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Cooperation between physicians and dentists for osteonecrosis of the jaw: a 2022 Japanese survey

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Abstract

Introduction

A 2015 survey of the Japan Osteoporosis Society (JOS) on medication-related osteonecrosis of the jaw (MRONJ) revealed that cooperation between physicians and dentists was poor. Discontinuation of antiresorptive agents before tooth extraction was found to increase adverse events without preventing MRONJ. We compared this 2015 survey with a new survey conducted in 2022 to investigate cooperation between physicians and dentists for MRONJ.

Materials and methods

A web-based structured questionnaire including 13 key queries was sent to 3813 physicians who were members of JOS, and 1227 (32.2%) responses were received.

Results

Of the 1227 respondents, 909 (74.1%) had complied with a discontinuation request from a dentist before tooth extraction, although 25.4% of medications were not related to the incidence of MRONJ. Of these, 177 respondents reported 252 adverse events including 10 (1.3%) cases of MRONJ. The prevalence of fractures increased from 4.8% in 2015 to 8.2% in 2022. The rates of respondents who requested oral health care by a dentist before antiresorptive agent therapy and reported cooperation between physicians and dentists were 72.7% and 42.4% in 2022 compared with 32.9% and 24.8% in 2015, respectively. The rates of cooperation among the 47 prefectures in Japan were significantly different, ranging from 10.0 to 83.3% (p = 0.02).

Conclusion

This study confirmed increased cooperation between physicians and dentists for MRONJ in Japan. However, a more equal distribution of cooperation across Japan is necessary to optimally manage MRONJ. Discontinuation of antiresorptive agents is no longer necessary because fractures during discontinuation continue to increase in Japan.

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References

  1. Marx RE (2003) Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 61:1115–1117

    Article  PubMed  Google Scholar 

  2. Ruggiero SL, Mehrotra B, Rosenberg TJ, Engroff SL (2004) Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofac Surg 62:527–534

    Article  PubMed  Google Scholar 

  3. Advisory Task Force on Bisphosphonate-Related Osteonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons (2007) American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 65:369–376

    Article  Google Scholar 

  4. Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, Taguchi A, Toyosawa S, Nagata T, Urade M (2010) Bisphosphonate-related osteonecrosis of the jaw: position paper from the Allied Task Force Committee of Japanese Society for Bone and Mineral Research, Japan Osteoporosis Society, Japanese Society of Periodontology, Japanese Society for Oral and Maxillofacial Radiology, and Japanese Society of Oral and Maxillofacial Surgeons. J Bone Miner Metab 28:365–383

    Article  CAS  PubMed  Google Scholar 

  5. Bedogni A, Blandamura S, Lokmic Z, Palumbo C, Ragazzo M, Ferrari F, Tregnaghi A, Pietrogrande F, Procopio O, Saia G, Ferretti M, Bedogni G, Chiarini L, Ferronato G, Ninfo V, Lo Russo L, Lo Muzio L, Nocini PF (2008) Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:358–364

    Article  PubMed  Google Scholar 

  6. García-Ferrer L, Bagán JV, Martínez-Sanjuan V, Hernandez-Bazan S, García R, Jiménez-Soriano Y, Hervas V (2008) MRI of mandibular osteonecrosis secondary to bisphosphonates. AJR Am J Roentgenol 190:949–955

    Article  PubMed  Google Scholar 

  7. Mücke T, Deppe H, Hein J, Wolff KD, Mitchell DA, Kesting MR, Retz M, Gschwend JE, Thalgott M (2016) Prevention of bisphosphonate-related osteonecrosis of the jaws in patients with prostate cancer treated with zoledronic acid—a prospective study over 6 years. J Craniomaxillofac Surg 44:1689–1693

    Article  PubMed  Google Scholar 

  8. Taguchi A, Shiraki M, Sugimoto T, Ohta H, Soen S, Japan Osteoporosis Society (2016) Lack of cooperation between physicians and dentists during osteoporosis treatment may increase fractures and osteonecrosis of the jaw. Curr Med Res Opin 32:1261–1268

    Article  Google Scholar 

  9. Hasegawa T, Kawakita A, Ueda N, Funahara R, Tachibana A, Kobayashi M, Kondou E, Takeda D, Kojima Y, Sato S, Yanamoto S, Komatsubara H, Umeda M, Kirita T, Kurita H, Shibuya Y, Komori T, Japanese Study Group of Cooperative Dentistry with Medicine (JCDM) (2017) A multicenter retrospective study of the risk factors associated with medication-related osteonecrosis of the jaw after tooth extraction in patients receiving oral bisphosphonate therapy: can primary wound closure and a drug holiday really prevent MRONJ? Osteoporos Int 28:2465–2473

    Article  Google Scholar 

  10. Hasegawa T, Hayashida S, Kondo E, Takeda Y, Miyamoto H et al (2019) Medication-related osteonecrosis of the jaw after tooth extraction in cancer patients: a multicenter retrospective study. Osteoporos Int 30:231–239

    Article  CAS  PubMed  Google Scholar 

  11. Shudo A, Kishimoto H, Takaoka K, Noguchi K (2018) Long-term oral bisphosphonates delay healing after tooth extraction: a single institutional prospective study. Osteoporos Int 29:2315–2321

    Article  CAS  PubMed  Google Scholar 

  12. Yamori M, Tamura M, Mikami M, Mori T, Noi M, Machida Y, Koshinuma S, Yamamoto G (2021) Differences in the knowledge and experience of physicians and dentists about medication-related osteonecrosis of the jaw in osteoporotic patients. Int Dent J 71:336–342

    Article  PubMed  PubMed Central  Google Scholar 

  13. Japanese Allied Committee on Osteonecrosis of the Jaw, Yoneda T, Hagino H, Sugimoto T, Ohta H, Takahashi S, Soen S, Taguchi A, Nagata T, Urade M, Shibahara T, Toyosawa S (2017) Antiresorptive agent-related osteonecrosis of the jaw: position Paper 2017 of the Japanese Allied Committee on Osteonecrosis of the Jaw. J Bone Miner Metab 35:6–19

    Article  Google Scholar 

  14. Han AL (2021) The awareness and practice of dentists regarding medication-related osteonecrosis of the jaw and its prevention: a cross-sectional survey. BMC Oral Health 21:155

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kamimura M, Taguchi A, Komatsu M, Koiwai H, Ashizawa R, Ichinose A, Takahara K, Uchiyama S, Kato H (2019) Long waiting time before tooth extraction may increase delayed wound healing in elderly Japanese. Osteoporos Int 30:621–628

    Article  CAS  PubMed  Google Scholar 

  16. Imai N, Endo N, Hoshino T, Suda K, Miyasaka D, Ito T (2016) Mortality after hip fracture with vertebral compression fracture is poor. J Bone Miner Metab 34:51–54

    Article  PubMed  Google Scholar 

  17. Shibahara T, Morikawa T, Yago K, Kishimoto H, Imai Y, Kurita K (2018) National survey on bisphosphonate-related osteonecrosis of the jaws in Japan. J Oral Maxillofac Surg 76:2105–2112

    Article  PubMed  Google Scholar 

  18. Kunihara T, Tohmori H, Tsukamoto M, Kobayashi M, Okumura T, Teramoto H, Hamasaki T, Yamasaki T, Nakagawa T, Okimoto N, Fujiwara S (2023) Incidence and trend of antiresorptive agent-related osteonecrosis of the jaw from 2016 to 2020 in Kure, Japan. Osteoporos Int 34:1101–1109

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kim SH, Lee YK, Kim TY, Ha YC, Jang S, Kim HY (2021) Incidence of and risk for osteonecrosis of the jaw in Korean osteoporosis patients treated with bisphosphonates: a nationwide cohort-study. Bone 143:115650

    Article  CAS  PubMed  Google Scholar 

  20. Miyazaki H, Motegi E, Yatabe K, Yamaguchi H, Maki Y (2005) A study of occlusion in elderly Japanese over 80 years with at least 20 teeth. Gerodontology 22:206–210

    Article  PubMed  Google Scholar 

  21. Ministry of Health, Labour and Welfare in Japan (2016) Survey of dental diseases. https://www.mhlw.go.jp/toukei/list/62-17.html. Accessed 2 June 2023 (Japanese)

  22. Yamanaka K, Nakagaki H, Morita I, Suzaki H, Hashimoto M, Sakai T (2008) Comparison of the health condition between the 8020 achievers and the 8020 non-achievers. Int Dent J 58:146–150

    Article  PubMed  Google Scholar 

  23. Komiyama T, Ohi T, Miyoshi Y, Murakami T, Tsuboi A, Tomata Y, Tsuji I, Watanabe M, Hattori Y (2016) Association between tooth loss, receipt of dental care, and functional disability in an elderly Japanese population: the Tsurugaya Project. J Am Geriatr Soc 64:2495–2502

    Article  PubMed  Google Scholar 

  24. Kwoen MJ, Park JH, Kim KS, Lee JR, Kim JW, Lee H, Lee HJ (2023) Association between periodontal disease, tooth extraction, and medication-related osteonecrosis of the jaw in women receiving bisphosphonates: a national cohort-based study. J Periodontol 94:98–107

    Article  CAS  PubMed  Google Scholar 

  25. Arnaud MP, Talibi S, Lejeune-Cairon S (2022) Knowledge and attitudes of French dentists on bone resorption inhibitors (bisphosphonates and denosumab): a cross-sectional study. J Stomatol Oral Maxillofac Surg 123:163–170

    Article  PubMed  Google Scholar 

  26. Miranda-Silva W, Montezuma MA, Benites BM, Bruno JS, Fonseca FP, Fregnani ER (2020) Current knowledge regarding medication-related osteonecrosis of the jaw among different health professionals. Support Care Cancer 28:5397–5404

    Article  PubMed  Google Scholar 

  27. Dos Santos FL, Abreu LG, Calderipe CB, Martins MD, Schuch LF, Vasconcelos ACU (2021) Is teriparatide therapy effective for medication-related osteonecrosis of the jaw? A systematic review and meta-analysis. Osteoporos Int 32:2449–2459

    Article  Google Scholar 

  28. Aboalela AA, Farook FF, Alqahtani AS, Almousa MA, Alanazi RT, Almohammadi DS (2022) The effect of antiresorptive drug holidays on medication-related osteonecrosis of the jaw: a systematic review and meta-analysis. Cureus 14:e30485

    PubMed  PubMed Central  Google Scholar 

  29. Ruggiero SL, Dodson TB, Aghaloo T, Carlson ER, Ward BB, Kademani D (2022) American Association of oral and maxillofacial surgeons’ position paper on medication-related osteonecrosis of the jaws – 2022 update. J Oral Maxillofac Surg 80:920–943

    Article  PubMed  Google Scholar 

  30. Papadakis I, Spanou A, Kalyvas D (2021) Success rate and safety of dental implantology in patients treated with antiresorptive medication: a systematic review. J Oral Implantol 47:169–180

    Article  PubMed  Google Scholar 

  31. Mendes V, Dos Santos GO, Calasans-Maia MD, Granjeiro JM, Moraschini V (2019) Impact of bisphosphonate therapy on dental implant outcomes: an overview of systematic review evidence. Int J Oral Maxillofac Surg 48:373–381

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank all the physicians who belong to the Japan Osteoporosis Society and responded to the web-based structured questionnaire. The authors would also like to express their sincere thanks to the office members of the Japan Osteoporosis Society for their help in sending the URL of the questionnaire to the physicians. We thank Helen Jeays, BDSc AE, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This study was partially funded by the Japan Society for the Promotion of Science (JSPS) KAKENHI grants provided to AT (grant nos. 21K09885 and 22K10208).

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, 399-0781, Japan

    Akira Taguchi

  2. Department of Rehabilitation, Sanin Rosai Hospital, 1-8-1 Shinden, Kaike, Tottori, 683-8605, Japan

    Hiroshi Hagino

  3. Third Department of Medicine, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan

    Daisuke Inoue

  4. Department of Orthopedic Surgery, Tsubame Rosai Hospital, 633 Sawatari, Tsubane, Niigata, 959-1228, Japan

    Naoto Endo

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  1. Akira Taguchi
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  2. Hiroshi Hagino
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  3. Daisuke Inoue
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  4. Naoto Endo
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  5. Japan Osteoporosis Society
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Contributions

AT: conceptualization, methodology, validation, formal analysis, investigation, resources, writing—original draft, writing—review and editing, and funding acquisition. HH: conceptualization, methodology, validation, project administration, writing—review and editing. DI: conceptualization, methodology, validation, project administration, writing—review and editing. NE: conceptualization, methodology, validation, project administration, writing—review and editing.

Corresponding author

Correspondence to Akira Taguchi.

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Conflict of interest

AT has received lecture fees from Asahi Kasei Pharma Corp., Daiichi Sankyo Co. Ltd, Chugai Pharmaceutical Co. Ltd, and Teijin Pharma Ltd. He has received a consultation fee from Media Corp. Ltd. HH received lecture fees or grants outside the submitted work from Amgen Inc., Asahi Kasei Pharma Corp., Astellas Pharma Inc., Chugai Pharmaceutical Co. Ltd., Daiichi Sankyo Co. Ltd., Eisai Co. Ltd., Eli Lilly Japan Co. Ltd., Mitsubishi Tanabe Pharma Corp., Mochida Pharma Co. Ltd., Ono Pharmaceutical Co. Ltd., Kyowa Kirin Co. Ltd., Pfizer Japan Inc., Taisho Pharmaceutical Co. Ltd., Teijin Pharma Ltd., and UCB Japan Co. Ltd. DI has received lecture fees from Asahi Kasei Pharma Corp., Daiichi Sankyo Co. Ltd, and Teijin Pharma Ltd. NE have no conflicts of interests.

Ethics approval

Our study did not require ethics approval from the Matsumoto Dental University ethics committee because neither individual data nor any kind of intervention was included in the protocol or the results. The respondents in this survey, all of whom represented their respective institutions, provided informed consent. This questionnaire-based survey was conducted according to the ethical guidelines for epidemiological studies from the Japanese Ministry of Health, Labour and Welfare. This study was conducted in accordance with the Declaration of Helsinki and its later amendments or comparable ethical standards.

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Taguchi, A., Hagino, H., Inoue, D. et al. Cooperation between physicians and dentists for osteonecrosis of the jaw: a 2022 Japanese survey. J Bone Miner Metab 41, 829–837 (2023). https://doi.org/10.1007/s00774-023-01458-3

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  • DOI: https://doi.org/10.1007/s00774-023-01458-3

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