Addressing Osteonecrosis: A preventable catastrophe - A multi-center study

  • Mafaza Alam Registrar Operative Dentistry and Endodontics, AFID, Rawalpindi.
  • Zahid Mehmood Khan FCPS Operative Dentistry and Endodontics, AFID, Rawalpindi.
  • Laima Alam Bahria Town International Hospital, Rawalpindi
  • Varqa Faraid Demonstrator Oral Medicine, School of Dentistry, Islamabad.
  • Adnan Khan Registrar Oro-maxillofacial Surgery, AFID, Rawalpindi.
Keywords: chemotherapy, bisphosphonate-related osteonecrosis of the jaw, osteonecrosis, radiotherapy


Objectives: To assess the knowledge of medical doctors about osteonecrosis who prescribe radiotherapy and bisphosphonates and dentists who receive these patients with such risk factors.

Methods: This cross sectional multicenter study was carried out from 15th October 2021 to 20th November 2021 in different set-ups of Pakistan. A validated and piloted questionnaire was sent to dental and non-dental doctors working in different set-ups of Pakistan through email. All data was analyzed in SPSS version 22 with p value <0.05 being significant.

Results: A total of 400 completed responses were received. Only 58% and 67% of the participants were actively educating their patients regarding the hazards of bisphosphonate and radiotherapy, respectively whereas only 45% of the medical doctors referred their patients to dentists before prescribing bisphosphonates and/or radiotherapy. Although the medical doctors had a statistically better knowledge of the definition of osteonecrosis, overall both the dental and non-dental doctors performed poorly regarding answering the questions pertaining to definition, clinical features and risk factors. The dental doctors also showed a poor performance for more technical and in depth questions that was statistically related to lesser work experience, working in a tertiary care facility and previous exposure to such patients.

Conclusion: The inadequate awareness of dentists and physicians about the prevention and management of osteonecrosis of jaw is alarming. Efforts should be undertaken to raise the knowledge of dentists and physicians in this regard.


How to cite this: Alam M, Khan ZM, Alam L, Faraid V, Khan A. Addressing Osteonecrosis: A preventable catastrophe - A multi-center study. Pak J Med Sci. 2023;39(1):262-267. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to Cite
Alam, M., Khan, Z. M., Alam, L., Faraid, V., & Khan, A. (2022). Addressing Osteonecrosis: A preventable catastrophe - A multi-center study. Pakistan Journal of Medical Sciences, 39(1).

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