Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Via L. Giuffrè 5, 90127, Palermo, PA, Italy.
Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, Messina, Italy.
Support Care Cancer. 2022 Aug;30(8):6429-6440. doi: 10.1007/s00520-022-06940-8. Epub 2022 Mar 16.
The prevention and early diagnosis of medication-related osteonecrosis of the jaw (MRONJ) is fundamental to reducing the incidence and progression of MRONJ. Many in the field believe that dental hygienists should play an integral role in primary and secondary MRONJ prevention. However, to date, very few publications in the literature have proposed standardised MRONJ protocols, which are dedicated to dental hygienists. The aim of this study was to provide guidance to the health care providers managing MRONJ.
The expert opinion in this study was developed by dental hygienists from the main Italian technical-scientific associations (Italian Dental Hygienists Association, AIDI and National Union of Dental Hygienists, UNID) and authors of the latest Italian recommendations regarding MRONJ from the field of dentistry and maxillofacial surgery.
The oral care protocol outlined in this position paper is focused on the role of dental hygienist in patients at risk or affected by MRONJ, and it regards 3 main issues: primary prevention, secondary prevention and supporting the treatment of MRONJ. Each issue contains easy-to-apply indications and procedures, as described by the authors, regarding the role of the dental hygienist.
Referring to the main issues under consideration (primary prevention, secondary prevention and the treatment of MRONJ), a clinical examination of periodontal tissue is critical in preventing MRONJ. It is the opinion of the authors of this study that the application of a periodontal screening score is fundamental in defining personalised strategies for patients at risk of MRONJ. By means of these basic procedures, a protocol for assisting the health care provider and the presentation of a practical approach for patients at risk or affected by MRONJ are described in this study.
预防和早期诊断药物相关性颌骨坏死（MRONJ）对于降低 MRONJ 的发生率和进展至关重要。许多领域的专家认为，口腔卫生师应在 MRONJ 的一级和二级预防中发挥重要作用。然而，迄今为止，文献中很少有出版物提出专门针对口腔卫生师的标准化 MRONJ 方案。本研究旨在为管理 MRONJ 的医疗保健提供者提供指导。
本研究中的专家意见由来自意大利主要技术科学协会（意大利口腔卫生师协会 AIDI 和全国口腔卫生师联盟 UNID）的口腔卫生师以及来自牙科和颌面外科领域的意大利最新 MRONJ 建议的作者提出。
本立场文件中概述的口腔护理方案侧重于口腔卫生师在 MRONJ 高危或受影响患者中的作用，涉及 3 个主要问题：一级预防、二级预防和支持 MRONJ 的治疗。每个问题都包含作者描述的口腔卫生师角色的易于实施的适应症和程序。
在考虑的主要问题（一级预防、二级预防和 MRONJ 的治疗）中，对牙周组织的临床检查对于预防 MRONJ 至关重要。本研究的作者认为，应用牙周筛查评分对于确定 MRONJ 高危患者的个性化策略至关重要。通过这些基本程序，本研究描述了一种辅助医疗保健提供者的方案和一种针对 MRONJ 高危或受影响患者的实用方法。
