Cooperation Between Physicians and Dentists for Osteonecrosis of the Jaw: a 2022 Japanese Survey

Overview

Journal J Bone Miner Metab

Specialty Endocrinology

Date 2023 Jul 29

PMID 37516668

Authors

Akira Taguchi

Hiroshi Hagino

Daisuke Inoue

Naoto Endo

Japan Osteoporosis Society

Affiliations

Soon will be listed here.

Abstract

Introduction: 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.

Materials And 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).

Conclusion: 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.

Citing Articles

Screening ability of dental students to detect osteoporosis on dental panoramic radiographs.

Osanai H, Kuroiwa H, Yamada S, Sugino N, Nakamoto T, Ohtsuka M Osteoporos Sarcopenia. 2025; 10(4):145-150.

PMID: 39835324 PMC: 11742331. DOI: 10.1016/j.afos.2024.10.002.

Materials and Techniques in Dentistry, Oral Surgery and Orthodontics.

Sfondrini M, Scribante A Materials (Basel). 2024; 17(13).

PMID: 38998328 PMC: 11243620. DOI: 10.3390/ma17133247.

Asia-Pacific consensus on long-term and sequential therapy for osteoporosis.

Tai T, Chen H, Shih C, Huang C, McCloskey E, Lee J Osteoporos Sarcopenia. 2024; 10(1):3-10.

PMID: 38690538 PMC: 11056428. DOI: 10.1016/j.afos.2024.02.001.

References

Marx R . Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003; 61(9):1115-7. DOI: 10.1016/s0278-2391(03)00720-1. View

Ruggiero S, Mehrotra B, Rosenberg T, Engroff S . Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg. 2004; 62(5):527-34. DOI: 10.1016/j.joms.2004.02.004. View

Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S . Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and.... J Bone Miner Metab. 2010; 28(4):365-83. DOI: 10.1007/s00774-010-0162-7. View

Bedogni A, Blandamura S, Lokmic Z, Palumbo C, Ragazzo M, Ferrari F . Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105(3):358-64. DOI: 10.1016/j.tripleo.2007.08.040. View

Garcia-Ferrer L, Bagan J, Martinez-Sanjuan V, Hernandez-Bazan S, Garcia R, Jimenez-Soriano Y . MRI of mandibular osteonecrosis secondary to bisphosphonates. AJR Am J Roentgenol. 2008; 190(4):949-55. DOI: 10.2214/AJR.07.3045. View

Mucke T, Deppe H, Hein J, Wolff K, Mitchell D, Kesting M . Prevention of bisphosphonate-related osteonecrosis of the jaws in patients with prostate cancer treated with zoledronic acid - A prospective study over 6 years. J Craniomaxillofac Surg. 2016; 44(10):1689-1693. DOI: 10.1016/j.jcms.2016.07.026. View

Hasegawa T, Hayashida S, Kondo E, Takeda Y, Miyamoto H, Kawaoka Y . Medication-related osteonecrosis of the jaw after tooth extraction in cancer patients: a multicenter retrospective study. Osteoporos Int. 2018; 30(1):231-239. DOI: 10.1007/s00198-018-4746-8. View

Shudo A, Kishimoto H, Takaoka K, Noguchi K . Long-term oral bisphosphonates delay healing after tooth extraction: a single institutional prospective study. Osteoporos Int. 2018; 29(10):2315-2321. DOI: 10.1007/s00198-018-4621-7. View

Yamori M, Tamura M, Mikami M, Mori T, Noi M, Machida Y . Differences in the Knowledge and Experience of Physicians and Dentists About Medication-Related Osteonecrosis of the Jaw in Osteoporotic Patients. Int Dent J. 2021; 71(4):336-342. PMC: 9275204. DOI: 10.1016/j.identj.2020.12.005. View

10.

Han A . The awareness and practice of dentists regarding medication-related osteonecrosis of the jaw and its prevention: a cross-sectional survey. BMC Oral Health. 2021; 21(1):155. PMC: 7992948. DOI: 10.1186/s12903-021-01475-6. View

11.

Kamimura M, Taguchi A, Komatsu M, Koiwai H, Ashizawa R, Ichinose A . Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese. Osteoporos Int. 2018; 30(3):621-628. DOI: 10.1007/s00198-018-4775-3. View

12.

Imai N, Endo N, Hoshino T, Suda K, Miyasaka D, Ito T . Mortality after hip fracture with vertebral compression fracture is poor. J Bone Miner Metab. 2014; 34(1):51-4. DOI: 10.1007/s00774-014-0640-4. View

13.

Shibahara T, Morikawa T, Yago K, Kishimoto H, Imai Y, Kurita K . National Survey on Bisphosphonate-Related Osteonecrosis of the Jaws in Japan. J Oral Maxillofac Surg. 2018; 76(10):2105-2112. DOI: 10.1016/j.joms.2018.04.009. View

14.

Kunihara T, Tohmori H, Tsukamoto M, Kobayashi M, Okumura T, Teramoto H . Incidence and trend of antiresorptive agent-related osteonecrosis of the jaw from 2016 to 2020 in Kure, Japan. Osteoporos Int. 2023; 34(6):1101-1109. PMC: 10203006. DOI: 10.1007/s00198-023-06732-8. View

15.

Kim S, Lee Y, Kim T, Ha Y, Jang S, Kim H . Incidence of and risk for osteonecrosis of the jaw in Korean osteoporosis patients treated with bisphosphonates: A nationwide cohort-study. Bone. 2020; 143:115650. DOI: 10.1016/j.bone.2020.115650. View

16.

Miyazaki H, Motegi E, Yatabe K, Yamaguchi H, Maki Y . A study of occlusion in elderly Japanese over 80 years with at least 20 teeth. Gerodontology. 2005; 22(4):206-10. DOI: 10.1111/j.1741-2358.2005.00076.x. View

17.

Yamanaka K, Nakagaki H, Morita I, Suzaki H, Hashimoto M, Sakai T . Comparison of the health condition between the 8020 achievers and the 8020 non-achievers. Int Dent J. 2008; 58(3):146-50. DOI: 10.1111/j.1875-595x.2008.tb00190.x. View

18.

Komiyama T, Ohi T, Miyoshi Y, Murakami T, Tsuboi A, Tomata Y . Association Between Tooth Loss, Receipt of Dental Care, and Functional Disability in an Elderly Japanese Population: The Tsurugaya Project. J Am Geriatr Soc. 2016; 64(12):2495-2502. DOI: 10.1111/jgs.14390. View

19.

Kwoen M, Park J, Kim K, Lee J, Kim J, Lee H . Association between periodontal disease, tooth extraction, and medication-related osteonecrosis of the jaw in women receiving bisphosphonates: A national cohort-based study. J Periodontol. 2022; 94(1):98-107. DOI: 10.1002/JPER.21-0611. View

20.

Arnaud M, Talibi S, Lejeune-Cairon S . Knowledge and attitudes of French dentists on bone resorption inhibitors (bisphosphonates and denosumab): A cross-sectional study. J Stomatol Oral Maxillofac Surg. 2021; 123(2):163-170. DOI: 10.1016/j.jormas.2021.04.010. View