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Vol. 27. Issue 6.
Pages 352-360 (November - December 2017)
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Vol. 27. Issue 6.
Pages 352-360 (November - December 2017)
Original Article
DOI: 10.1016/j.enfcle.2017.04.008
Intervention to improve awareness of the risk factors for osteonecrosis of the jaw in patients under treatment with bisphosponates. Randomised clinical trial
Intervención para la mejora del conocimiento de los factores de riesgo para el desarrollo de osteonecrosis maxilar en pacientes a tratamiento con bisfosfonatos. Ensayo clínico aleatorizado
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Lucía García-Martíneza,
Corresponding author
luciagarmar@gmail.com

Corresponding author.
, Rubén Martín-Payob, Alejandro Pelaz-Garcíac, Matilde Sierra-Vegad, Luis Manuel Junquera-Gutiérreze
a Complejo Asistencial Universitario de León, León, Spain
b Departamento de Medicina, Área de Enfermería, Universidad de Oviedo, Oviedo, Spain
c Servicio de Cirugía Oral y Maxilofacial, Hospital de Cabueñes, Gijón, Asturias, Spain
d Departamento de Farmacia, Universidad de León, León, Spain
e Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
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Tables (6)
Table 1. List of dos and don’ts for the prevention of osteonecrosis of the jaw in patients with bisphosphonates (DL. AS671-2013).
Table 2. Variables gathered in the study and coding for analysis.
Table 3. Contingency table “increased frequency of tooth brushing”.
Table 4. Comparison of adherence to oral hygiene behaviours.
Table 5. Comparison of adherence to secondary prevention measures.
Table 6. Comparison of variables relating to adherence to treatment and dental checks.
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Abstract
Purpose

To evaluate the effectiveness of a health education programme on knowledge and reduction of the risk factors for bisphosphonate-related osteonecrosis of the jaw.

Methods

An experimental study control group without intervention was performed with 60 subjects who had started treatment with bisphosphonates in the University Hospital of León from October to December 2014. Patients in the experimental group received a structured education intervention in two sessions. The data was collected from a heteroadministered questionnaire at the beginning and at the end of the study period for both groups.

Results

The educational intervention designed showed a significantly increased adherence to healthy behaviours related to oral hygiene such as mechanical control of plaque and the use of clorhexidine prior to invasive oral procedures. All subjects reported that they had not been advised to maintain a good level of oral health before starting treatment. After the intervention high percentages of recognition of early diagnostic measures starting from a baseline total ignorance of them were determined. No conclusive information about the use of removable dental prostheses, toxic habits or maintaining proper metabolic control in patients with diabetes mellitus was observed.

Conclusions

Improving adherence to healthy behaviours related to oral health following the intervention, as well as their contribution to the early identification of warning signs of jaw osteonecrosis, stresses the importance of the use of health education as a tool in routine clinical practice.

Keywords:
Prevention and control
Bisphosphonates
Osteonecrosis of the jaw
Risk factors
Health education
Resumen
Objetivo

Evaluar la efectividad de un programa de educación para la salud sobre el conocimiento y modificación de los factores de riesgo de aparición de osteonecrosis maxilar en pacientes tratados con bisfosfonatos.

Método

Estudio experimental del tipo «grupo control sin intervención», con 60 pacientes que iniciaron tratamiento con bisfosfonatos en el Hospital Universitario de León de octubre a diciembre de 2014. Los pacientes pertenecientes al grupo experimental recibieron una intervención educativa estructurada en dos sesiones. La recogida de datos se llevó a cabo mediante un cuestionario heteroadministrado, al inicio y al final del período de estudio, para ambos grupos.

Resultados

La intervención educativa diseñada mejoró significativamente la práctica de medidas básicas de higiene oral, como el control mecánico de la placa y el uso de clorhexidina previa a procedimientos orales invasivos. Ningún paciente declaró haber sido advertido de la necesidad de poner su boca en salud antes del inicio del tratamiento. Tras la intervención se determinan porcentajes elevados de reconocimiento de medidas de diagnóstico precoz partiendo de una situación basal de desconocimiento total de las mismas. No resultaron concluyentes los datos recogidos sobre el uso de prótesis dental, hábitos tóxicos o control metabólico en pacientes con diabetes mellitus.

Conclusiones

La mejora de la adhesión a conductas saludables relacionadas con la salud bucodental tras la intervención educativa, así como su contribución a la identificación precoz de los signos de alarma de osteonecrosis maxilar, remarca la importancia del empleo de la educación para la salud como herramienta en la práctica clínica habitual.

Palabras clave:
Prevención y control
Bisfosfonatos
Osteonecrosis maxilar
Factores de riesgo
Educación para la salud

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