia amongst this cohort of patients in a primary care setting. As there continues to be a shift to providing dentoalveolar services in primary care, we must ensure that those performing the treatments have a greater understanding of potential MRONJ risks and have guidance as to when to refer.

摘要

背景 近期证据表明,与药物相关的颌骨坏死(MRONJ)可由多种抗吸收和抗血管生成药物引起,不限于双膦酸盐类。牙科从业者了解这些药物的相关知识很重要。

方法 对129名普通牙科从业者(GDPs)进行了关于他们对MRONJ及其病因认识的调查。

结果 超过90%的抽样GDPs不知道除双膦酸盐类以外的有导致MRONJ潜在风险的抗吸收和抗血管生成药物。略多于40%的抽样GDPs有信心在初级保健中治疗服用口服双膦酸盐的患者。对管理这些患者存在诸多顾虑的主要原因是缺乏可获取的指南和不明确的方案。

结论 结果表明了GDPs对服用双膦酸盐患者的态度,并凸显出在初级保健环境中,需要进一步开展教育以增强这组患者中进行简单拔牙术的信心。由于向在初级保健中提供牙槽服务的转变仍在持续,我们必须确保进行治疗的人员更深入了解潜在的MRONJ风险,并了解何时进行转诊的指导原则。

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