Approach and awareness of medical practitioners prescribing antiresorptive drugs regarding medication-related osteonecrosis of the jaw

Purpose: Patients who are undergoing treatment with antiresorptive or antiangiogenic agents, or have a treatment history, who have not received radiotherapy in the head and neck region, and do not have metastatic disease in the head and neck region, and have exposed bone associated with an intraoral or extraoral fistula that has been present for more than 8 weeks in the maxillofacial regions are defined as medication-related osteonecrosis of the jaw (MRONJ). The main agents causing MRONJ are bisphosphonates. Bisphosphonates are commonly used today to treat the skeletal effects of metabolic diseases and malignancies. The purpose of this study is to assess the awareness and approaches of medical practitioners prescribing antiresorptive drugs regarding MRONJ. Materials and Methods: Our study included 81 medical practitioners who specialize in the fields of internal medicine, oncology, orthopedics, and physical medicine and rehabilitation. Questionnaires containing 15 questions related to MRONJ were completed by the physicians, and their awareness of MRONJ was evaluated. Results: It has been determined that the specialist physicians participating in our study prescribe zoledronic acid more frequently than other antiresorptive drugs and that bisphosphonate group drugs are most commonly prescribed for osteoporosis. It was observed that physicians prescribe intravenous bisphosphonates more frequently than oral bisphosphonates. Approximately half of the specialist physicians participating in our study were found to have knowledge about MRONJ, and only 21% referred their patients for dental examination before antiresorptive treatment. The rate of using biochemical tests to assess the risk of MRONJ among physicians is 30.9%. Conclusion: To increase awareness of MRONJ, a well-coordinated consultation system should be established through a multidisciplinary approach between the fields of medicine and dentistry. This system should ensure that patients undergo dental examinations and interventional dental procedures before initiating antiresorptive drug therapy. To enhance awareness on this issue, educational strategies such as academic publications, training seminars, or symposiums should be developed.