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日本私人牙科诊所中牙科保健员对药物相关性颌骨坏死的认知

Dental Hygienists' Awareness of Medication-Related Osteonecrosis of the Jaw in Private Dental Clinics in Japan.

作者信息

Iijima Yosuke, Yamada Miki, Amano Mai, Watanabe Saya, Fujimaru Miki, Uematsu Ayako, Hino Shunsuke, Sano Motohiko, Horie Norio, Sakagami Hiroshi, Kaneko Takahiro

机构信息

Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

Division of Applied Pharmaceutical Education and Research, Hoshi University, Tokyo, Japan.

出版信息

Gerontol Geriatr Med. 2024 Oct 31;10:23337214241292794. doi: 10.1177/23337214241292794. eCollection 2024 Jan-Dec.

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) caused by bisphosphonates (BPs) and denosumab (Dmab) is still a major oral adverse event caused by cancer treatment and may be under-recognized by private dental services. With the aim of reducing the prevalence of MRONJ, this study, which is a pilot study for a planned future large-scale survey, compared knowledge about MRONJ between dental hygienists (DHs) in private dental clinics and those in cancer center hospitals. We conducted a questionnaire-based survey regarding MRONJ between 1 November 2023 and 31 January 2024 on DHs at a cancer base hospital and a private clinic in Saitama, Japan. We statistically analyzed the data collected using the χ test or Fisher's exact test with the level of significance set at 5%. This study included 10 in-hospital and 53 private clinic DHs. The in-hospital DHs had appropriate knowledge of MRONJ. However, compared with the in-hospital DHs, although the private clinic DHs knew that BPs are used for osteoporosis, significantly fewer had knowledge of Dmab ( < .001) or knew that BPs and Dmab could also be used to treat cancer (both  < .001). In addition, few private clinic DHs were aware of MRONJ cases refractory to antibiotic treatment alone ( = .012). These findings suggest that private clinic DHs have less knowledge of MRONJ than those in cancer base hospitals.

摘要

由双膦酸盐(BPs)和地诺单抗(Dmab)引起的药物性颌骨坏死(MRONJ)仍是癌症治疗导致的主要口腔不良事件,可能未被私立牙科服务机构充分认识。为降低MRONJ的发生率,本研究作为一项计划中的未来大规模调查的试点研究,比较了私立牙科诊所和癌症中心医院的口腔保健员(DHs)对MRONJ的了解情况。2023年11月1日至2024年1月31日,我们在日本埼玉县的一家癌症专科医院和一家私立诊所,对口腔保健员进行了关于MRONJ的问卷调查。我们使用χ检验或Fisher精确检验对收集到的数据进行统计分析,显著性水平设定为5%。本研究纳入了10名医院内的口腔保健员和53名私立诊所的口腔保健员。医院内的口腔保健员对MRONJ有适当的了解。然而,与医院内的口腔保健员相比,尽管私立诊所的口腔保健员知道双膦酸盐用于治疗骨质疏松症,但了解地诺单抗的人数明显较少(<0.001),或者知道双膦酸盐和地诺单抗也可用于治疗癌症的人数也较少(均<0.001)。此外,很少有私立诊所的口腔保健员意识到仅用抗生素治疗难治的MRONJ病例(=0.012)。这些发现表明,私立诊所的口腔保健员对MRONJ的了解不如癌症专科医院的口腔保健员。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8d6/11528679/cdaac26da523/10.1177_23337214241292794-fig1.jpg

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