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
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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DOI：
10.1007/s00223-015-0045-y
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发表时间：
2015-12-01
影响因子：
4.2
通讯作者：
Orimo, Hajime
中科院分区：
文献类型：
--
作者：
Taguchi, Akira;Shiraki, Masataka;Orimo, Hajime
牙医要求在拔牙前后停止使用抗吸收剂，如双磷酸盐，以防止颌骨骨坏死（ONJ）。然而，很少有人知道这是如何影响ONJ和骨质疏松症的治疗，以及医疗专业人员和牙医如何合作治疗骨质疏松症患者的ONJ。本研究旨在阐明ONJ对日本骨质疏松症治疗的影响。作为日本骨质疏松干预试验（JOINT）-04的一部分，向488名医疗专业人员发送了一份结构化问卷，其中包括14个关键临床问题，共收到206份回复。共有173名受访者收到了牙医的中止请求。其中，28名受访者经历了30起不良事件，包括10起骨折和1起ONJ事件。拒绝中止请求的受访者没有观察到ONJ病例。大约16%的受访者有患者在拔牙后要求停药后停止骨质疏松治疗。牙医要求停用许多与ONJ发病率无关的药物。大约76%的受访者在骨质疏松症治疗前从未向牙医要求过口腔保健，72%的受访者报告其所在地区的牙医和医疗专业人员之间没有合作。我们的研究结果表明，停药可能会增加不良事件，并干扰骨质疏松症的治疗，而不能完全预防ONJ。目前，日本的医疗专业人士和牙医仍然继续推荐自己的治疗位置。需要一个论坛来在医疗专业人员、牙医和患者之间分享ONJ的信息。
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.