Serbest diş hekimlerinin ve ağız-diş ve çene cerrahisi asistanlarının, ilaca bağlı çene osteonekrozu hastalarının tedavi yaklaşımlarındaki bilgi düzeyinin karşılaştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Anti-rezorptif ve anti-anjiyojenik ilaçlar; osteoporoz, kemik metastazı bulunan maligniteler ve metabolik kemik hastalıklarının tedavisinde sıklıkla kullanılmaktadır. Bu ilaçların kullanımı, dentoalveoler operasyon uygulanan hastalarda ilaca bağlı görülen çene osteonekrozu riskini arttırmaktadır. Bu çalışmada, serbest diş hekimlerinin ve Ağız, Diş ve Çene Cerrahisi bölümünde eğitim görmekte olan diş hekimlerinin anti-rezorptif ve anti-anjiyojenik ilaçlar ve ilaca bağlı çene osteonekrozu hakkındaki bilgilerinin ve farklı evrelerdeki tedavi yaklaşımlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Katılımcılara; demografik verileri, anti-rezorptif ve anti-anjiyojenik ilaçlar hakkındaki bilgi düzeyleri, MRONJ hakkındaki bilgileri ve farklı evrelerdeki tedavi yaklaşımları üzerine 27 adet sorudan oluşan anket formu dijital ortamda hazırlanıp dağıtılmıştır. Katılımcılar Ağız, Diş ve Çene Cerrahi bölümünde uzmanlık/doktora eğitimi gören ve serbest diş hekimi olacak şekilde 2 gruba ayrılmıştır. Veriler ki-kare testi ile değerlendirilmiştir. İstatistiksel anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Çalışmaya 120 serbest diş hekimi ve 116 Ağız, Diş ve Çene Cerrahi bölümünde eğitim gören uzmanlık ve doktora öğrencisi olacak şekilde toplam 236 hekim dahil edilmiştir. Anti-rezorptif ve anti-anjiyojenik ilaçların kullanıldığı hastalıkların sorulduğu soruda hekimler en çok %90,7 (Uzmanlık/Doktora %98,3, Serbest %83,3) ile osteoporoz, ardından %72,4 (Uzmanlık/Doktora %91,4, Serbest %54,4) ile meme kanseri, en az ise %55,1 ile Paget hastalığını (Uzmanlık/Doktora %77,6, Serbest %33,3) işaretlemişlerdir. Uzmanlık/doktora grubunun %99,2'si, serbest diş hekimlerinin %91,7'si anti-rezorptif ve anti-anjiyojenik ilaç kullanan hastalarını, dentoalveoler operasyondan önce ilacı yazan hekime konsülte ettiğini belirtmiştir. MRONJ'un en sık hangi çenede görüldüğü sorusuna uzmanlık/doktora grubunun %97,4'ü, serbest diş hekimlerinin %65,8'i "Mandibula" cevabını vermiştir. Uzmanlık/doktora grubu %76,7'u, serbest diş hekimlerinin ise %30'u oral anti-rezorptif ilaç kullanan hastalarda diş çekimi yapılabileceğini belirtmiştir. Operatif olmayan yaklaşımların her MRONJ evresinde uygulanabileceğini işaretleyen uzmanlık/doktora öğrencisi oranı %74,1, serbest diş hekimlerinin oranı ise %45'tir. Genel olarak, uzmanlık/doktora grubundaki hekimlerin bilgi ve farkındalığı serbest diş hekimlerinden daha yüksek bulunmuştur. Sonuç: Serbest diş hekimlerinin ve Ağız, Diş ve Çene Cerrahisi bölümde uzmanlık/doktora yapan hekimlerin anti-rezorptifler ve anti-anjiyojenikler hakkındaki farkındalıklarının artması MRONJ'un önlenmesi ve tedavisinde önemlidir. Bu nedenle, anti-rezorptif ve anti-anjiyojenik ilaçlar ve MRONJ ile ilgili eğitim stratejileri oluşturulmalı, sempozyum ve konferanslar aracılığı ile güncel literatür bilgisi aktarılmalıdır. Anahtar Kelimeler; anti-rezorptif; anti-anjiyojenik; MRONJ; farkındalık; diş hekimi.
Objective: Anti-resorptive and anti-angiogenic drugs are frequently used in the treatment of osteoporosis, malignancies with bone metastases and metabolic bone diseases. The use of these drugs increases the risk of medication-related osteonecrosis of the jaws in patients undergoing dentoalveolar surgery. The aim of this study was to evaluate the knowledge of dental practitioners and oral and maxillofacial surgery (OMFS) residents about anti-resorptive and anti-angiogenic drugs and medication-related osteonecrosis of the jaws (MRONJ) and treatment strategies at different stages. Materials and Methods: A questionnaire, comprising 27 questions covering demographic information, the extent of familiarity with anti-resorptive and anti-angiogenic drugs, understanding of MRONJ and treatment strategies, was prepared and electronically distributed to the participants. The participants were divided into two groups consisting of dental practitioners and OMFS residents. Chi-square test was used to evaluate the data. The level of statistical significance was set at 0.05. Results: A total of 236 participants, including 120 dentists and 116 oral and maxillofacial surgery residents were included in this study. Among the systemic diseases that anti-resorptive and anti-angiogenic drugs are most frequently used, osteoporosis emerged as the most prevalent, with 90.7% (OMFS Residents 98.3%, Practitioners 83.3%), followed by breast cancer, with 72.4% (OMFS Residents 91.4%, Practitioners 54.4%). Paget's disease was the least known, recognized by 55.1% (OMFS Residents 77.6%, Practitioners 33.3%). %99,2 of the OMFS residents and % 91,7 of the dental practitioners stated that they consult the patient to the physician before dentoalveolar surgery. Cited by 97.4% of OMFS residents and 65.8% of dental practitioners, it was commonly agreed that 'mandible' is the most frequent anatomical site for MRONJ. OMFS residents and dental practitioners who stated that tooth extraction could be performed in patients using oral anti-resorptive drugs were %76,7 and %30, respectively. 74.1% of the OMFS residents and 45% of the dental practitioners have indicated that non-operative treatment approaches can be implemented in every stage of MRONJ. In general, it was noted that OMFS residents exhibited a higher degree of knowledge and awareness compared to dental practitioners. Conclusion: Increasing the awareness of dental practitioners and OMFS residents about anti-resorptives and anti-angiogenics is important in the prevention and treatment of MRONJ. Therefore, educational strategies concerning this matter should be developed, and the latest information from the literature should be disseminated via symposiums, conferences, educational programs, and workshops. Keywords; anti-resorptives; anti-angiogenics; MRONJ; awareness; dentist.
Objective: Anti-resorptive and anti-angiogenic drugs are frequently used in the treatment of osteoporosis, malignancies with bone metastases and metabolic bone diseases. The use of these drugs increases the risk of medication-related osteonecrosis of the jaws in patients undergoing dentoalveolar surgery. The aim of this study was to evaluate the knowledge of dental practitioners and oral and maxillofacial surgery (OMFS) residents about anti-resorptive and anti-angiogenic drugs and medication-related osteonecrosis of the jaws (MRONJ) and treatment strategies at different stages. Materials and Methods: A questionnaire, comprising 27 questions covering demographic information, the extent of familiarity with anti-resorptive and anti-angiogenic drugs, understanding of MRONJ and treatment strategies, was prepared and electronically distributed to the participants. The participants were divided into two groups consisting of dental practitioners and OMFS residents. Chi-square test was used to evaluate the data. The level of statistical significance was set at 0.05. Results: A total of 236 participants, including 120 dentists and 116 oral and maxillofacial surgery residents were included in this study. Among the systemic diseases that anti-resorptive and anti-angiogenic drugs are most frequently used, osteoporosis emerged as the most prevalent, with 90.7% (OMFS Residents 98.3%, Practitioners 83.3%), followed by breast cancer, with 72.4% (OMFS Residents 91.4%, Practitioners 54.4%). Paget's disease was the least known, recognized by 55.1% (OMFS Residents 77.6%, Practitioners 33.3%). %99,2 of the OMFS residents and % 91,7 of the dental practitioners stated that they consult the patient to the physician before dentoalveolar surgery. Cited by 97.4% of OMFS residents and 65.8% of dental practitioners, it was commonly agreed that 'mandible' is the most frequent anatomical site for MRONJ. OMFS residents and dental practitioners who stated that tooth extraction could be performed in patients using oral anti-resorptive drugs were %76,7 and %30, respectively. 74.1% of the OMFS residents and 45% of the dental practitioners have indicated that non-operative treatment approaches can be implemented in every stage of MRONJ. In general, it was noted that OMFS residents exhibited a higher degree of knowledge and awareness compared to dental practitioners. Conclusion: Increasing the awareness of dental practitioners and OMFS residents about anti-resorptives and anti-angiogenics is important in the prevention and treatment of MRONJ. Therefore, educational strategies concerning this matter should be developed, and the latest information from the literature should be disseminated via symposiums, conferences, educational programs, and workshops. Keywords; anti-resorptives; anti-angiogenics; MRONJ; awareness; dentist.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
