牙医对药物相关性颌骨坏死及其预防的认知和实践：一项横断面调查。
The awareness and practice of dentists regarding medication-related osteonecrosis of the jaw and its prevention: a cross-sectional survey.
机构信息
Department of Family Medicine, Wonkwang University Hospital, Iksan, Jeollabuk-do, 54538, South Korea.
出版信息
BMC Oral Health. 2021 Mar 24;21(1):155. doi: 10.1186/s12903-021-01475-6.
BACKGROUND
Accurate documentation of a patient's prior medication use and awareness of side effects associated with anti-osteoporotic agents can assist dentists to prevent medication-related osteonecrosis of the jaw. I aimed to determine the awareness of Korean dentists regarding medication-related osteonecrosis of the jaw and the duration of drug holidays they prescribe to patients who need to undergo various dental procedures.
METHODS
An online, questionnaire-based survey was conducted among 1000 dentists registered in an online community in Korea. The following were determined: general characteristics; type of practice; recordkeeping regarding patients' use of bone-modifying agents; requirement of a doctor's referral letter; advice given regarding drug holidays of bone-modifying agents before dental surgery procedures; and experience with medication-related osteonecrosis of the jaw. Differences between dentists with and without experience in treating patients with medication-related osteonecrosis of the jaw were evaluated using the χ test.
RESULTS
Although a relatively high proportion (293/1000, 29.3%) of dentists had experienced cases of medication-related osteonecrosis of the jaw, only 650/1000 (65.0%) routinely documented the type of bone-modifying agent used by patients and the duration of its use. Moreover, only 591/1000 (59.1%) dentists routinely requested referral letters from doctors before performing dental surgery on patients. Although the recommended period for a drug holiday differs for each drug, 533/1000 (53.3%) dentists did not make such a distinction. There was a statistically significant difference in the level of detail documented in terms of anti-osteoporotic drug use between dentists who had no experience in medication-related osteonecrosis of the jaw (707/1000) and those who had such experience (P = 0.007). There was a statistically significant difference in the length of drug holidays prescribed between dentists with and without prior experience with the condition (P = 0.001).
CONCLUSIONS
These results suggest that dentists do not respond consistently to patients' drug history prior to performing dental procedures. This implies the need for increased cooperation between dentists and physicians, as well as the development of targeted educational interventions for the dental profession, to reduce the risk of medication-related osteonecrosis of the jaw.
TRIAL REGISTRATION
Not applicable.
背景
准确记录患者先前使用的药物以及对抗骨质疏松药物相关副作用的认知，可帮助牙医预防药物相关性颌骨坏死。本研究旨在确定韩国牙医对药物相关性颌骨坏死的认知，以及他们为需要进行各种牙科手术的患者规定药物停药期的时长。
方法
对韩国一个在线社区中注册的 1000 名牙医进行了一项在线问卷调查。调查内容包括：一般特征；执业类型；记录患者使用骨修饰剂的情况；是否需要医生转诊信；在进行牙科手术前，关于骨修饰剂停药期的建议；以及药物相关性颌骨坏死的治疗经验。采用 χ 检验评估有和无药物相关性颌骨坏死治疗经验的牙医之间的差异。
结果
尽管相对较高比例（293/1000，29.3%）的牙医经历过药物相关性颌骨坏死病例，但仅有 650/1000（65.0%）的牙医常规记录患者使用的骨修饰剂类型及其使用时长。此外，仅有 591/1000（59.1%）的牙医在为患者进行牙科手术前常规要求医生开具转诊信。虽然每种药物的停药期推荐不同，但 533/1000（53.3%）的牙医并未对此加以区分。与无药物相关性颌骨坏死治疗经验的牙医（707/1000）相比，有该经验的牙医在抗骨质疏松药物使用方面记录的详细程度存在统计学差异（P=0.007）。有和无该疾病治疗经验的牙医开具的药物停药期长度存在统计学差异（P=0.001）。
结论
这些结果表明，牙医在进行牙科手术前对患者的药物史反应不一致。这意味着需要牙医和医生之间加强合作，并为牙科专业人员开展有针对性的教育干预，以降低药物相关性颌骨坏死的风险。
试验注册
不适用。
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