CC BY-NC-ND 4.0 · Eur J Dent 2017; 11(04): 461-468
DOI: 10.4103/ejd.ejd_27_17
Original Article
Dental Investigation Society

Dental students' knowledge of medication-related osteonecrosis of the jaw

Daniele Rosella
1   Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Roma, Italy
,
Piero Papi
1   Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Roma, Italy
,
Giorgio Pompa
1   Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Roma, Italy
,
Mario Capogreco
2   Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
,
Francesca De Angelis
1   Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Roma, Italy
,
Stefano Di Carlo
1   Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Roma, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
01 October 2019 (online)

ABSTRACT

Objectives: The aim of this study was to evaluate and assess knowledge and attitude of dental students about medication-related osteonecrosis of the jaw (MRONJ), to optimize future training programs in this field. Materials and Methods: A cross-sectional study was administrated. Ninety-eight participants agreed to complete an anonymous questionnaire. It was divided into two sections: the first section was about general information such as interviewer's gender and date of birth; the second section included questions about bisphosphonates (BPs), others medication associated to osteonecrosis of the jaw (ONJ), risk factors, and prevention of osteonecrosis. Descriptive statistics were computed and the odds ratio was used to compare the odds for the groups. Results: Ninety-nine percent of participants declared to know BPs, but only 26.9% of 4th year and 34.8% of 6th year students knew the correct definition of MRONJ. Almost all of students identified the importance to report, in anamnesis, the use of BPs, as well as to check-up patients before the beginning of treatment; on the other hand, the knowledge about how invasive dental treatment might be carried out in patients under therapy was not adequate. In addition, half of the students did not recognize any active principle or commercial name of BPs. The situation was even worse regarding alternative drugs involved in ONJ. Conclusions: These findings are alarming and the lack of knowledge about MRONJ suggests that greater educational efforts should be performed about this pathology at undergraduate level.

 
  • REFERENCES

  • 1 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: 1938-56
  • 2 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 (Suppl. 05) 2-12
  • 3 Aapro M, Abrahamsson PA, Body JJ, Coleman RE, Colomer R, Costa L. et al. Guidance on the use of bisphosphonates in solid tumours: Recommendations of an international expert panel. Ann Oncol 2008; 19: 420-32
  • 4 Mallik S, Mallik G, Macabulos ST, Dorigo A. Malignancy associated hypercalcaemia-responsiveness to IV bisphosphonates and prognosis in a palliative population. Support Care Cancer 2016; 24: 1771-7
  • 5 Van den Wyngaert T, Delforge M, Doyen C, Duck L, Wouters K, Delabaye I. et al. Prospective observational study of treatment pattern, effectiveness and safety of zoledronic acid therapy beyond 24 months in patients with multiple myeloma or bone metastases from solid tumors. Support Care Cancer 2013; 21: 3483-90
  • 6 McClung MR, Balske A, Burgio DE, Wenderoth D, Recker RR. Treatment of postmenopausal osteoporosis with delayed-release risedronate 35 mg weekly for 2 years. Osteoporos Int 2013; 24: 301-10
  • 7 Chapurlat RD, Laroche M, Thomas T, Rouanet S, Delmas PD, de Vernejoul MC. Effect of oral monthly ibandronate on bone microarchitecture in women with osteopenia-a randomized placebo-controlled trial. Osteoporos Int 2013; 24: 311-20
  • 8 Bishop N, Adami S, Ahmed SF, Antón J, Arundel P, Burren CP. et al. Risedronate in children with osteogenesis imperfecta: A randomised, double-blind, placebo-controlled trial. Lancet 2013; 382: 1424-32
  • 9 Yoh K, Takata S, Yoshimura N, Hashimoto J. Efficacy, tolerability, and safety of risedronate in Japanese patients with Paget's disease of bone. J Bone Miner Metab 2010; 28: 468-76
  • 10 Delmas PD. Clinical potential of RANKL inhibition for the management of postmenopausal osteoporosis and other metabolic bone diseases. J Clin Densitom 2008; 11: 325-38
  • 11 Fizazi K, Carducci M, Smith M, Damião R, Brown J, Karsh L. et al. Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: A randomised, double-blind study. Lancet 2011; 377: 813-22
  • 12 Rosella D, Papi P, Giardino R, Cicalini E, Piccoli L, Pompa G. Medication-related osteonecrosis of the jaw: Clinical and practical guidelines. J Int Soc Prev Community Dent 2016; 6: 97-104
  • 13 Dimopoulos MA, Kastritis E, Bamia C, Melakopoulos I, Gika D, Roussou M. et al. Reduction of osteonecrosis of the jaw (ONJ) after implementation of preventive measures in patients with multiple myeloma treated with zoledronic acid. Ann Oncol 2009; 20: 117-20
  • 14 Ripamonti CI, Maniezzo M, Campa T, Fagnoni E, Brunelli C, Saibene G. et al. Decreased occurrence of osteonecrosis of the jaw after implementation of dental preventive measures in solid tumour patients with bone metastases treated with bisphosphonates. The experience of the National Cancer Institute of Milan. Ann Oncol 2009; 20: 137-45
  • 15 Pompa G, Bignozzi I, Cristalli MP, Quaranta A, Di Carlo S. Bisphosphonates and Osteonecrosis of the jaw: The oral surgeon's perspective. Eur J Inflamm 2012; 101: 11-23
  • 16 Saad F, Brown JE, Van Poznak C, Ibrahim T, Stemmer SM, Stopeck AT. et al. Incidence, risk factors, and outcomes of osteonecrosis of the jaw: Integrated analysis from three blinded active-controlled phase III trials in cancer patients with bone metastases. Ann Oncol 2012; 23: 1341-7
  • 17 Lo JC, O'Ryan FS, Gordon NP, Yang J, Hui RL, Martin D. et al. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 2010; 68: 243-53
  • 18 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
  • 19 Marx RE, Sawatari Y, Fortin M, Broumand V. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: Risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 2005; 63: 1567-75
  • 20 Hellstein JW, Adler RA, Edwards B, Jacobsen PL, Kalmar JR, Koka S. et al. Managing the care of patients receiving antiresorptive therapy for prevention and treatment of osteoporosis: Executive summary of recommendations from the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2011; 142: 1243-51
  • 21 López-Jornet P, Camacho-Alonso F, Molina-Miñano F, Gomez-Garcia F. Bisphosphonate-associated osteonecrosis of the jaw. Knowledge and attitudes of dentists and dental students: A preliminary study. J Eval Clin Pract 2010; 16: 878-82
  • 22 de Lima PB, Brasil VL, de Castro JF, de Moraes Ramos-Perez FM, Alves FA, dos Anjos Pontual ML. et al. Knowledge and attitudes of Brazilian dental students and dentists regarding bisphosphonate-related osteonecrosis of the jaw. Support Care Cancer 2015; 23: 3421-6
  • 23 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
  • 24 Japanese Allied Committee on Osteonecrosis of the Jaw. Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi 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
  • 25 Monwell B, Blix O, Gerdner A, Bülow P. Drug list as a cognitive support to provide detailed information on a patient's drug use: A comparison of two methods within the assessment of drug misuse and dependence. Subst Use Misuse 2016; 51: 1470-6