title: 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.
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.
authors.affiliation: Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, 399-0781, Japan. akiro@po.mdu.ac.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Taguchi
authors.affiliation: Research Institute and Practice for Involutional Diseases, 1610-1 Meisei, Misato, Azumino, Nagano, 399-8101, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Shiraki
authors.affiliation: Public Health Research Foundation, 1-1-7 Nishiwaseda, Shinjuku-ku, Tokyo, 169-0051, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tsukiyama
authors.affiliation: Public Health Research Foundation, 1-1-7 Nishiwaseda, Shinjuku-ku, Tokyo, 169-0051, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Orthopaedic Surgery and Rheumatology, Nara Hospital, Kinki University School of Medicine, 1248-1, Otodacho, Ikoma, Nara, 630-0293, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Soen
authors.affiliation: 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.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ohta
authors.affiliation: National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Japan Osteoporosis Foundation, 11-2, Nihonbashi, Kobunacho, Chuo-ku, Tokyo, 103-0024, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Orimo
mesh_terms: D000328:Adult; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw; D003815:Dentists; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007400:Interprofessional Relations; D007564:Japan; D008297:Male; D010024:Osteoporosis / Q000188:drug therapy*; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Adverse event; Cooperation; Discontinuation; Jaw; Osteonecrosis; Osteoporosis