Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Terms of Staging and Treatment Strategies by Dental Students at Different Educational Levels

Abstract

Background: The role of medication-related osteonecrosis of the jaw (MRONJ) as a dento-maxillo-facial pathology is becoming increasingly important due to its growing prevalence. The success of preventive and therapeutic measures relies mainly on the dentist’s ability to correctly diagnose the disease. Methods: The aim of this study was to evaluate the skills of dental students of different educational levels in choosing the correct stage, diagnostics, and treatment option for MRONJ based on clinical and radiographic imaging (panoramic radiograph, CBCT). The study was designed as a cross-sectional cohort study. Twenty dental students were asked to complete a questionnaire in their third and fifth year of studies in which they had to correctly stage the disease, choose the radiological diagnostics and recommend the treatment. The control group contained experienced oral and maxillofacial surgeons. Results: With an overall performance of 59% (third year: 145.2/248 points; fifth year: 145.3/248 points), no statistically significant difference between the educational levels could be observed. The classification based on CBCT imaging was significantly more often correct compared to panoramic radiographs (p < 0.001). Conclusions: This study highlights students’ lack of knowledge in staging, diagnostics, and treatment of MRONJ, even though the CBCT positively affected decision-making. No significant increase in knowledge could be confirmed through clinical education. This study highlights the need for students to catch up on MRONJ diagnostics and treatment planning. Further expansion of teaching in this disease’s context and X-ray diagnostics is needed.

WITHDRAWN: Site-specific assessment of radiographic interdental bone loss as proposed in the recent classification of periodontal diseases: Potential impact of location, severity, and clinical training

“…In the literature, studies on education levels are grouped into annual education, for example, term 3, term 5 (21). Although the experience of physicians at various education levels is also measured annually, there are many factors that affect the experience.…”

“…Although the experience of physicians at various education levels is also measured annually, there are many factors that affect the experience. (21,22) Physicians with different education levels may make different diagnoses for the same patient and the reasons for this should be investigated (22).…”

Osteonecrosis como complicación postquirúrgica en cirugía oral en pacientes sometidos a tratamientos con antirresortivos. Revisión integrativa

“…Como resultado, el citoesqueleto de los osteoclastos se desintegra y el borde rugoso de los mismos desaparece, induciendo así al proceso llamado apoptosis. (Shibahara, 2019;Heimes et al, 2023).…”

“…Al mismo tiempo los osteoblastos y las células mesenquimales producen la osteoprotegerina del receptor señuelo RANKL (OPG), que inhibe la unión de RANKL a RANK, Por lo tanto, la diferenciación y función de los osteoclastos está regida por el equilibrio entre RANKL y OPG producido por los osteoblastos y las células mesenquimales. De esta manera se desarrolló un anticuerpo neutralizante de RANKL como fármaco (Denosumab) para suprimir la resorción ósea osteoclástica (Heimes et al, 2023;Shibahara, 2019).…”

“…Una de las complicaciones en pacientes que toman bifosfonatos, es que no se cicatriza la herida y al no cicatrizar la herida da lugar a que se desarrolle osteonecrosis, más frecuente en de la mandíbula con un 73% y en maxilar con un 22,5% (Heimes et al, 2023), el 43% de osteonecrosis se debe a las extracciones dentales (Shibahara, 2019;Coropciuc et al, 2023).…”