Awareness among patient at risk of developing Medication Related Osteonecrosis of the Jaw (MRONJ) - A primary prevention strategy

Assessing the Potential Role of Artificial Intelligence in Medication-Related Osteonecrosis of the Jaw Information Sharing

BACKGROUND

Artificial Intelligence, by answering questions about disease prevention strategies, can contribute to making diseases more treatable in their early stages.

PURPOSE

This study aims to evaluate the quality of patient information by assessing the responses of the Chat Generative Pretrained Transformer (ChatGPT, Open AI, USA) artificial intelligence model to questions related to medication-related osteonecrosis of the jaw (MRONJ).

STUDY DESIGN, SETTING, SAMPLE

The study was prospective cross-sectional design. The study was conducted within the Department of Oral and Maxillofacial Surgery. The study's questions were prepared by an experienced oral and maxillofacial surgeon and directed to the artificial intelligence platform. The responses were evaluated by oral and maxillofacial surgeons using the Global Quality Scale (GQS).

PREDICTOR VARIABLE

The predictor variable is question type. A total of 120 questions were categorized into six groups, which encompassed general information about MRONJ (Group 1), queries from patients about to initiate medication therapy (Group 2), questions from patients currently undergoing medication treatment (Group 3), inquiries from patients who had completed medication usage (Group 4), general treatment-related information (Group 5), and case scenarios (Group 6).

MAIN OUTCOME VARIABLES

The main variable is the GQS score. The GQS rates the quality of information and its utility for the patients. The scores are as follows: Score 1: Poor quality, Score 2: Generally poor quality, Score 3: Moderate quality, Score 4: Good quality, Score 5: Excellent quality.

COVARIATES

Not applicable.

ANALYSES

Kruskal-Wallis and Mann-Whitney U tests were applied for intragroup and intergroup analyses. The statistical significance level was determined as P < .05 and P < .01.

RESULTS

The average score for all questions was calculated to be 3.9 ± 0.8, which is above the "moderate quality" threshold. Group 1 had a mean score of 3.4 ± 1.1; group 2 had 4.1 ± 0.7; group 3 had 3.8 ± 0.8; group 4 had 4.3 ± 0.6; group 5 had 4.2 ± 0.7; and group 6 had 4.1 ± 0.5. The variations in mean scores among these groups did not exhibit statistical significance (P > .05).

CONCLUSION AND RELEVANCE

The artificial intelligence model has generated responses of moderate quality to questions about MRONJ. The use of the artificial intelligence platform may assist in patients gaining a fundamental understanding of MRONJ.

Potential Relationship between Poor Oral Hygiene and MRONJ: An Observational Retrospective Study

Medication-related osteonecrosis of the jaw (MRONJ) is a drug-related side effect linked but not limited to antiresorptive and antiangiogenic molecules. It recognizes several triggers in dental procedures, such as surgery, endodontic treatments, and root planing, but also prosthesis decubitus or with a spontaneous onset. Although there are many reports about the onset of this pathology, oral hygiene status is mainly described as a consequence of MRONJ. Not so much is known about the oral hygiene situation as a concurrent factor in the pathogenesis of severe stages and about non-surgical periodontal therapy in patients affected by MRONJ. Actually, clear instructions for non-surgical periodontal therapy are poor in the literature. The primary outcome of the present study is to evaluate the oral hygiene status in MRONJ patients. In addition, a secondary outcome is to review the factor of poor oral hygiene as a cause or worsening aspect for MRONJ. A total of 45 subjects (19 males and 26 females) with a mean age of 59 ± 12 were enrolled. The Pearson correlation coefficient showed no significant results for the variable of the Simplified Oral Hygiene Index (OHI-S) and the American Association of Oral and Maxillofacial Surgeons (AAOMS) stage, although the majority of patients showed poor oral hygiene with an OHI-S average of 3.39 ± 1.83. As stated by the last AAOMS position paper, poor plaque control is related to a worsened MRONJ stage. The relation between the lack of oral hygiene and MRONJ onset is still unclear.

Antiresorptive medication in oncology: the clinical and dental profile of patients in a reference center

Objectives

: The aim of this study was to evaluate the profile of patients on antiresorptive therapies for cancer treatment and assess presence of oral lesions, oral hygiene status, and knowledge regarding medication-related osteonecrosis of the jaw (MRONJ).

Materials and Methods

This was an observational cross-sectional study that evaluated patients treated with antiresorptive medication at a single cancer hospital. Clinical data were collected and oral examination was performed to assess patient oral health.

Results

From July 2017 to December 2018, 90 patients were assessed; 64 were female and 26 were male, and the mean age was 61 years. The most common drug was an intravenous bisphosphonate, zoledronic acid. Among the 90 patients, 47 presented with some type of oral disease, isolated or associated. Among these 47 patients, 9 patients (10%) developed osteonecrosis. Oral hygiene was evaluated, and most patients, with or without MRONJ, presented with regular to poor condition. Regarding patient knowledge of the risks of MRONJ and the risks associated with dental surgery, 60% stated that they were not aware of the risks.

Conclusion

Identifying the profile of patients and their needs facilitates not only the preventive process, but also the emergence of new therapeutic options. Our study shows that most patients are weakened both by metastatic disease and antineoplastic treatment as well as by issues associated with aging because most were over 60 years of age. Collectively, this information should be considered for management of preventive and therapeutic measures.