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

Flávia Godinho Costa Wanderley Rocha; Roberto Paulo Correia de Araújo

Authors

Flávia Godinho Costa Wanderley Rocha
Roberto Paulo Correia de Araújo

Keywords:

Diphosphonates, Bone Density Conservation Agents, Oral Medicine

Abstract

Objective: To determine the level of scientific information of dental surgeons who carry out their professional activities in Brazil about antiresorptive drugs and indicated pharmacological procedures aiming at the prevention of osteonecrosis of the jaws and the therapy of drug sequelae that may occur, considering the time since graduation in Dentistry. Material and Methods: This is a quantitative cross-sectional study in which 339 dentists were consulted using the virtual questionnaire containing topics of personal nature, elements contained in the anamnesis carried out and knowledge about antiresorptive drugs, including indications, adverse effects and treatments applied. Chi-square and Fisher's exact tests were performed to analyze associations of data described by absolute and relative frequencies with professionals' time since graduation. All analyses were performed using the R software, with a 5% significance level. Results: Those who revealed to have graduated for more than five years with the highest academic degree were those who demonstrated maximum knowledge of antiresorptive drugs or revealed that, somehow, they had information about them (p<0.05). Conclusion: Dental surgeons in Brazil who have more than five years since graduation have more scientific information about antiresorptive drugs and pharmacological procedures, which can positively contribute to the prevention of osteonecrosis of the jaws and treatment of drug sequelae that may occur.

References

Kim JM, Lin C, Stavre Z, Greenblatt MB, Shim JH. Osteoblast-osteoclast communication and bone homeostasis. Cells 2020; 9(9):2073. https://doi.org/10.3390/cells9092073

Kuźnik A, Październiok-Holewa A, Jewula P, Kuźnik N. Bisphosphonates-much more than only drugs for bone diseases. Eur J Pharmacol 2020; 866:172773. https://doi.org/10.1016/j.ejphar.2019.172773

Xing L, Ebetino FH, Boeckman RK Junior, Srinivasan V, Tao J, Sawyer TK, et al. Targeting anti-cancer agents to bone using bisphosphonates. Bone 2020; 138:115492. https://doi.org/10.1016/j.bone.2020.115492

Allen MR. Recent advances in understanding bisphosphonate effects on bone mechanical properties. Curr Osteoporos Rep 2018; 16(2):198-204. https://doi.org/10.1007/s11914-018-0430-3

Dell'aquila E, Armento G, Iuliani M, Simonetti S, D'Onofrio L, Zeppola T, et al. Denosumab for cancer-related bone loss. Expert Opin Biol Ther 2020; 20(11):1261-74. https://doi.org/10.1080/14712598.2020.1814731

Endo Y, Kumamoto H, Nakamura M, Sugawara S, Takano-Yamamoto T, Sasaki K, et al. Underlying mechanisms and therapeutic strategies for BisphosphonateRelated Osteonecrosis of the Jaw (BRONJ). Biol Pharm Bull 2017; 40(6):739-50. https://doi.org/10.1248/bpb.b16-01020

Farrier AJ, Sanchez Franco LC, Shoaib A, Gulati V, Johnson N, Uzoigwe CE, et al. New anti-resorptives and antibody mediated anti-resorptive therapy. Bone Joint J 2016; 98-B(2):160-5. https://doi.org/10.1302/0301-620X.98B2.36161

Aldhalaan NA, Baqais A, Al-omar A. Medication-related osteonecrosis of the jaw: a review. Cureus 2020; 12(2):6944. https://doi.org/10.7759/cureus.6944

Giudice A, Antonelli A, Chiarella E, Baudi F, Barni T, Di Vito A. The case of medication-related osteonecrosis of the jaw addressed from a pathogenic point of view. innovative therapeutic strategies: focus on the most recent discoveries on oral mesenchymal stem cell-derived exosomes. Pharmaceuticals 2020; 13(12):423. https://doi.org/10.3390/ph13120423

Voss PJ, Steybe D, Poxleitner P, Schmelzeisen R, Munzenmayer C, Fuellgraf H, et al. Osteonecrosis of the jaw in patients transitioning from bisphosphonates to denosumab treatment for osteoporosis. Odontology 2018; 106(4);469-80. https://doi.org/10.1007/s10266-018-0362-5

Vallina C, Ramírez L, Torres J, Casañas E, Hernández G, López-Pintor RM. Osteonecrosis of the jaws produced by sunitinib: a systematic review. Med Oral Patol Oral Cir Bucal 2019; 24(3):e326-e338. https://doi.org/10.4317/medoral.22858

Maluf G, Caldas RJ, Fregnani ER, da Silva Santos PS. A rare case of bevacizumab-related osteonecrosis of the jaw associated with dental implants. Int J Implant Dent 2019; 5(1):34. https://doi.org/10.1186/s40729-019-0188-0

Hasegawa T, Kawakita A, Ueda N, Funahara R, Tachibana A, Kobayashi M, et al. A multicenter retrospective study of the risk factors associated with medication-related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy: can primary wound closure and a drug holiday really prevent MRONJ? Osteoporos Int 2017; 28(8):2465-73. https://doi.org/10.1007/s00198-017-4063-7

Wick A, Bankosegger P, Otto S, Hohlweg-Majert B, Steiner T, Probst F, et al. Risk factors associated with onset of medication-related osteonecrosis of the jaw in patients treated with denosumab. Clin Oral Investig 2022; 26(3):2839-52. https://doi.org/10.1007/s00784-021-04261-4

Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, et al. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127(2):117-35. https://doi.org/10.1016/j.oooo.2018.09.008

Song M. Dental care for patients taking antiresorptive drugs: a literature review. Restor Dent Endod 2019; 44(4):e42. https://doi.org/10.5395/rde.2019.44.e42

Kim HY. Review and update of the risk factors and prevention of antiresorptive-related osteonecrosis of the jaw. Endocrinol Metab 2021; 36(5):917-27. https://doi.org/10.3803/EnM.2021.1170

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(1):117-20. https://doi.org/10.1093/annonc/mdn554

Yarom N, Shapiro CL, Peterson DE, Van Poznak CH, Bohlke K, Ruggiero SL, et al. Medication-related osteonecrosis of the jaw: MASCC/ISOO/ASCO clinical practice guideline. J Clin Oncol 2019; 37(25):2270-90. https://doi.org/10.1200/ JCO.19.01186

Maluf G, Caldas RJ, Silva Santos PS. Use of leukocyte- and platelet-rich fibrin in the treatment of medication-related osteonecrosis of the jaws. J Oral Maxillofac Surg 2018; 76(1):88-96. https://doi.org/10.1016/j.joms.2017.06.004

Di Fede O, Canepa F, Panzarella V, Mauceri R, Del Gaizo C, Bedogni A, et al. The Treatment of Medication-Related Osteonecrosis of the Jaw (MRONJ): a systematic review with a pooled analysis of only surgery versus combined protocols. Int J Environ Res Public Health 2021; 18(16):8432. https://doi.org/10.3390/ijerph18168432

Monteiro L, Vasconcelos C, Pacheco JJ, Salazar F. Photobiomodulation laser therapy in a Lenvatinib-related osteonecrosis of the jaw: a case report. J Clin Exp Dent 2021; 13(6):e626-9. https://doi.org/10.4317/jced.58323

Almeida MVDC, Moura AC, Santos L, Gominho L, Cavalcanti UDNT, Romeiro K. Photodynamic therapy as an adjunct in the treatment of medication-related osteonecrosis of the jaw: a case report. J Lasers Med Sci 2021; 12:e12. https://doi.org/10.34172/jlms.2021.12

Hayashida S, Soutome S, Yanamoto S, Fujita S, Hasegawa T, Komori T, et al. Evaluation of the Treatment Strategies for Medication-Related Osteonecrosis of the Jaws (MRONJ) and the factors affecting treatment outcome: a multicenter retrospective study with propensity score matching analysis. J Bone Miner Res 2017; 32(10):2022-9. https://doi.org/10.1002/jbmr.3191

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(12):3421-6. https://doi.org/10.1007/s00520-015-2689-6

R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing 2022. Available from: https://www.R-project.org/ [Acessed on February 9, 2023]

Paredes L, Gonçalves LS, Miranda AMMA, Netto JNS, Perez DEC, Pires FR. Knowledge of dental professionals and dental students on bisphosphonates and bisphosphonate-associated osteonecrosis of the jaws. Res Soc Dev 2022; 11(9):e16211931553. https://doi.org/10.33448/rsd-v11i9.31553

Marliére DAA, Costa TE, Junqueira RB, Barbosa SM, Asprino L, Chaves Netto HDM. Knowledge and clinical behavior on antiresorptivemedications and osteonecrosis of the jaws: a cross-sectional study. RGO 2019; 67:e20190058. http://doi.org/10.1590/1981-863720190005820190018

Vinitzky-Brener I, Ibáñez-Mancera NG, Aguilar-Rojas AM, Álvarez-Jardón AP. Knowledge of bisphosphonate-related osteonecrosis of the Jawsamong Mexican dentists. Med Oral Patol Oral Cir Bucal 2017; 22(1):e84-e87. https://doi.org/10.4317/medoral.21433

Dahlgren M, Wexell CL. Uncertainty managing patients treated with antiresorptive drugs: a cross-sectional study of attitudes and self-reported behavior among dentists in Sweden. Acta Odontol Scand 2020; 78(2):109-17. https://doi.org/10.1080/00016357.2019.1655586

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(10):1938-56. https://doi.org/10.1016/j.joms.2014.04.031

Tanna N, Steel C, Stagnell S, Bailey E. Awareness of medication related osteonecrosis of the jaws (MRONJ) amongst general dental practitioners. Br Dent J 2017; 222(2):121-5. https://doi.org/10.1038/sj.bdj.2017.79

Alqhtani NR, Almalki AK, Zuhair FA, Alenazi AA, Nabhan AB, Alqahtani M. Knowledge, attitude, and management of general dentist toward medication-related osteonecrosis of the jaws. J Pharm Bioallied Sci 2020; 12(Suppl 1):S151-S154. https://doi.org/10.4103/jpbs.JPBS_47_20

Escobedo M, García-Consuegra L, Junquera S, Olay S, Ascani G, Junquera L. Medication-related osteonecrosis of the jaw: A survey of knowledge, attitudes, and practices among dentists in the principality of Asturias (Spain). J Stomatol Oral Maxillofac Surg 2018; 119(5):395-400. https://doi.org/10.1016/j.jormas.2018.04.008