Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Antirezorptif İlaç Reçete Eden Tıp Hekimlerinin MRONJ Yaklaşımı
MRONJ Approach of Medical Doctors Who Prescribing Antiresorptive Drug
Gamze ŞENOLa , İpek Necla GÜLDİKEN b , Muazzez SUZEN a , Hayrunisa KOÇYİĞİTc, Çağrı DELİLBAŞI c
aMedipol Mega Üniversite Hastanesi, Ağız, Diş ve Çene Cerrahisi ABD, İstanbul, TÜRKİYE
bMedipol Esenler Üniversite Hastanesi, Ağız, Diş ve Çene Cerrahisi ABD, İstanbul, TÜRKİYE
cMedipol Unkapanı Üniversite Hastanesi, Ağız, Diş ve Çene Cerrahisi ABD, İstanbul, TÜRKİYE
Turkiye Klinikleri J Dental Sci. 2021;27(2):168-77
doi: 10.5336/dentalsci.2020-75321
Article Language: TR
Full Text
ÖZET
 Amaç: Diş çekimi gibi çene üzerinde cerrahi işlem uygulandığında, kemik iyileşmesinin bozulmasıyla çenenin bifosfonat ilişkili nekrozu meydana gelebilir. Bifosfonat kullanan hasta sayısının her geçen gün artması ve çenelerin ilaçlara bağlı gelişen osteonekrozu (MRONJ) olgularındaki yükseliş, hekimlerin bu komplikasyonla karşılaşma ihtimalîni artırmaktadır. Hekimler, diş hekimleri ve hastalar tarafından MRONJ farkındalığı; erken teşhis, tedavi ve önlenmesi açısından önemlidir. Bu çalışmada, antirezorptif ve antianjiyojenik ilaçları reçete eden tıp doktorlarının, ciddi bir komplikasyon olan MRONJ ile ilgili farkındalıklarını ve yaklaşımlarını değerlendirmek amaçlanmıştır. Gereç ve Yöntemler: Araştırmaya bazı üniversite hastaneleri, eğitim ve araştırma hastaneleri ve özel sağlık kurumlarında çalışan; ortopedi, dahiliye, romatoloji, fizik tedavi ve rehabilitasyon ve onkoloji uzmanları dâhil edilmiştir. Katılan hekimlere, bifosfonatlar ve MRONJ hakkındaki bilgileri, tedavi sürecindeki yaklaşımları ile ilgili 15 sorudan oluşan bir anket formunu yanıtlamaları istenmiştir. Bulgular: Çalışmaya katılan hekimlerin %46'sı asistan, %54'ü uzman doktordur. Hekimlerin %74'ü bu ilaçları osteoporoz tedavisi için reçete ederken, %47'si alendronatı tercih ettiklerini belirtmişlerdir. Hekimlerin %21'i tedavi öncesi dental muayeneyi önerirken, %51'i dental tedaviyi hastanın şikâyeti olduğunda önerdiğini bildirmiştir. Hekimlerin %22'si bifosfonat grubu MRONJ ile karşılaştığını bildirmiştir. Ayrıca hekimlerin uzmanlık alanları arasında, bifosfonata bağlı çene nekrozu hakkında bilgi durumu dağılım oranları açısından istatistiksel olarak anlamlı farklılık bulunmaktadır. Bununla beraber hekimlerin %16'sı bifosfonat grubu ilaç kullanımına bağlı çene nekrozu hakkında bilgisinin olmadığını bildirmiştir. Sonuç: Bifosfonat grubu ilaçları reçete eden tıp hekimlerinin, çenelerde gelişen MRONJ hakkındaki farkındalıklarının artması için bifosfonatlar ve MRONJ ile ilgili eğitim stratejileri oluşturulmalıdır.

Anahtar Kelimeler: MRONJ; BRONJ; anket; farkındalık
ABSTRACT
 Objective: The number of patients using bisphosphonates is increasing day by day and the increase in medication-related osteonecrosis of the jaw (MRONJ) cases increases the possibility of physicians to encounter this complication. In this study, it is aimed to evaluate the awareness and approaches of medical doctors who prescribe antiresorptive and antiangiogenic drugs about MRONJ, which is a serious complication. Material and Methods: Some researchers working in university hospitals, education and research hospitals and private health institutions; orthopedics, internal medicine, rheumatology, physical therapy-rehabilitation and oncology specialists are included in this study. To the attending physicians; they were asked to answer a questionnaire consisting of 15 questions about their knowledge about bisphosphonates and MRONJ and their approach to the treatment process. Results: Fourty six percent of the physicians participating in the study were residents and 54% were specialists. Seventy four percent of the physicians prescribed these drugs for osteoporosis treatment, while 47% preferred alendronate. While 21% of the physicians recommended dental examination before treatment, 51% reported that they recommended dental treatment when the patient complained. 22% of physicians reported that they encountered jaw necrosis due to drug use in the bisphosphonate group. In addition, there is a statistically significant difference between the specialties of the physicians in terms of knowledge distribution of jaw necrosis due to bisphosphonate. However, 16% of physicians reported that they did not know about chin necrosis related to the use of bisphosphonate drugs. Conclusion: Training strategies about bisphosphonates and MRONJ should be developed in order to increase the awareness of the physicians who prescribe bisphosphonate group drugs about the developing MRONJ.

Keywords: MRONJ; BRONJ; questionnaire; awarness
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