Awareness and Preventive Practices of Medication-Related Osteonecrosis of the Jaw Among Dental Practitioners in Tripoli, Libya

Abstract

Medication-Related Osteonecrosis of the Jaw (MRONJ), a severe adverse reaction characterized by exposed maxillofacial bone persisting for over eight weeks in patients exposed to bone-modifying agents (BMAs) without prior radiation therapy, requires diligent preventative screening by dental practitioners. This descriptive cross-sectional study evaluated baseline awareness and clinical preventive practices regarding MRONJ among 100 practicing dentists across multiple clinical settings in Tripoli, Libya, between November 2025 and January 2026 using a structured, self-administered questionnaire analyzed via SPSS version 27.0. The analysis demonstrated that 58.0% of respondents possessed a moderate level of awareness regarding BMAs and MRONJ, while 24.0% exhibited high awareness, and 18.0% scored low. Although 87.0% accurately identified tooth extraction as the most critical local surgical risk factor triggering osteonecrosis, a substantial clinical gap was highlighted, as only 45.0% of practitioners reported routinely and comprehensively inquiring about the use of bone-modifying medications during standard medical history intake. No statistically significant correlations were observed between overall awareness levels and clinical experience (p = 0.126) or dental specialization (p = 0.823). While fundamental theoretical knowledge surrounding MRONJ is moderate among Tripoli dental practitioners, it fails to routinely transition into robust, defensive clinical history-taking and prevention, indicating that standardized pre-surgical screening protocols and targeted continuous medical education are urgently required to bridge this clinical gap.