Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
J Med Life. 2022 Mar;15(3):368-373. doi: 10.25122/jml-2021-0085.
Bone modifying agents (BMA) like bisphosphonates, antiangiogenic, and antiresorptive agents are widely used to manage bone diseases and cancer. Medication-related osteonecrosis of the jaw (MRONJ) is a potentially serious complication seen in patients on BMA therapy. Dental infection is one of the primary risk factors for MRONJ manifestation; hence its complete removal before initiation of BMA is significant. This can be achieved when a medical professional understands MRONJ and its risk factors and implements timely and regular dental referrals. This multicentre study was performed to assess the knowledge about MRONJ and awareness about the implementation of dental referrals among medical professionals. A custom-designed questionnaire tool was designed and validated by a pilot study. 450 practitioners from 6 medical schools and private practitioners in and around the district were surveyed. The results were analyzed using descriptive statistics. 63.5% (n=80) of the respondents prescribed bisphosphonates at a frequency of 0-5 times in a month. However, 62% (n=78) of the practitioners could correctly indicate the most appropriate definition of MRONJ. Only 49.2% (n=62) of them considered dental consultation mandatory. 73% (n=92) of the practitioners were unaware of management guidelines. There exists a significant gap in the knowledge-based applications in the management of MRONJ. Lack of referrals to dentists before BMA therapy can be a pivotal factor in patient morbidity. Practitioners prescribing BMA should advise patients about regular dental visits and monitor for symptoms of MRONJ.
骨修饰剂（BMA），如双磷酸盐、抗血管生成和抗吸收剂，被广泛用于治疗骨疾病和癌症。药物相关性下颌骨坏死（MRONJ）是 BMA 治疗患者中出现的一种潜在严重并发症。牙科感染是 MRONJ 表现的主要危险因素之一；因此，在开始 BMA 治疗之前彻底清除感染非常重要。当医疗专业人员了解 MRONJ 及其危险因素并及时定期转诊牙科时，就可以实现这一点。这项多中心研究旨在评估医疗专业人员对 MRONJ 的认识和对实施牙科转诊的意识。设计了一个定制的问卷工具，并通过试点研究进行了验证。对来自 6 所医学院和该地区内外的 450 名从业者进行了调查。使用描述性统计方法分析结果。63.5%（n=80）的受访者每月开具双磷酸盐的频率为 0-5 次。然而，62%（n=78）的从业者能够正确指出 MRONJ 的最恰当定义。只有 49.2%（n=62）的人认为牙科咨询是强制性的。73%（n=92）的从业者不知道管理指南。在 MRONJ 管理的基于知识的应用方面存在显著差距。在开始 BMA 治疗之前未向牙医转诊可能是患者发病率的关键因素。开具 BMA 的从业者应告知患者定期看牙医，并监测 MRONJ 的症状。
