Medication-related osteonecrosis of the jaw: who knows more? A cross-sectional study of general dental practitioners and oral maxillofacial surgery assistants

Anti-resorptive and anti-angiogenic drugs, commonly prescribed for osteoporosis, bone metastases, and metabolic bone diseases, increase the risk of medication-related osteonecrosis of the jaw (MRONJ) following dentoalveolar surgery. This study aimed to assess the knowledge of general dental practitioners and oral and maxillofacial surgery (OMFS) assistants regarding these drugs, MRONJ, and related treatment approaches. Methods: A questionnaire addressing demographics, familiarity with these medications, understanding of MRONJ, and treatment strategies was electronically distributed. Participants were classified into general dental practitioners and OMFS assistants. Data were analyzed using chi-square tests with a significance threshold of 0.05. Results: Awareness of MRONJ risk was significantly higher among OMFS assistants (98.3%) than general dental practitioners (75.8%). OMFS assistants were more likely to consult prescribing physicians before tooth extraction (99.2% vs. 91.7%) and correctly identify the mandible as the most commonly affected jaw (97.3% vs. 65.8%). Knowledge of drug discontinuation before dentoalveolar surgery in patients using denosumab was higher in OMFS assistants (66.4% vs. 31.7%). OMFS assistants also demonstrated greater familiarity with the conditions treated by these drugs, including osteoporosis (98.3% vs. 83.3%), breast cancer (91.4% vs. 54.1%), and multiple myeloma (87.1% vs. 40.8%). Conclusion: Dentists undergoing specialty or doctoral training demonstrated greater knowledge and awareness of MRONJ and related treatment approaches compared to general dental practitioners, highlighting the need for targeted educational programs to improve clinical practice and patient safety.