Dentists’ Awareness of Medication-Related Osteonecrosis of the Jaw (Risk Factors, Drugs, and Prevention) in the Republic of Croatia

INTRODUCTION: Antiresorptive drugs (AR) have been used for many years in the treatment of various bone conditions such as osteoporosis, osteopenia, Paget's disease, bone metastases, multiple myeloma and the associated malignant hypercalcemia. As a side effect of AR therapy, medication-related osteonecrosis of the jaw, which affects the mandible more commonly than the maxilla, (MRONJ) has become an increased risk regarding patients’ health and quality of life. The incidence of osteonecrosis has increased significantly in the last few years. One of the main methods of the disease prevention is the education of patients and doctors of dental medicine (DDMs). This is evidenced by the national program of information and prevention of antiresorptive therapy side effects, which was also the impetus for this study. PURPOSE: This study aims to test the knowledge of DDMSs on AR, especially on bisphosphonate (BF) therapy, MRONJ as well as on the risk factors of the disease itself. MATERIAL AND METHODS: 458 DDMs from the Republic of Croatia participated in the survey and responded by an anonymous questionnaire to questions about the knowledge of AR/BF and the risk of MRONJ. RESULTS: The results showed that 36.68% of DDMs do not know that MRONJ is the main complication of AR/BF therapy. The results are significantly different in terms of academic degree, specialization, workplace, and work experience. 60.26% of respondents do not know the main indications for AR/BF use, 53.26% do not know the factors affecting the onset of the disease, and 42.58% do not know which therapy is not recommended for patients on AR/BF therapy. 93.89% of respondents expressed the desire to educate on this issue. This current study was carried out to further investigate the pilot study findings which was conducted in the year 2015, but it had a significantly lower number of participants. CONCLUSION: This research suggests that further education of DDMS on this topic is necessary to prevent or to start early treatment of MRONJ.