Evaluation of Dentistry Students' Knowledge About the Medication-Related Osteonecrosis of the Jaw (MRONJ)

Year 2024, , 132 - 136, 19.08.2024

Meryem Şahin , Fatma Büşra Doğan , Azize Demir

https://doi.org/10.15311/selcukdentj.1334465

Abstract

Background: An undesirable side effect of bisphosphonates and similar antiangiogenic and antiresorptive drugs used in the treatment of pathologies such as osteoporosis, Paget's disease, and multiple myeloma, especially in the treatment of cancer patients with bone metastasis, is osteonecrosis of the jaws. The aim of this study is to evaluate the knowledge level of dentistry students about medication-related osteonecrosis of the jaw (MRONJ), to raise awareness and to emphasize the importance of MRONJ in dentistry.
Methods: After obtaining the necessary ethical approval for the study, the students were informed about the survey study. Questionnaires consisting of 10 questions, questioning the definition of MRONJ, indications for use of bisphosphonate and similar drugs, duration of use, dosage and the importance of use of drugs, were distributed to the students who agreed to participate in the study, and no data source was allowed during the answering process. Data analysis was done using IBM SPSS 25 program.
Results: A total of 202 students, 102 4th grade students and 100 5th grade students participated in the study. In the first question in which the terminology is questioned, it is seen that the most known term is BRONJ with a rate of 98%. There are 42 students who correctly answered all three criteria for the diagnosis of MRONJ, and 36 students who did not answer any of the criteria. It was observed that the students who knew all of these criteria gave more correct answers to the other questions.
Conclusion: This study shows that almost all of the students consider it important to question the use of drugs that cause osteonecrosis of the jaw in the anamnesis and to see the dentist before starting treatment with these drugs. However, it is also seen that they do not have sufficient knowledge in terms of the diagnosis of MRONJ, risk factors, causative drugs and diseases that are used.

Keywords

osteonecrosis, biphosphonate, denosumab

Diş Hekimliği Öğrencilerinin İlaca Bağlı Olarak Çene Kemiklerinde Görülen Osteonekroz (MRONJ) ile İlgili Bilgi Düzeylerinin Değerlendirilmesi

Abstract

Amaç: Başta kemik metastazı olan kanser hastalarının tedavisi olmak üzere osteoporoz, Paget hastalığı, multiple myelom gibi patolojilerin tedavisinde kullanılan bifosfanatların ve benzeri özellikteki antianjiojenik ve antirezorptif ilaçların istenmeyen bir yan etkisi çenelerde görülen osteonekrozdur. Bu çalışmada amaç diş hekimliği öğrencilerinin ilaçla ilişkili çene osteonekrozu (MRONJ) ile ilgili bilgi düzeylerini değerlendirmek, farkındalık oluşturmak aynı zamanda diş hekimliğinde MRONJ’un önemini vurgulamaktır.
Gereç ve Yöntemler: Çalışma için gerekli etik onay alındıktan sonra öğrencilere anket çalışması hakkında bilgi verilmiştir. MRONJ tanımı, bifosfanat ve benzeri ilaçların kullanım endikasyonları, ilaçların kullanım süresi, dozajı ve kullanım şeklinin önemini sorgulayan, 10 sorudan oluşan anket soruları çalışmaya katılmayı kabul eden öğrencilere dağıtılmış, cevaplama sırasında herhangi bir veri kaynağına izin verilmemiştir. Verilerin analizi IBM SPSS 25 programı kullanılarak yapılmıştır.
Bulgular: Çalışmaya 102 4.sınıf öğrencisi, 100 5.sınıf öğrencisi olmak üzere toplam 202 öğrenci katılmıştır. Terminolojinin sorgulandığı ilk soruda en fazla bilinen terimin % 98’lik oranla BRONJ olduğu görülmektedir. MRONJ tanısı için gerekli üç kriteri de doğru cevaplayan 42 öğrenci, hiçbir kriteri cevaplamayan 36 öğrenci mevcuttur. Bu kriterlerin tamamını bilen öğrencilerin diğer sorulara daha doğru cevaplar verdiği görülmüştür.
Sonuçlar: Bu çalışma öğrencilerin tamamına yakınının anamnezde çene osteonekrozuna neden olan ilaç kullanımını sorgulamayı ve hastaların bu ilaçlarla tedaviye başlamadan önce diş hekimine muayene olmalarını önemli gördüğünü göstermektedir. Bununla birlikte MRONJ tanısı, risk faktörleri, neden olan ilaçlar ve kullanıldığı hastalıklar yönünden yeterli bilgi düzeyine sahip olmadıkları da görülmektedir.
Anahtar Kelimeler: Osteonekroz, bifosfonat, denosumab

Keywords

Osteonekroz, bifosfonat, denosumab

References

• 1. 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. International journal of environmental research and public health. 2021;18(9):4466.
• 2. Franchi S, Brucoli M, Bofano P, Dosio C, Benech A. Medical students’ knowledge of medication related osteonecrosis of the jaw. Journal of stomatology, oral and maxillofacial surgery. 2020;121(4):344-6.
• 3. YAZICI T, Şentürk MF, Koçer G. İlaca Bağlı Olarak Çene Kemiklerinde Görülen Osteonekroz (Mronj): Derleme. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2017;8(2):50-7.
• 4. 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):505-9.
• 5. Al-Eid R, Alduwayan T, Khuthaylah MB, Al Shemali M. Dentists' knowledge about medication-related osteonecrosis of the jaw and its management. Heliyon. 2020;6(7).
• 6. El-Ma’aita A, Da’as N, Al-Hattab M, Hassona Y, Al-Rabab’ah M, Al-Kayed M-A. Awareness of the risk of developing medication-related osteonecrosis of the jaw among bisphosphonate users. Journal of International Medical Research. 2020;48(9):0300060520955066.
• 7. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, et al. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw—2014 update. Journal of oral and maxillofacial surgery. 2014;72(10):1938-56.
• 8. Arnaud M-P, Talibi S, Lejeune-Cairon S. Knowledge and attitudes of French dentists on bone resorption inhibitors (bisphosphonates and denosumab): A cross-sectional study. Journal of stomatology, oral and maxillofacial surgery. 2022;123(2):163-70.
• 9. Wood J, Bonjean K, Ruetz S, Bellahcène A, Devy L, Foidart JM, et al. Novel antiangiogenic effects of the bisphosphonate compound zoledronic acid. Journal of Pharmacology and Experimental Therapeutics. 2002;302(3):1055-61.
• 10. Hoff AO, Toth B, Hu M, Hortobagyi GN, Gagel RF. Epidemiology and risk factors for osteonecrosis of the jaw in cancer patients. Annals of the New York Academy of Sciences. 2011;1218(1):47-54.
• 11. AlRowis R, Aldawood A, AlOtaibi M, Alnasser E, AlSaif I, Aljaber A, et al. Medication-related osteonecrosis of the jaw (MRONJ): a review of pathophysiology, risk factors, preventive measures and treatment strategies. The Saudi Dental Journal. 2022;34(3):202-10.
• 12. Schwech N, Nilsson J, Gabre P. Incidence and risk factors for medication‐related osteonecrosis after tooth extraction in cancer patients—A systematic review. Clinical and Experimental Dental Research. 2023;9(1):55-65.
• 13. Şahin M, Ünalan F, Çakarer S. Bifosfonat Tedavisinin Hareketli Bölümlü Protez Kullanan Hastalar Üzerine Etkisi. Turkiye Klinikleri Journal of Dental Sciences. 2019;25(2).
• 14. Rosella D, Papi P, Pompa G, Capogreco M, De Angelis F, Di Carlo S. Dental students' knowledge of medication-related osteonecrosis of the jaw. European journal of dentistry. 2017;11(04):461-8.
• 15. 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 Pharmaceutical Journal. 2021;29(1):96-103.
• 16. Lupsa BC, Insogna K. Bone health and osteoporosis. Endocrinology and Metabolism Clinics. 2015;44(3):517-30.
• 17. ŞAHİN M, ÇAKARER S, ÜNALAN F. Different Treatment Applications of Medication-Related Osteonecrosis of the Jaw on Osteoporotic Removable Partial Denture Patients: A Clinical Report. Türkiye Klinikleri Journal of Case Reports. 2022;30(2).
• 18. Ikesue H, Mouri M, Tomita H, Hirabatake M, Ikemura M, Muroi N, et al. Associated characteristics and treatment outcomes of medication-related osteonecrosis of the jaw in patients receiving denosumab or zoledronic acid for bone metastases. Supportive Care in Cancer. 2021;29:4763-72.