Pre-antiresorptive therapy dental screening (PADS): a successful intervention against medication related osteonecrosis of the jaws (MRONJ)

Background: Medication-Related Osteonecrosis of the Jaws (MRONJ) is a serious complication of antiresorptive therapy. The aim of the study was to assess the level of knowledge and awareness regarding MRONJ among Polish dentists and students of dentistry. Methods: The online self-administered questionnaire was sent out electronically among dentists in Poland and dentistry students of the Medical University of Gdansk. The results obtained were statistically analyzed. The results were considered statistically significant if the condition p ≤ 0.05 was met. Results: A total of 203 respondents participated in this survey. A total of 94.6% of them declared knowledge of the term MRONJ. However, the length of bisphosphonates persistence in the body was known to 51.5% of participants, while the knowledge of oral and maxillofacial surgeons concerning this topic was significantly higher (87.0%). Conclusion: Dental and maxillofacial surgeons presented the highest level of knowledge about MRONJ. The remaining groups did not differ in their knowledge. It must be noted that the knowledge of the students was similar to that of dentists. A better level of knowledge by dentists could contribute to a decline of the occurrence of the disease in future. Theoretical and practical initiatives should be promoted to improve the knowledge about MRONJ.

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Choosing the Right Partner for Medication Related Osteonecrosis of the Jaw: What Central European Dentists Know

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094466 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4466

Author(s):

Emanuel Bruckmoser ◽

Miriam Palaoro ◽

Lukas Latzko ◽

Dagmar Schnabl ◽

Sabrina B. Neururer ◽

...

Keyword(s):

Professional Education ◽

Online Survey ◽

Early Stage ◽

Knowledge Score ◽

Osteonecrosis Of The Jaw ◽

Point Of View ◽

Antiresorptive Therapy ◽

Maximum Score ◽

Dental Screening ◽

The Mean

Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of antiresorptive drugs. In this online survey, the awareness and knowledge of dentists regarding MRONJ was evaluated, and potential implications for oncologists are discussed. Questionnaires were emailed to dentists from Germany, Austria, Switzerland, and South Tyrol to evaluate disease-related knowledge and management. In addition to the overall score, a separate score was calculated for knowledge (maximum score: 15 points) and management (maximum score: 6 points) questions, and 1197 valid replies with completed questionnaires were received. The mean overall score was 10.45 ± 3.97 points, the mean knowledge score was 7.68 ± 3.05 points, and the mean management score was 2.76 ± 1.77 points. Factors influencing the outcome of the overall score were age, specialization, continuous professional education, and the number of dental screening exams in patients before antiresorptive therapy. Due to the considerable lack of knowledge regarding MRONJ among dentists, MRONJ patients and subjects at risk should be guided towards specialists for dental screening, treatment, and follow-up. This is important from an oncologic point of view to avoid any delay for treatment start of antiresorptives, and to reveal a potentially emerging osteonecrosis at an early stage, thus, avoiding the need for interruption or even cancellation of antiresorptive therapy.

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Medication-Related Osteonecrosis of the Jaws: Considerations on a New Antiresorptive Therapy (Denosumab) and Treatment Outcome after a 13-Year Experience

International Journal of Dentistry ◽

10.1155/2016/1801676 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 10

Author(s):

Gianfranco Favia ◽

Angela Tempesta ◽

Luisa Limongelli ◽

Vito Crincoli ◽

Eugenio Maiorano

Keyword(s):

Staging System ◽

Osteonecrosis Of The Jaw ◽

Clinicopathological Features ◽

Antiresorptive Therapy ◽

Osteonecrosis Of The Jaws ◽

Current Series ◽

Antiresorptive Drugs ◽

Radiological Healing ◽

Invasive Surgical Approach

Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive therapies for bone neoplastic localizations and osteoporosis. The aim of this study was to evaluate the clinicopathological features of MRONJ in a cohort of patients treated by new antiresorptive drugs (denosumab) and the corresponding outcome after 13-year maximum follow-up. Overall, 244 patients affected by MRONJ were treated from 2003 to 2015. After clinical and radiological examinations, all lesions were staged according to a dimensional staging system and then surgically treated. All the denosumab-related lesions were classified as stage II or III, thus requiring a more or less invasive surgical approach, despite the results of many recent studies, which suggested a conservative medical approach with early resolution for MRONJ in patients on denosumab. In the current series, 86.9% of treated lesions showed complete clinical and radiological healing, while 13.1% recurred; all recurrences were detected in patients who could not interrupt chemotherapy, steroids, and/or antiresorptive drugs administration due to their general conditions. In conclusion, all oral specialists should be aware of the MRONJ risk among patients taking new antiresorptive drugs; moreover, our protocol based on surgical treatment guided by dimensional staging could be considered effective in view of the low recurrence rate.

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