Postgraduate Dental Students’ Knowledge Levels Toward Medication-Related Osteonecrosis of the Jaws

Year 2023, Volume: 13 Issue: 4, 829 - 836, 29.12.2023

Elif Aslan Elif Şener Erinc Önem Ali Mert Hülya Çankaya

https://doi.org/10.33808/clinexphealthsci.1209004

Abstract

Objective: Objective: Medication-related osteonecrosis of the jaws (MRONJ), is often described as a side-effect of bisphosphonates within the dental school curriculum. However, as highlighted in the current literature, some antiresorptive and antiangiogenic drugs may also cause MRONJ. This study aimed to investigate the awareness and knowledge of post-graduate dental students (PDSs) from different specialty/doctoral programs towards MRONJ.
Methods: An electronic questionnaire containing 28 questions in 3 different sections focusing on demographic characteristics, general information, and clinical attitude, was prepared. Two-thousand PDSs from 27 universities were invited to participate in the survey in December 2021. The obtained data were evaluated statistically using descriptive statistics and the Chi-Square test (p=.05).
Results: The response rate of the survey was 10%. The number of PDSs showed a homogeneous distribution for each specialty, whereas the number of women participants was higher than that of men (p<.05). In the general information section, the highest correct answer rates belonged to students from Oral and Maxillofacial Surgery and Oral and Maxillofacial Radiology departments. However, there was no statistically significant difference between different dental specialties regarding correct answer rates (p>.05). PDSs had higher rates of correct answers to general information questions about antiresorptive drugs than for antiangiogenic drugs. 92% of participants stated that they obtained their knowledge about MRONJ from their undergraduate education.
Conclusion: The findings of this study reveal the necessity of updating the dental school curriculum in line with the current literature on MRONJ, as well as including more postgraduate courses on MRONJ during the specialty/doctoral education period.

Keywords

Bisphosphonate-associated osteonecrosis of the jaw, dental education, dental students, medication-related osteonecrosis of jaws, postgraduate dental students

References

• Di Fede O, Canepa F, Panzarella V, Mauceri R, Del Gaizo C, Bedogni A, Fusco V, Tozzo P, Pizzo G, Campisi G, Galvano A. The treatment of medication-related osteonecrosis of the jaw (MRONJ): A systematic review with a pooled analysis of only surgery versus combined protocols. Int J Environ Res Public Health 2021;18(16):8432. DOI: 10.3390/ijerph18168432.
• Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61(9):1115-1117. DOI: 10.1016/s0278-2391(03)00720-1.
• Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws--2009 update. J Oral Maxillofac Surg 2009;67(5 Suppl):2-12. DOI: 10.1016/j.joms.2009.01.009.
• Ruggiero SL, Dodson TB, Fantasia J. American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg 2014;72(10):1938-1956. DOI: 10.1016/j.joms.2014.04.031.
• Khan AA, Morrison A, Hanley DA. International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res 2015;30(1):3-23. DOI: 10.1002/jbmr.2405.
• Hinson AM, Smith CW, Siegel ER, Stack BC Jr. Is bisphosphonate-related osteonecrosis of the jaw an infection? A histological and microbiological ten-year summary. Int J Dent. 2014;2014:452737. DOI: 10.1155/2014/452737.
• Escobedo M, García-Consuegra L, Junquera S, Olay S, Ascani G, Junquera L. Medication-related osteonecrosis of the jaw: A survey of knowledge, attitudes, and practices among dentists in the principality of Asturias (Spain). J Stomatol Oral Maxillofac Surg 2018;119(5):395-400. DOI: 10.1016/j.jormas.2018.04.008.
• Al-Eid R, Alduwayan T, Bin Khuthaylah M, Al Shemali M. Dentists’ knowledge about medication-related osteonecrosis of the jaw and its management. Heliyon. 2020;6(7):e04321. DOI: 10.1016/j.heliyon.2020.e04321.
• Ekmekcioglu A, Akay G, Karadag O, Gungor K. The Awareness and Knowledge of Dentists of MedicationRelated Osteonecrosis of the Jaw. Clin Exp Health Sci. 2021;11:163-169. DOI: 10.33808/clinexphealthsci.701257.
• Han AL. The awareness and practice of dentists regarding medication-related osteonecrosis of the jaw and its prevention: a cross-sectional survey. BMC Oral Health 2021;21(1):155. DOI: 10.1186/s12903-021-01475-6.
• de Lima PB, Brasil VLM, de Castro JFL, de Moraes Ramos-Perez FM, Alves FA, dos Anjos Pontual ML, da Cruz Perez DE. Knowledge and attitudes of Brazilian dental students and dentists regarding bisphosphonate-related osteonecrosis of the jaw. Support Care Cancer 2015;23(12):3421-3426. DOI: 10.1007/s00520-015-2689-6.
• Almousa MA, Alharbi GK, Alqahtani AS, Chachar Y, Alkadi L, Aboalela A. Dental practitioners’ and students’ knowledge of medication related osteonecrosis of the jaw (MRONJ). Saudi Pharm J 2021;29(1):96-103. DOI: 10.1016/j.jsps.2020.12.012.
• Rosella D, Papi P, Pompa G, Capogreco M, De Angelis F, Di Carlo S. Dental students’ knowledge of medication-related osteonecrosis of the jaw. Eur J Dent 2017;11(4):461-468. DOI: 10.4103/ejd.ejd_27_17.
• Yamori M, Tamura M, Mikami M, Mori T, Noi M, Machida Y, Koshinuma S, Yamamoto G. Differences in the knowledge and experience of physicians and dentists about medication-related osteonecrosis of the jaw in osteoporotic patients. Int Dent J 2021;71(4):336-342. DOI: 10.1016/j.identj.2020.12.005.
• Miranda-Silva W, Montezuma MA, Benites BM, Bruno JS, Fonseca FP, Fregnani ER. Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals. Support Care Cancer 2020;28:5397-5404. DOI: 10.1007/s00520-020-05374-4.
• Arnaud MP, Talibi S, Lejeune-Cairon S. Knowledge and attitudes of French dentists on bone resorption inhibitors (bisphosphonates and denosumab): A cross-sectional study. J Stomatol Oral Maxillofac Surg 2022;123(2):163-170. DOI: 10.1016/j.jormas.2021.04.010.
• Bruckmoser E, Palaoro M, Latzko L, Schnabl D, Neururer SB, Laimer J. Choosing the right partner for medication related osteonecrosis of the jaw: What central European dentists know. Int J Environ Res Public Health 2021;18(9). DOI: 10.3390/ijerph18094466.
• Deveci H, Ugar Cankal DA. Investigation of the Approach of Dentists in Ankara to Patients Who Use Drugs as Bisphosphonates, Denosumab and Similars. ADO Klinik Bilimler Dergisi. 2021;10(2):99-105.
• Sahin O. Medication-related osteonecrosis of the jaw: A survey of knowledge, practices and opinions of dentists. Ann Med Res 2020;27(9):2421-7. DOI: 10.5455/annalsmedres.2020.03.259.
• Patil V, Acharya S, Vineetha R, Nikhil K. Awareness about medication-related osteonecrosis of the jaw among dental professionals: A multicentre study. Oral Health Prev Dent 2020;18(1):505-509. DOI: 10.3290/j.ohpd.a43361.
• Alhussain A, Peel S, Dempster L, Clokie C, Azarpazhooh A. Knowledge, practices, and opinions of ontario dentists when treating patients receiving bisphosphonates. J Oral Maxillofac Surg 2015;73(6):1095-1105. DOI: 10.1016/j.joms.2014.12.040
• Yoo JY, Park YD, Kwon YD. Survey of Korean dentists on the awareness on bisphosphonate-related osteonecrosis of the jaws: A survey on the awareness of BRONJ. J Investig Clin Dent 2010;1(2):90-95. DOI: 10.1111/j.2041-1626.2010.00024.x.
• Gaballah K, Hassan M. Knowledge and attitude of dentists on bisphosphonates use in the UAE: a descriptive cross-sectional study. Int Surg J 2017;4(4):1398. DOI:10.18203/2349-2902.isj20171150.
• Şenol G, Güldi̇ken İN, Suzen M, Koçyi̇ği̇t H, Deli̇lbaşi Ç. Antirezorptif İlaç Reçete Eden Tıp Hekimlerinin MRONJ Yaklaşımı. Turkiye Klinikleri J Dental Sci, 27(2), 168–177 (Turkish). DOI: 10.5336/dentalsci.2020-75321.
• Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D. American Association of Oral and Maxillofacial Surgeons’ position paper on medication-related osteonecrosis of the jaws-2022 update. J Oral Maxillofac Surg 2022;80(5):920-943. DOI: 10.1016/j.joms.2022.02.008.