Ankara’daki Diş Hekimlerinin Bifosfonat, Denosumab ve Benzeri İlaç Kullanan Hastalara Yaklaşımlarının Değerlendirilmesi
Abstract
AMAÇ: Bifosfonat, denosumab ve benzer yan etkilere sahip ilaçların osteoporoz, kanser ile ilişkili kemik metastazları ve Paget hastalığı gibi kemik ile ilişkili hastalıklarda kullanımının artması ile ilaçla ilişkili osteonekroz (Medication-Related Osteonecrosis of the Jaws, MRONJ) tablosunun görülme sıklığı da artmaktadır. Bu sebeple söz konusu ilaçları reçete eden tıp hekimlerinin ve diş hekimlerinin ilaçların kullanım alanları, etki mekanizmaları, ortaya çıkabilecek komplikasyonları konusunda gerekli bilgi ve donanımına sahip olmaları gerekmektedir.
GEREÇ ve YÖNTEM: Bu çalışmada Ankara’da hizmet veren diş hekimlerinin MRONJ ile ilgili bilgi düzeylerinin ve yaklaşımlarının değerlendirilmesi amaçlanmıştır. Bu amaçla çalışmada diş hekimlerine web-tabanlı anket ve yüz yüze görüşme metodu olarak 2 farklı yaklaşım uygulanmıştır. Çalışmada 130 kişi web-tabanlı ankete, 173 kişi ise yüzyüze ankete katılmıştır.
BULGULAR: Tüm cevaplar değerlendirildiğinde bifosfonat, denosumab ve benzer yan etkilere sahip ilaçların osteonekroza sebep olabileceğinin farkındalığının %94,1 (285 kişi) oranında olmasına ve osteonekrozun en sık hangi çenede görüldüğü sorusuna %74 oranında doğru cevap verilmesine rağmen bu tür ilaçların kullanım endikasyonlarında doğru cevap oranının %6,6’yı geçmediği görülmüştür. Osteonekrozun teşhisi konusunda %25 olan doğru cevap oranının bu tür ilaçları kullanan hastalara risk oluşturacak tedavi yaklaşımlarının bilinirliğinde %7,9’a düştüğü görülmüştür.
SONUÇ: Çalışmasının sonuçları değerlendirildiğinde, hem diş hekimliği eğitimi sırasında, hem mezuniyet sonrası sürekli eğitim yapılarak diş hekimlerinin MRONJ konusunda bilgi düzeylerinin arttırılmasının gerekli olduğu sonucuna ulaşılmıştır.
Keywords
References
- 1. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate‐related osteonecrosis of the Jaw–2009 Update. Aust Endod J 2009;35:119–130.
- 2. Farrier AJ, Franco LCS, Shoaib A, Gulati V, Johnson N, Uzoigwe CE, et al. New anti-resorptives and antibody mediated anti-resorptive therapy. Bone Joint J 2016;98:160–165.
- 3. Shah AD, Shoback D, Lewiecki EM. Sclerostin inhibition: A novel therapeutic approach in the treatment of osteoporosis. Int J Womens Health 2015;7: 565-80.
- 4. 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;72:1938–1956. 5. Public Health Agency of the Ministry of Health of Turkey; Cancer statistics in 2012. https://hsgm.saglik.gov.tr/tr/kanser-istatistikleri/yillar/532-2012-y%C4%B1l%C4%B1-t%C3%BCrkiye-kanser-istatistikleri-2.html [Available: 25 Feb 2021].
- 6. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer 2018;103:356-87.
- 7. Liberman UA, Weiss SR, Bröll J, Minne HW, Quan H, Bell NH, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 1995;333:1437–1444.
- 8. Filleul O, Crompot E, Saussez S. Bisphosphonate-induced osteonecrosis of the jaw: A review of 2,400 patient cases. J Cancer Res Clin Oncol 2010;136:1117–1124.
- 9. 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 2011;23:1341-7.
- 10. Yoo J, Park Y, Kwon Y, Kim D, Ohe J. Survey of Korean dentists on the awareness on bisphosphonate‐related osteonecrosis of the jaws. J Investig Clin Dent 2010;1:90–95.
- 11. El Osta L, El Osta B, Lakiss S, Hennequin M, El Osta N. Bisphosphonate-related osteonecrosis of the jaw: Awareness and level of knowledge of Lebanese physicians. Support Care Cancer 2015;23:2825–31.
- 12. McLeod NMH, Davies BJB, Brennan PA. Management of patients at risk of bisphosphonate osteonecrosis in maxillofacial surgery units in the UK. The Surgeon 2009;7:18–23.
Investigation of the Approach of Dentists in Ankara to Patients Who Use Drugs as Bisphosphonates, Denosumab and Similars
Abstract
AIM: Increased use of bisphosphonates, denosumab, and other drugs with similar side effects, which are prescribed for osteoporosis, cancer-related metastases and bone-related diseases like Paget’s disease, have resulted in an elevated frequency of Medication-Related Osteonecrosis of the Jaw (MRONJ) cases. Thus, medical doctors and dentists who prescribe these drugs should have full knowledge about their indications, mechanisms of action and complications caused by these drugs.
METHODS: In this study, we aimed to assess the knowledge of dentists who work in Ankara, Turkey, on the correct procedures and approach they would apply when treating patients with MRONJ. We used two approaches for this purpose: a web-based survey and face-to-face interviews with dentists. 130 subjects filled the online survey and 173 subjects were interviewed.
RESULTS:The overall responses showed that despite 94.1% (285 subjects) know that bisphosphonates, denosumab, and other drugs with similar side effects may cause osteonecrosis of the jaws, and despite 74% of them correctly answering the question “which jaw is more likely to be affected by osteonecrosis of the jaw,” only 6.6% accurately answered questions about the indications of such drugs. While 25% of the participants correctly answered the questions regarding the diagnosis of MRONJ, only 7.9% of them knew all the dental treatments which could put the patient at risk for MRONJ.
CONCLUSION: After evaluating the results, we concluded that the awareness among dentists should be increased by educating the dentists both prior to and after graduation from dentistry faculties.
Keywords
References
- 1. Ruggiero SL, Dodson TB, Assael LA, Landesberg R, Marx RE, Mehrotra B. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate‐related osteonecrosis of the Jaw–2009 Update. Aust Endod J 2009;35:119–130.
- 2. Farrier AJ, Franco LCS, Shoaib A, Gulati V, Johnson N, Uzoigwe CE, et al. New anti-resorptives and antibody mediated anti-resorptive therapy. Bone Joint J 2016;98:160–165.
- 3. Shah AD, Shoback D, Lewiecki EM. Sclerostin inhibition: A novel therapeutic approach in the treatment of osteoporosis. Int J Womens Health 2015;7: 565-80.
- 4. 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;72:1938–1956. 5. Public Health Agency of the Ministry of Health of Turkey; Cancer statistics in 2012. https://hsgm.saglik.gov.tr/tr/kanser-istatistikleri/yillar/532-2012-y%C4%B1l%C4%B1-t%C3%BCrkiye-kanser-istatistikleri-2.html [Available: 25 Feb 2021].
- 6. Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer 2018;103:356-87.
- 7. Liberman UA, Weiss SR, Bröll J, Minne HW, Quan H, Bell NH, et al. Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis. N Engl J Med 1995;333:1437–1444.
- 8. Filleul O, Crompot E, Saussez S. Bisphosphonate-induced osteonecrosis of the jaw: A review of 2,400 patient cases. J Cancer Res Clin Oncol 2010;136:1117–1124.
- 9. 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 2011;23:1341-7.
- 10. Yoo J, Park Y, Kwon Y, Kim D, Ohe J. Survey of Korean dentists on the awareness on bisphosphonate‐related osteonecrosis of the jaws. J Investig Clin Dent 2010;1:90–95.
- 11. El Osta L, El Osta B, Lakiss S, Hennequin M, El Osta N. Bisphosphonate-related osteonecrosis of the jaw: Awareness and level of knowledge of Lebanese physicians. Support Care Cancer 2015;23:2825–31.
- 12. McLeod NMH, Davies BJB, Brennan PA. Management of patients at risk of bisphosphonate osteonecrosis in maxillofacial surgery units in the UK. The Surgeon 2009;7:18–23.
Details
| Primary Language | English |
|---|---|
| Subjects | Dentistry |
| Journal Section | Araştırma Makalesi |
| Authors | |
| Publication Date | May 25, 2021 |
| Submission Date | February 25, 2021 |
| Published in Issue | Year 2021 Volume: 10 Issue: 2 |
