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. 2025 Jul 2;25(1):985.
doi: 10.1186/s12903-025-06490-5.

Awareness and Attitude Towards MRONJ Among Physicians Prescribing Antiresorptive Drugs: A Cross-Sectional Study

Murat Mutlu  1 , Serpil Altundoğan  1 , Ömer Faruk Kocamaz  2
Affiliations

Awareness and Attitude Towards MRONJ Among Physicians Prescribing Antiresorptive Drugs: A Cross-Sectional Study

Murat Mutlu et al. BMC Oral Health. .

Abstract

Background: MRONJ (Medication-Related Osteonecrosis of the Jaw) refers to a condition characterized by osteonecrosis of the jawbone associated with the use of certain medications. One of the most common causes of MRONJ is bisphosphonates, which are frequently used today to treat osteoporosis, metabolic bone diseases, and the skeletal effects of malignancies.

Objective: The aim of this study is to assess the awareness and approaches of medical doctors who prescribe bisphosphonate group drugs regarding MRONJ.

Method: A total of 125 physicians specializing in the departments of oncology, orthopedics and traumatology, physical medicine and rehabilitation, and obstetrics and gynecology participated in our study. The participants completed questionnaire forms consisting of 15 questions related to MRONJ, and the results were analyzed.

Results: The specialists who participated in the study were found to prescribe zoledronate and alendronate more frequently than other antiresorptive medications. Over the past year, when examining the frequency of encountering patients with MRONJ, 56% of physicians had not encountered any cases, while 44% had encountered between one and four cases. The group that most frequently requested consultations from physicians regarding bisphosphonates was identified as dentists, with a rate of 50.4%, followed by oral and maxillofacial surgeons at 36.8%. The specialists who participated in the study reported that when they encounter patients with osteonecrosis, 39.2% most frequently referred them to oral and maxillofacial surgery.

Conclusion: To enhance awareness of MRONJ, a multidisciplinary approach should be adopted between medical and dental disciplines, and a well-coordinated consultation system should be established. This will ensure that patients undergo dental examinations and complete necessary interventional dental procedures before commencing antiresorptive drug therapy. Furthermore, implementing educational strategies such as academic publications, training seminars, and symposia is of great importance to increase the level of awareness on this issue.

Keywords: Awareness; Bisphosphonate; Denosumab; Medication-related osteonecrosis of the jaw.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Ankara University Health Sciences Sub-Ethics Committee has approved the research protocol (decision date. 29/01/2024, decision number. 02/05). The purpose and content of the study were explained to the participants of the study. Those who agreed to participate were asked to sign an informed consent form and complete the questionnaire. The study has been conducted in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Scheme of the study design
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Specialties of the participants
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