# Awareness of Medication-Related Osteonecrosis of the Jaws amongst Dental Professionals in Poland
## 3 Results  
All participants were divided into four groups to evaluate their knowledge about BP and MRONJ. The first group (group G1) included oral and maxillofacial surgeons, the second group (group G2) consisted of other specialists in dentistry and the third group (group G3) comprised of general dental practitioners. The fourth group (group G4) included dentistry students in the 4 th and 5 th year of the MUG's. Figure 1 presents the distribution of all participants who responded to the survey. The ratio of dentists belonging to group G2, that is: specialists in fields other than dental surgery and maxillofacial surgery, in presented in Figure 2. The participants, with the exception of students, were further divided into work sectors (Figure 3) and according to years of experience (Table 1). The results of the survey of dentists and dental students concerning the knowledge about BP, MRONJ and assessing behavior in clinical situations are shown in Tables 1-5. Among the 200 respondents, 94.6% of them declared knowledge of the term MRONJ, and in their clinical practice less than half of the respondents (47.0%) encountered medication-related osteonecrosis of the jaw. A total of 69.7% correctly defined the clinical picture of osteopathy visible in the oral cavity, including 82.6% from the G1 group, who are specialists in the field of dental and maxillofacial surgery. In the remaining groups, the number of correct answers to this question is lower and amounts to: G2--63.2%, G3--66.7%, G4--67.7% (Table 1). Only 60.9% oral and maxillofacial surgeons (G1) were aware of drugs correlated with Medication-Related Osteonecrosis of the Jaw, whereas the knowledge of the rest of the participants was at a significantly lower level. It is disturbing to note a very low level of knowledge among dentists who work in the private sector--only 16.0%. It must be noted that dentists who work exclusively in the private sector also encounter MRONJ more rarely (24.0%) in their practice than their colleagues working in both the public and private sector (64.6%) and their knowledge of MRONJ symptoms is lower (58.0%) (Table 1). Figure 1: The distribution of participants who responded to the survey. Figure 2: The number of the specialists in fields other than dental surgery and maxillofacial surgery (group G2). Most of the participants knew the principal disease entities treated with BP such as osteoporosis, bone metastases and multiple myeloma. Besides the above mentioned diseases, the less-frequently known osteogenesis imperfeta was not recognized as well (Table 2). Most of the participants were aware of how to administer BP--oral and IV (93.1%) and of the necessity of oral sanitation before BP treatment is fundamental (96.0%) (Table 3). The importance of referral to the dentists before BP therapy were perceived by 95.7%, 94.7%, 93.3% and 96.0% of groups G1, G2, G3 and G4, respectively. However, the length of BP persistence, which is predicted as up to 10 years in the organism, were known in less than 50% in groups G2 (42.1%) and G3 (36.7%), slightly more in group G4 (52.5%), whilst the knowledge of oral and maxillofacial surgeons (group G1) about this topic was significantly higher and 87.0% of respondents in this group gave the correct answer to this question. When asked about the increased risk of MRONJ in the case of intravenous (IV) administration of BP, 58.9% of all participants gave the correct answer. Moreover, taking into account the specialization of the respondents, as many as 91.3% of surgeons answered this question correctly. In the remaining groups the results were lower, G2--42.1%, G3--53.3%, G4--57.6%, respectively. Interestingly, the results of the analysis of the survey showed that 34.2% of the study participants admitted that they did not know the answer, and 6.9% answered incorrectly. Furthermore, participants presented their knowledge regarding MRONJ--treatment recommendations, risk factors and guidelines (Tables 4 and 5). Periodontal disease (93.1%) and poor oral hygiene (93.1%) was the best recognized risk factor of MRONJ.