Survey on Medical doctors' awareness and perceptions of Bisphosphonate-related osteonecrosis of the jaw

비스포스포네이트 관련 악골괴사 (Bisphosphonate-Related Osteonecrosis of the Jaw)에 관한 의사의 인식도 조사

  • Kim, Jin-Woo (Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Jeong, Su-Ra (Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Pang, Eun-Kyoung (Graduate School of Clinical Dentistry, Ewha Womans University) ;
  • Kim, Sun-Jong (Graduate School of Clinical Dentistry, Ewha Womans University)
  • 김진우 (이화여자대학교 임상치의학대학원 구강보건학과) ;
  • 정수라 (이화여자대학교 임상치의학대학원 구강보건학과) ;
  • 방은경 (이화여자대학교 임상치의학대학원 구강보건학과) ;
  • 김선종 (이화여자대학교 임상치의학대학원 구강보건학과)
  • Received : 2015.06.02
  • Accepted : 2015.09.03
  • Published : 2015.10.01

Abstract

The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.

Keywords

References

  1. Allen MR, Burr DB. Bisphosphonate effects on bone turnover, microdamage, and mechanical properties: what we think we know and what we know that we don't know. Bone 2011;49(1):56-65. https://doi.org/10.1016/j.bone.2010.10.159
  2. 최성욱, 김상림, 이광복, et al. 골다공증 환자에서 경구 비스포스포네이트 치료 중 발생한 악골 괴사. 대한정형외과학회지 2010;45(2):151-154. https://doi.org/10.4055/jkoa.2010.45.2.151
  3. 이덕원, 이현우, 권용대. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) 에 대한 biochemical bone markers 와 악골괴사와 연관된 nonbisphosphonate drugs. 대한치과의사협회지 2014;52(4):203-217.
  4. 김경민, 이유미. 종설 : 비스포스포네이트의 치료 기간. 대한내과학회지 2014;87(2):151-155.
  5. Won Y, Lim JR, Kim YH, et al. Atypical femoral fracture combined with osteonecrosis of jaw during osteoporosis treatment with bisphosphonate. J Bone Metab 2014;21(2):155-159. https://doi.org/10.11005/jbm.2014.21.2.155
  6. 안기찬, 박대현, 공규민, et al. 원저 : 지속적인 비스포스포네이트 제제 사용으로 발생한 대퇴부 부전 골절의 치료 및 경과. 대한골절학회지 2014;27(1):10-16.
  7. Ruggiero SL, Dodson TB, Fantasia J, et al. 2014 AAOMS Position Paper on Medication-Related Osteonecrosis of the Jaw. American Association of Oral and Maxillofacial Surgeons; 2014. Available from:http://www.aaoms.org/index.php.
  8. Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. Journal of Oral and Maxillofacial Surgery 2003;61(9):1115-1117. https://doi.org/10.1016/S0278-2391(03)00720-1
  9. Ruggiero SL, Dodson TB, Assael LA, et al. American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate?Related Osteonecrosis of the Jaw?2009 Update. Australian endodontic journal 2009;35(3):119-130. https://doi.org/10.1111/j.1747-4477.2009.00213.x
  10. Ruggiero SL, Dodson TB, Fantasia J, et al. American Association of Oral and Maxillofacial Surgeons Position Paper on Medication-Related Osteonecrosis of the Jaw?2014 Update. Journal of Oral and Maxillofacial Surgery 2014.
  11. 박용덕, 김영란, 김덕윤, et al. 한국인 치과의사의 비스포스포네이트 관련 악골괴사에 대한 인식 연구. 대한구강악안면외과학회지 2009;35(3):153-157.
  12. 강경연. 비스포스포네이트 관련 악골괴사(BRONJ) 에 관한 서울시 치과위생사의 인식도 조사. 서울: 이화여자대학교 임상치의학대학원; 2014.
  13. Al-Mohaya MA, Al-Khashan HI, Mishriky AM, Al- Otaibi LM. Physicians' awareness of bisphos phonates-related osteonecrosis of the jaw. Saudi Med J 2011;32(8):830-835.
  14. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175-191. https://doi.org/10.3758/BF03193146
  15. 오지수, 김수관, 유재식, et al. 종설 : 비스포스포 네이트 관련 악골 골괴사: 문헌고찰. 口腔生物學 硏究2014;38(1):1-8.
  16. Katz J, Ordoveza PA. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) associated with a once-yearly IV infusion of zoledronic acid (Reclast) 5 mg: two cases and review of the literature. Quintessence Int 2014;45(8):685-690.
  17. Lam DK, Sandor GK, Holmes HI, et al. A review of bisphosphonate-associated osteonecrosis of the jaws and its management. J Can Dent Assoc 2007;73(5):417-422.
  18. Khosla S, Burr D, Cauley J, et al. Bisphosphonateassociated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2007;22(10):1479-1491. https://doi.org/10.1359/jbmr.0707onj
  19. Do Jung S, Son HR, Chung YJ, Mo JH. A Case of Sinusitis due to Bisphosphonate Related Osteonecrosis of Jaw. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:590-594. https://doi.org/10.3342/kjorl-hns.2012.55.9.590