Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals
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ORIGINAL ARTICLE
Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals Wanessa Miranda-Silva 1 & Marco Aurélio Montezuma 1 & Bernar Monteiro Benites 1 & Julia Stephanie Bruno 1 & Felipe Paiva Fonseca 2 & Eduardo Rodrigues Fregnani 1 Received: 7 November 2019 / Accepted: 20 February 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To assess the current knowledge regarding medication-related osteonecrosis of the jaw (MRONJ); the adverse effects of anti-resorptive (AR) and anti-angiogenic (AA) drugs; strategies for MRONJ prevention and treatment; and perception of the dentist’s role in assisting patients who use these drugs among physicians, dentists, and nurses. Methods Using questionnaires, the current knowledge of MRONJ was assessed among dentists, physicians, and nurses, who were divided into group I, which included specialties that directly assist cancer patients, and group II, which included other specialties. The questionnaires assessed the characteristics of the health professionals, training time, and specialties; their knowledge of AR and AA drugs; and their knowledge of MRONJ. Results A total of 1370 health professionals participated in the study, including 1032 dentists, 239 physicians, and 99 nurses. Among dentists and physicians, the training time (p = 0.036 and p < 0.001, respectively) and specialization in group I domains (p < 0.001 and p < 0.001, respectively) had a significant impact on MRONJ knowledge, while nurses showed no significant impact regardless of the training time and specialty. Less than 10% of the physicians and dentists could correlate the signs and symptoms of all stages of MRONJ. Conclusion The findings indicated a notable lack of knowledge regarding MRONJ among dental surgeons and physicians, and especially among nurses. More experienced professionals and specialists in the areas that assist cancer patients usually have a greater understanding of the dentist’s role in MRONJ prevention, diagnosis, treatment, and patient care and will introduce or are already using AR and AA drugs. Keywords Medication-related osteonecrosis of the jaw . Bisphosphonate-related osteonecrosis of the jaw . Osteonecrosis of the jaw . Questionnaires . Health professionals
Introduction Medication-related osteonecrosis of the jaw (MRONJ) was first reported to occur in association with the use of bisphosphonates (BP) by oral and maxillofacial surgeons in
2003 and 2004 [1, 2]. Subsequently, this condition has been shown to be associated with other drug classes as well, including anti-resorptive (AR) and anti-angiogenic (AA) drugs. AR drugs include oral and intravenous (IV) BP and denosumab (RANKL inhibitors), while AA drugs include tyrosine kinase
* Eduardo Rodrigues Fregnani [email protected]
Julia Stephanie Bruno [email protected]
Wanessa Miranda-Silva [email protected]
Felipe Paiva Fonseca [email protected]
Marco Aurélio Montezuma [email protected]
1
Department of Oral Medicine, H
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