Knowledge and clinical behavior on antiresorptive medications and osteonecrosis of the jaws: a cross-sectional study

Abstract

Objective: This present study assessed the knowledge and clinical behaviors of dentists on antiresorptive medications (AM) and osteonecrosis of the jaws (ONJ). Methods: A cross-sectional study was performed by a questionnaire applied to a sample of 101 dentists. It inquired about general information, knowledge on AM and ONJ, behaviors regarding clinical cases of patients, and knowledge acquisition sources. Kappa coefficient (ƙ) checked the questionnaire’s reliability. Descriptive statistics were computed, Fisher’s test assessed the association between behaviors and knowledge. Logistic regression analysis to estimate propensity score. Statistical significance was set at p ≤ 0.05. Results: The reliability showed good agreement (ƙ = 0.8). 59% of the dentists reporting to know AM, 83% believing it is important to know whether patients took AM during anamnesis and 53% indicating that they knew that ONJ was a side effect of AM. However, 5% of the dentists informed that they could fully recognize brand name of AM, and that 50% would not perform any dental invasive treatment, with 73% acquiring knowledge on AM and ONJ from scientific articles. Conclusion: dentists recognized AM, but they would not be comfortable treating patients who had taken AM or developed ONJ. Educational efforts might be made to promote the knowledge of dentists.

Analysis of the Degree of Information of Dental Surgeons about Antiresorptive Drugs According to the Time Since Graduation in Dentistry

“…The results corroborate those found in this study, demonstrating that most professionals ask in the anamneses of all patients which medications they are using, before performing any procedure (94.7%). Although it is unanimous on the part of dentists in the present study and those of Marliére et al [28] that it is extremely important to know during anamnesis which medications are under use by patient, and it will not be useful to know that the patient uses one of the Zometa group, for example, if the dentist is not aware that this is an antiresorptive drug and that, as such, it can cause maxillary osteonecrosis for those who use this medication.…”

“…Marliére et al [28] carried out a cross-sectional study using a questionnaire applied to a sample of 101 dentists, whose aim was to assess the knowledge and clinical conduct of these professionals regarding antiresorptive drugs and osteonecrosis of the jaws. When asked whether they asked in the anamnesis of all patients which medications they were using before performing any procedure, 83% of dentists reported that it was important to know during anamnesis whether the patient was under the use of antiresorptive drugs.…”

“…Marliére et al [28] also asked their participants if they knew about the possible adverse effects of antiresorptive drugs. Thus, 53% indicated that they knew that osteonecrosis of the jaws was a side effect of antiresorptive drugs.…”

“…Another question in the questionnaire developed by Marliére et al [28] was whether dentists performed surgical procedures on individuals using antiresorptive drugs. Thus, half of the participants reported that they did not perform any invasive dental treatment in patients under these drugs (50%).…”

“…Thus, most dentists interviewed reported performing surgical procedures in their clinical practice (76.4%), while more than half of the sample reported performing surgical procedures with bone exposure (58.8%) in their dental routine. If dentists interviewed in studies by Marliére et al [28] had more knowledge about antiresorptive drugs, the number of professionals who would perform surgical procedures on patients using antiresorptive drugs would be greater, provided that care is taken to avoid bone exposure. On the other hand, the interviewees of the present study in fact need to know if patients submitted to surgical procedures with bone exposure are or have been under the use of antiresorptive drugs, so that they cannot cause maxillary osteonecrosis in these individuals.…”