Abstract：
BACKGROUND: A 2015 survey of the Japan Osteoporosis Society (JOS) on medication-related osteonecrosis of the jaw (MRONJ) revealed that cooperation between physicians and dentists was poor. Discontinuation of antiresorptive agents before tooth extraction was found to increase adverse events without preventing MRONJ. We compared this 2015 survey with a new survey conducted in 2022 to investigate cooperation between physicians and dentists for MRONJ.
METHODS: A web-based structured questionnaire including 13 key queries was sent to 3813 physicians who were members of JOS, and 1227 (32.2%) responses were received.
RESULTS: Of the 1227 respondents, 909 (74.1%) had complied with a discontinuation request from a dentist before tooth extraction, although 25.4% of medications were not related to the incidence of MRONJ. Of these, 177 respondents reported 252 adverse events including 10 (1.3%) cases of MRONJ. The prevalence of fractures increased from 4.8% in 2015 to 8.2% in 2022. The rates of respondents who requested oral health care by a dentist before antiresorptive agent therapy and reported cooperation between physicians and dentists were 72.7% and 42.4% in 2022 compared with 32.9% and 24.8% in 2015, respectively. The rates of cooperation among the 47 prefectures in Japan were significantly different, ranging from 10.0 to 83.3% (p = 0.02).
CONCLUSIONS: This study confirmed increased cooperation between physicians and dentists for MRONJ in Japan. However, a more equal distribution of cooperation across Japan is necessary to optimally manage MRONJ. Discontinuation of antiresorptive agents is no longer necessary because fractures during discontinuation continue to increase in Japan.
METHODS: A web-based structured questionnaire including 13 key queries was sent to 3813 physicians who were members of JOS, and 1227 (32.2%) responses were received.
RESULTS: Of the 1227 respondents, 909 (74.1%) had complied with a discontinuation request from a dentist before tooth extraction, although 25.4% of medications were not related to the incidence of MRONJ. Of these, 177 respondents reported 252 adverse events including 10 (1.3%) cases of MRONJ. The prevalence of fractures increased from 4.8% in 2015 to 8.2% in 2022. The rates of respondents who requested oral health care by a dentist before antiresorptive agent therapy and reported cooperation between physicians and dentists were 72.7% and 42.4% in 2022 compared with 32.9% and 24.8% in 2015, respectively. The rates of cooperation among the 47 prefectures in Japan were significantly different, ranging from 10.0 to 83.3% (p = 0.02).
CONCLUSIONS: This study confirmed increased cooperation between physicians and dentists for MRONJ in Japan. However, a more equal distribution of cooperation across Japan is necessary to optimally manage MRONJ. Discontinuation of antiresorptive agents is no longer necessary because fractures during discontinuation continue to increase in Japan.
摘要：
背景：2015年日本骨质疏松学会（JOS）对药物相关颌骨坏死（MRONJ）的调查显示，医生和牙医之间的合作很差。发现在拔牙前停用抗吸收剂会增加不良事件，而不会预防MRONJ。我们将2015年的这项调查与2022年进行的一项新调查进行了比较，以调查MRONJ医生和牙医之间的合作。
方法：向3813名JOS成员的医生发送了一份基于网络的结构化问卷，其中包括13个关键查询。收到1227份(32.2%)回复。
结果：在1227名受访者中，909（74.1％）在拔牙前遵守了牙医的停药要求，尽管25.4%的药物与MRONJ的发病率无关.其中,177名受访者报告了252起不良事件，包括10例（1.3%）MRONJ。骨折的患病率从2015年的4.8%上升到2022年的8.2%。2022年，在抗吸收剂治疗之前要求牙医进行口腔保健并报告医生与牙医合作的受访者比例分别为72.7％和42.4％，而2015年分别为32.9％和24.8％。日本47个都道府县之间的合作率明显不同,范围从10.0到83.3%(p=0.02)。
结论：这项研究证实了日本MRONJ医生和牙医之间的合作增加。然而,为了优化管理MRONJ，有必要在日本各地进行更平等的合作分配。不再需要停用抗吸收剂，因为在日本，停药期间的骨折继续增加。
方法：向3813名JOS成员的医生发送了一份基于网络的结构化问卷，其中包括13个关键查询。收到1227份(32.2%)回复。
结果：在1227名受访者中，909（74.1％）在拔牙前遵守了牙医的停药要求，尽管25.4%的药物与MRONJ的发病率无关.其中,177名受访者报告了252起不良事件，包括10例（1.3%）MRONJ。骨折的患病率从2015年的4.8%上升到2022年的8.2%。2022年，在抗吸收剂治疗之前要求牙医进行口腔保健并报告医生与牙医合作的受访者比例分别为72.7％和42.4％，而2015年分别为32.9％和24.8％。日本47个都道府县之间的合作率明显不同,范围从10.0到83.3%(p=0.02)。
结论：这项研究证实了日本MRONJ医生和牙医之间的合作增加。然而,为了优化管理MRONJ，有必要在日本各地进行更平等的合作分配。不再需要停用抗吸收剂，因为在日本，停药期间的骨折继续增加。
