AB1635-HPR DENTISTS’ MISCONCEPTIONS REGARDING BISPHOSPHONATE THERAPY IN EVERYDAY PRACTICE
Authors: S. Bouzid, Y. Makhlouf, S. Miladi, A. Fazaa, H. Boussaa, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, A. Laatar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The advent of various medications such as bisphosphonates (BPs) has resulted in reported cases of medication-related osteonecrosis of the jaw [1]. The lack of substantial explanation for the generating mechanism of this complication leads to skepticism of dentists towards the management of patients on BPs. <h3>Objectives:</h3> This study aimed to evaluate the perception of dentists of BPs and bisphosphonate-related osteonecrosis of the jaw (BRONJ). <h3>Methods:</h3> We conducted a cross-sectional study including Tunisian dentists. They were invited to answer a questionnaire via Google form. Survey questions included sociodemographic data, the knowledge of dentists regarding BRONJ (prevalence, risk factors, avoided dental procedures), and their attitude in the management of patients on BPs. <h3>Results:</h3> The study included 34 respondents. Fifty-three percent of the participants (n=18) were working in the hospital. The mean number of years of practice was 6.38 (7) years [1-25]. Thirteen participants had already received training on the management of patients on BPs: university courses (11 cases) and add-on courses (2 cases). Only 23% of the participants (n=8) knew the exact prevalence of the BRONJ. Two participants identified amino-BPs as a risk factor for BRONJ, while 91% wrongly identified the dose of BPs as a risk factor. Overall, 82% stated that their practice differed depending on the method of BP administration (per os or intravenously). When asked about general causes, only 3 participants were able to determine obesity as a risk factor for BRONJ. Likewise, only 47% of the practitioners identified removable dentures as a local risk factor. For patients who were candidates for BPs, participants stated that BPs should only be started after mucous membrane healing and after bone healing in 50% and 82%, respectively. For patients already receiving BPs, practitioners felt more at ease performing both dental implants (26% vs 6%, p=0.038) and treatments involving direct bone contact when the BP was administered orally (23% vs 6%, p=0.041). Once osteonecrosis was established, the immediate discontinuation of BPs was indicated by 26%, while 35% chose to discontinue BPs based on the level of osteonecrosis. Bone resection was systematically indicated according to 59%. Antibiotics and NSAIDs were indicated by 65% (n=22) and 6% (n=2), respectively. The number of years of experience was significantly associated with the number of good answers about both dental treatments to avoid in patients on intravenous BPs (p=0.035) and appropriate therapeutic strategies of BRONJ (p=0.003). <h3>Conclusion:</h3> Our study highlighted the dentists' lack of knowledge of some risk factors of BRONJ and dental procedures that needed to be avoided. These findings showed the importance of the implementation of educational programs regarding BRONJ for medical and dental professionals. <h3>REFERENCES:</h3> [1] Rosella D, Papi P, Giardino R, Cicalini E, Piccoli L, Pompa G. Medication-related osteonecrosis of the jaw: Clinical and practical guidelines. J Int Soc Prev Community Dent. 2016 Mar-Apr;6(2):97-104. doi: 10.4103/2231-0762.178742. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>