Department of Periodontics, JSS Dental College & Hospital, Bannimantap, Mysuru 570015, India.
Ivanovski Tissue Engineering and Additive Manufacturing Group (iTEAM), University of Queensland, 288, Herston Road, Herston, Australia.
Curr Drug Saf. 2023;18(3):361-367. doi: 10.2174/1574886317666220514160507.
An invasive dental procedure is considered one of the risk factors for osteonecrosis of the jaw, especially among patients on bisphosphonates. This study aimed to determine the awareness and perceptions of medical practitioners regarding bisphosphonate-related osteonecrosis of the jaw (BRONJ), and their attitude towards dental referrals of such patients.
This cross-sectional questionnaire-based study was conducted among medical practitioners in and around Mysore city, Karnataka, India, who commonly prescribe bisphosphonates. The sample included orthopaedic doctors, physicians, endocrinologists, and oncologists, divided based on the duration of practice and speciality. Data on the type of practice, awareness of BRONJ, referral to a dentist before/during therapy, and patient education about adverse effects, were collected and analyzed. A p-value ≤0.05 was considered statistically significant.
Among 58 practitioners, 84.5% (49) were aware of the association between bisphosphonates and BRONJ, while 56.9% (33/58) believed dental procedure to be a risk factor, and 55.2% (32/58) did not recommend screening of the oral cavity by a dentist before initiation of bisphosphonate therapy. A majority (65.5%) of them educated their patients about adverse effects. Mean knowledge scores varied with specialization (post-graduation vs. super specialization = 1.43 vs. 2; p = 0.01) but not with the duration of practice (<= 10 years vs. >10 years= 1.57 vs. 1.4; p= 0.24).
The practitioners in our study were oblivious to dental procedures' role in the osteonecrosis of the jaw, highlighting the need for continuing education programs regarding BRONJ for medical and dental professionals. Clinicians updated regarding evidence-based practices and working cooperatively in teams may reduce the incidence of medication-related osteonecrosis of the jaw.
侵袭性牙科手术被认为是颌骨坏死的危险因素之一，尤其是在接受双膦酸盐治疗的患者中。本研究旨在确定医疗从业者对与双膦酸盐相关的颌骨坏死（BRONJ）的认识和看法，以及他们对这些患者进行牙科转诊的态度。
本横断面问卷调查研究在印度卡纳塔克邦迈索尔市及其周边地区的医疗从业者中进行，这些从业者通常会开双膦酸盐。样本包括骨科医生、内科医生、内分泌学家和肿瘤学家，根据从业时间和专业进行了划分。收集并分析了关于实践类型、对 BRONJ 的认识、在治疗前/期间是否向牙医转诊、以及对患者进行有关不良反应教育的数据。p 值≤0.05 被认为具有统计学意义。
在 58 名从业者中，84.5%（49 名）知道双膦酸盐与 BRONJ 之间的关联，而 56.9%（33/58）认为牙科手术是一个危险因素，55.2%（32/58）在开始双膦酸盐治疗前不建议由牙医对口腔进行筛查。他们中的大多数（65.5%）会向患者教育有关不良反应的知识。平均知识得分随专业化程度而变化（研究生毕业后与超级专业化=1.43 与 2；p=0.01），但与从业时间无关（<=10 年与>10 年=1.57 与 1.4；p=0.24）。
我们研究中的从业者忽视了牙科手术在颌骨坏死中的作用，这凸显了需要为医疗和牙科专业人员提供有关 BRONJ 的继续教育计划。更新关于循证实践的知识并以团队合作的方式进行合作的临床医生可能会降低与药物相关的颌骨坏死的发生率。
