Araştırma Makalesi
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İlaç kullanımına bağlı gelişen çene osteonekrozu: bir grup tıp doktorunun farkındalığı ve bilgi düzeyleri

Yıl 2022, Cilt: 9 Sayı: 2, 494 - 500, 24.08.2022
https://doi.org/10.15311/selcukdentj.978802

Öz

Amaç: Bu çalışma, bifosfonatların (BPs) yan etkilerine karşı tıp hekimlerinin bilgisi ve farkındalık seviyesini değerlendirmeyi amaçlamaktadır.
Gereç ve Yöntemler: Bu kesitsel çalışma Tıp Fakültesi Hastanesinde gerçekleştirilmiştir. Veriler, BPs reçete eden iç hastalıkları (onkolog, endokrinolog ve romatolog) ortopedi, fizik tedavi, kadın doğum ve hastalıkları ve üroloji araştırma görevlilerine uygulanan anket sorularıyla toplanmıştır. Sorular mesleki yıl, ilaçla ilgili bilgi verme, ilacı reçete etmeden önce ve reçete ettikten sonra diş hekimine yönlendirme, ilaç kullanımına bağlı gelişen çene osteonekrozu (MRONJ) deneyimi ve BPs alım şekli ile kesilmesi gibi tedavi modifikasyonlarından oluşmaktadır.
Bulgular: 106 araştırma görevlisinin 91’i hastalarını bifosfonat ile tedavi etmektedir. Bunların %89’u hastalara ilacın yan etkilerinden bahsetmesine rağmen, sadece %16,5’u bifosfonat reçete etmeden önce hastalarını diş hekimine konsülte etmektedir. Dental yönlendirme fizik tedavi, iç hastalıkları, kadın doğum ve hastalıkları, üroloji ve ortopedi olacak şekilde azalarak devam etmektedir. İstatistiksel olarak bilgi düzeyi ve çalışma yılı arasında belirgin bir farklılık olmamakla birlikte (p=0.3) uzmanlık dalına göre ortopedistlerin bilgi düzeyi ve farkındalığı daha düşük bulunmuştur (p=0.02).
Sonuç: BPs reçete eden araştırma görevlileri MRONJ riskinin çoğunlukla farkında değildir. Bu yüzden eğitim programlarının devamlılığı ve hekimler arası iş birliği, farkındalığın arttırılması için gereklidir.

Kaynakça

  • 1- Mahdaviazad H, Keshtkar V, Emami MJ. Osteoporosis guideline awareness among Iranian family physicians: results of a knowledge, attitudes, and practices survey. Prim Health Care Res Dev 2018;19:485-491.
  • 2- Voss PJ, Poxleitner P, Schmelzeisen R, Stricker A, Semper-Hogg W. Update MRONJ and perspectives of its treatment. J Stomatol Oral Maxillofac Surg 2017;118:232-235.
  • 3- McLeod NMH, Davies BJB, Brenan PA. Bisphosphonate osteonecrosis of the jaws; an increasing problem for the dental practitioner. Br Dent J 2007;203:641-644.
  • 4- Aparecida Cariolatto F, Carelli J, de Campos Moreira T, Pietrobon R, Rodrigues C, Bonilauri Ferreira AP. Recommendations for the prevention of bisphosphonate-related osteonecrosis of the jaw: a systematic review. J Evid Based Dent Pract 2018;18:142-152.
  • 5- Baqain ZH, Sawair FA, Tamimi Z, Bsoul N, Edwan GA, Almasad JK, et al. Osteonecrosis of jaws related to intravenous bisphosphonates: the experience of a Jordanian teaching hospital. Ann R Coll Surg Engl 2010;92:489-94.
  • 6- 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. J Oral Maxillofac Surg 2014;72:1938-1956.
  • 7- Migliorati CA, Schubert MM, Peterson DE, Seneda LM. Bisphosphonate associated osteonecrosis of mandibular and maxillary bone: an emerging oral complication of supportive cancer therapy. Cancer 2005;104:83-93.
  • 8- Badros A, Weikel D, Salama A, Goloubeva O, Schneider A, Rapoport A, et al. Ostonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors. J Clin Oncol 2006;24:945-952.
  • 9- Campisi G, Di Fede O, Musciotto A, Lo Casto A, Lo Muzio L, Fulfaro F, et al. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis. Ann Oncol 2007;6:168-172.
  • 10- Sarin J, DeRossi SS, Akintoye SO. Updates on bisphosphonates and potential pathobiology of bisphosphonate-induced jaw osteonecrosis. Oral Dis 2008;14:277-285.
  • 11- Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61:1115‐1117.
  • 12- Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004;62:527-534.
  • 13- Vandone AM, Donadio M, Mozzati M, Ardine M, Polimeni MA, Beatrice S, et al. Impact of dental care in the prevention of bisphosphonate-associated osteonecrosis of the jaw: a single center clinical experience. Ann Oncol 2012;23:193-200.
  • 14- Hinchy NV, Javaprakash V, Rossito RA, Anders PL, Korff KC, Canallatos P, et al. Osteonecrosis of the jaw-prevention and treatment strategies for oral health professional. Oral Oncol 2013;49:878-886.
  • 15- Ruggiero SL, Fantasia J, Carlson E. Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:433-441.
  • 16- Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O’Ryan F, et al. 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;30:3-23.
  • 17- Rayman S, Almas K, Dincer E. Bisphosphonate-related jaw necrosis: a team approach to management and prevention. Int J Dent Hyg 2009;7:90-95.
  • 18- Kim JW, Jeong SR, Kim SJ, Kim Y. Perceptions of medical doctors on bisphosphonate-related osteonecrosis of the jaw. BMC Oral Health 2016;16:92.
  • 19- El Osta L, EL Osta B, Lakiss S, Hennequin M, El Osta N. Bisphosphonate-related osteonecrosis of the jaw: awareness and level of knowledge of Lebanese physicians. Supportive Care Cancer 2015;23:2825-2831.
  • 20- Al-Mohaya MA, Al-Khashan HI, Mishriky AM, Al-Otaibi LM. Physicians' awareness of bisphosphonates-related osteonecrosis of the jaw. Saudi Med J 2011;32:830-835.
  • 21- 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.
  • 22- Van Poznak CH, Temin S, Yee GC, Janjan NA, Barlow WE, Biermann JS, et al. American Society of Clinical Oncology executive summary of the clinical practice guideline update on the role of bone-modifying agents in metastatic breast cancer. J Clin Oncol 2011;29:1221.
  • 23- Yoo JY, Park YD, Kwon YD, Kim DY, Ohe JY. Survey of Korean dentists on the awareness on bisphosphonate-related osteonecrosis of the jaws. J Investig Clin Dent 2010;1:90-95.
  • 24- Powell D, Bowler C, Roberts T, Garton M, Matthews C, McCall I, Davie M. Incidence of serious side effects with intravenous bisphosphonate: a clinical audit. QJM 2012;105:965-971.
  • 25- Cuevas-Gonzalez MV, Diaz-Aguirre CM, Perez EE, Cuevas-Gonzalez JC. Prevalence of osteonecrosis of the jaw and oral characteristics of oncologic patients treated with bisphosphonates at the General Hospital of Mexico. J Korean Assoc Oral Maxillofac Surg 2016;42:365-369.
  • 26- Estefania FR, Ponte FR, Guirre Urizar JM. Bisphosphonates and oral pathology II. Osteonecrosis of the jaws: review of the literature before 2005. Med Oral Patol Oral Cir Bucal 2006;11:456-461.
  • 27- Hewitt C, Farah CS. Bisphosphonate-related osteonecrosis of the jaws: a comprehensive review. J Oral Pathol Med 2007;36:319-328.
  • 28- Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22:1479-1491.
  • 29- Lam DK, Sandor GK, Holmes HI, Evans AW, Clokie CM. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. J Can Dent Assoc 2007;73:417-422.
  • 30- Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, et al. Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw. J Bone Miner Metab 2017;35:6-19.
  • 31- Kim KM, Rhee Y, Kwon YD, Kwon TG, Lee JK, Kim DY. Medication Related Osteonecrosis of the Jaw: 2015 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons. J Bone Metab 2015;22:151-65.

Medication-related osteonecrosis of the jaw: awareness and level of knowledge of a group of Turkish physicians

Yıl 2022, Cilt: 9 Sayı: 2, 494 - 500, 24.08.2022
https://doi.org/10.15311/selcukdentj.978802

Öz

Background: The aim of this study was to evaluate physicians’ level of knowledge and awareness regarding the side effects of bisphosphonates (BPs).
Methods: A cross-sectional descriptive study was conducted at University Hospital. Data were collected through a self-administered questionnaire given to a group of research assistants all of whom were required to prescribe BPs, including internists (oncologists, endocrinologists and rheumatologists), orthopaedic specialists, physiotherapists, obstetricians and gynaecologists, and urologists. The questionnaire consisted of a range of questions covering such matters as length of time in occupation, how information is given out, whether a dentist is consulted before or in the course of prescribing the medicine, and previous experience of medication-related osteonecrosis of the jaw (MRONJ) and any treatment modifications.
Results: Ninety-one out of 106 physicians included in our sample were found to be treating patients with BPs. Although 89% of the physicians informed their patients about the side effects of BPs, only 16.5% advised their patients to consult a dentist for dental treatment before prescribing BPs. When the different specialist groups were ranked in terms of their rate of dental referrals, from highest to lowest, the order was as follows: physiotherapists, internists, obstetricians and gynaecologists, urologists and orthopaedists. A statistically significant correlation was found between knowledge and specialty (p=0.02), but no significant correlation was observed between knowledge and years of experience (p=0.3).
Conclusion: There is a lack of awareness among research assistants about the risk of MRONJ when prescribing BPs. Therefore, continuous education programmes and multiple interventions are needed to increase awareness.

Kaynakça

  • 1- Mahdaviazad H, Keshtkar V, Emami MJ. Osteoporosis guideline awareness among Iranian family physicians: results of a knowledge, attitudes, and practices survey. Prim Health Care Res Dev 2018;19:485-491.
  • 2- Voss PJ, Poxleitner P, Schmelzeisen R, Stricker A, Semper-Hogg W. Update MRONJ and perspectives of its treatment. J Stomatol Oral Maxillofac Surg 2017;118:232-235.
  • 3- McLeod NMH, Davies BJB, Brenan PA. Bisphosphonate osteonecrosis of the jaws; an increasing problem for the dental practitioner. Br Dent J 2007;203:641-644.
  • 4- Aparecida Cariolatto F, Carelli J, de Campos Moreira T, Pietrobon R, Rodrigues C, Bonilauri Ferreira AP. Recommendations for the prevention of bisphosphonate-related osteonecrosis of the jaw: a systematic review. J Evid Based Dent Pract 2018;18:142-152.
  • 5- Baqain ZH, Sawair FA, Tamimi Z, Bsoul N, Edwan GA, Almasad JK, et al. Osteonecrosis of jaws related to intravenous bisphosphonates: the experience of a Jordanian teaching hospital. Ann R Coll Surg Engl 2010;92:489-94.
  • 6- 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. J Oral Maxillofac Surg 2014;72:1938-1956.
  • 7- Migliorati CA, Schubert MM, Peterson DE, Seneda LM. Bisphosphonate associated osteonecrosis of mandibular and maxillary bone: an emerging oral complication of supportive cancer therapy. Cancer 2005;104:83-93.
  • 8- Badros A, Weikel D, Salama A, Goloubeva O, Schneider A, Rapoport A, et al. Ostonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors. J Clin Oncol 2006;24:945-952.
  • 9- Campisi G, Di Fede O, Musciotto A, Lo Casto A, Lo Muzio L, Fulfaro F, et al. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis. Ann Oncol 2007;6:168-172.
  • 10- Sarin J, DeRossi SS, Akintoye SO. Updates on bisphosphonates and potential pathobiology of bisphosphonate-induced jaw osteonecrosis. Oral Dis 2008;14:277-285.
  • 11- Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 2003;61:1115‐1117.
  • 12- Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 2004;62:527-534.
  • 13- Vandone AM, Donadio M, Mozzati M, Ardine M, Polimeni MA, Beatrice S, et al. Impact of dental care in the prevention of bisphosphonate-associated osteonecrosis of the jaw: a single center clinical experience. Ann Oncol 2012;23:193-200.
  • 14- Hinchy NV, Javaprakash V, Rossito RA, Anders PL, Korff KC, Canallatos P, et al. Osteonecrosis of the jaw-prevention and treatment strategies for oral health professional. Oral Oncol 2013;49:878-886.
  • 15- Ruggiero SL, Fantasia J, Carlson E. Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:433-441.
  • 16- Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O’Ryan F, et al. 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;30:3-23.
  • 17- Rayman S, Almas K, Dincer E. Bisphosphonate-related jaw necrosis: a team approach to management and prevention. Int J Dent Hyg 2009;7:90-95.
  • 18- Kim JW, Jeong SR, Kim SJ, Kim Y. Perceptions of medical doctors on bisphosphonate-related osteonecrosis of the jaw. BMC Oral Health 2016;16:92.
  • 19- El Osta L, EL Osta B, Lakiss S, Hennequin M, El Osta N. Bisphosphonate-related osteonecrosis of the jaw: awareness and level of knowledge of Lebanese physicians. Supportive Care Cancer 2015;23:2825-2831.
  • 20- Al-Mohaya MA, Al-Khashan HI, Mishriky AM, Al-Otaibi LM. Physicians' awareness of bisphosphonates-related osteonecrosis of the jaw. Saudi Med J 2011;32:830-835.
  • 21- 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.
  • 22- Van Poznak CH, Temin S, Yee GC, Janjan NA, Barlow WE, Biermann JS, et al. American Society of Clinical Oncology executive summary of the clinical practice guideline update on the role of bone-modifying agents in metastatic breast cancer. J Clin Oncol 2011;29:1221.
  • 23- Yoo JY, Park YD, Kwon YD, Kim DY, Ohe JY. Survey of Korean dentists on the awareness on bisphosphonate-related osteonecrosis of the jaws. J Investig Clin Dent 2010;1:90-95.
  • 24- Powell D, Bowler C, Roberts T, Garton M, Matthews C, McCall I, Davie M. Incidence of serious side effects with intravenous bisphosphonate: a clinical audit. QJM 2012;105:965-971.
  • 25- Cuevas-Gonzalez MV, Diaz-Aguirre CM, Perez EE, Cuevas-Gonzalez JC. Prevalence of osteonecrosis of the jaw and oral characteristics of oncologic patients treated with bisphosphonates at the General Hospital of Mexico. J Korean Assoc Oral Maxillofac Surg 2016;42:365-369.
  • 26- Estefania FR, Ponte FR, Guirre Urizar JM. Bisphosphonates and oral pathology II. Osteonecrosis of the jaws: review of the literature before 2005. Med Oral Patol Oral Cir Bucal 2006;11:456-461.
  • 27- Hewitt C, Farah CS. Bisphosphonate-related osteonecrosis of the jaws: a comprehensive review. J Oral Pathol Med 2007;36:319-328.
  • 28- Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22:1479-1491.
  • 29- Lam DK, Sandor GK, Holmes HI, Evans AW, Clokie CM. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. J Can Dent Assoc 2007;73:417-422.
  • 30- Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, et al. Antiresorptive agent-related osteonecrosis of the jaw: Position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw. J Bone Miner Metab 2017;35:6-19.
  • 31- Kim KM, Rhee Y, Kwon YD, Kwon TG, Lee JK, Kim DY. Medication Related Osteonecrosis of the Jaw: 2015 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons. J Bone Metab 2015;22:151-65.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Diş Hekimliği
Bölüm Araştırma
Yazarlar

Gözde Işık 0000-0001-9572-3049

Meltem Özden Yüce 0000-0002-7088-9701

Banu Özveri Koyuncu Bu kişi benim 0000-0002-0074-0055

Aliye Mandıracıoğlu 0000-0002-0873-4805

Yayımlanma Tarihi 24 Ağustos 2022
Gönderilme Tarihi 4 Ağustos 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 9 Sayı: 2

Kaynak Göster

Vancouver Işık G, Özden Yüce M, Özveri Koyuncu B, Mandıracıoğlu A. Medication-related osteonecrosis of the jaw: awareness and level of knowledge of a group of Turkish physicians. Selcuk Dent J. 2022;9(2):494-500.