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Impact of Osteonecrosis of the Jaw on Osteoporosis Treatment in Japan: Results of a Questionnaire-Based Survey by the Adequate Treatment of Osteoporosis (A-TOP) Research Group

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Abstract

Dentists request a discontinuation of antiresorptive agents, such as bisphosphonate, before and after tooth extractions to prevent osteonecrosis of the jaw (ONJ). However, little is known about how this affects ONJ and osteoporosis treatment and how medical professionals and dentists cooperate to treat ONJ in patients with osteoporosis. This study aimed to clarify the impact of ONJ on osteoporosis treatment in Japan. A structured questionnaire including 14 key clinical queries was sent to 488 medical professionals as part of the Japanese Osteoporosis Intervention Trial (JOINT)-04, and 206 responses were received. A total of 173 respondents had received discontinuation requests from dentists. Of these, 28 respondents experienced 30 adverse events including ten fractures and one incidence of ONJ. The respondents who refused discontinuation requests observed no cases of ONJ. Approximately 16 % of respondents had patients who discontinued osteoporosis treatment, following a requested drug discontinuation, after tooth extraction. Dentists requested discontinuations for many medications that were not associated with the incidence of ONJ. Approximately 76 % of respondents had never requested oral health care from dentists before osteoporosis treatment and 72 % reported no cooperation between dentists and medical professionals in their region. Our results suggest that drug discontinuation may increase adverse events and disturb osteoporosis treatment without completely preventing ONJ. Currently, both medical professionals and dentists in Japan still continue to recommend their own treatment position. A forum to share information about ONJ among medical professionals, dentists, and patients is required.

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Acknowledgments

The authors express sincere thanks to the members of the Adequate Treatment of Osteoporosis (A-TOP) Research Group.

Funding

This work was supported in part by Grants-in-Aid from the Japan Society for the Promotion of Science (Nos. 24592849, 26463148 and 90119222).

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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. Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano, 399-8101, Japan

    Masataka Shiraki

  3. Public Health Research Foundation, 1-1-7 Nishiwaseda, Shinjuku-ku, Tokyo, 169-0051, Japan

    Mayumi Tsukiyama & Teruhiko Miyazaki

  4. Department of Orthopaedic Surgery and Rheumatology, Nara Hospital, Kinki University School of Medicine, 1248-1, Otodacho, Ikoma, Nara, 630-0293, Japan

    Satoshi Soen

  5. Department of Clinical Medical Research Center, International University of Health and Welfare, Women’s Medical Center of Sanno Medical Center, 2-2-15 Minamiaoyama, Minato-ku, Tokyo, 107-0062, Japan

    Hiroaki Ohta

  6. National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Toshitaka Nakamura

  7. Japan Osteoporosis Foundation, 11-2, Nihonbashi, Kobunacho, Chuo-ku, Tokyo, 103-0024, Japan

    Hajime Orimo

Authors
  1. Akira Taguchi
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  2. Masataka Shiraki
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  3. Mayumi Tsukiyama
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  4. Teruhiko Miyazaki
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  5. Satoshi Soen
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  6. Hiroaki Ohta
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  7. Toshitaka Nakamura
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  8. Hajime Orimo
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Corresponding author

Correspondence to Akira Taguchi.

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Conflict of Interest

Taguchi received consultancy or lectures fee from Asahi Kasei, Teijin, and Ono; Shiraki received consultancy or lectures fee from Asahi Kasei, Teijin, Ono, Asteras, Pfizer, MSD, Chugai, Daiichisankyo, and Eisai; Soen received consultancy or lectures fee from Asahi Kasei, Asteras, Daiichisankyo, Eisai, Eli Lilly Japan, MSD, Ono, Pfizer, Taishotoyama, Takeda, Chugai, and Teijin; and Ohta received consultancy or lecture fee from Pola, Eisai, Astellas, Teijin, and Pfizer. Tsukiyama, Miyazaki, Nakamura, and Orimo have no conflict of interest to declare in this study.

Human and Animal Rights and Informed Consent

The entire A-TOP research study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed and approved by the Central Ethical Committee of the A-TOP research group. All participants gave informed consent.

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Taguchi, A., Shiraki, M., Tsukiyama, M. et al. Impact of Osteonecrosis of the Jaw on Osteoporosis Treatment in Japan: Results of a Questionnaire-Based Survey by the Adequate Treatment of Osteoporosis (A-TOP) Research Group. Calcif Tissue Int 97, 542–550 (2015). https://doi.org/10.1007/s00223-015-0045-y

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