Bisphosphonate-associated osteonecrosis of the jaw, with healing after teriparatide: a review of the literature and a case report.
This paper reports the case history of a patient who had bisphosphonate-associated osteonecrosis of the jaw (ONJ) in which adjunctive treatment with teriparatide was used. The patient was treated for 5 years with alendronate for osteoporosis and developed ONJ after extraction of maxillary teeth. An implant was placed at the site of the extracted teeth. The pathology report confirmed the clinical diagnosis of ONJ; treatment was changed from alendronate to teriparatide and the ONJ resolved. To our knowledge, this is the third case history reported in the literature in which teriparatide was successfully used as adjunct therapy in ONJ because it has an anabolic effect and presumed role in accelerating bone healing. ONJ is a serious but infrequent condition that has been recently associated with nitrogen-containing bisphosphonate therapy. Teriparatide may be a useful adjunctive therapy when ONJ develops.
Narongroeknawin
Pongthorn
P
Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Danila
Maria I
MI
Humphreys
Lewis G
LG
Barasch
Andrei
A
Curtis
Jeffrey R
JR
D019386:Alendronate / Q000009:adverse effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001861:Bone Regeneration / Q000187:drug effects; D015921:Dental Implants; D004164:Diphosphonates / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008439:Maxillary Diseases / Q000139:chemically induced* / Q000188:drug therapy; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy; D010020:Osteonecrosis / Q000139:chemically induced* / Q000188:drug therapy; D010024:Osteoporosis / Q000188:drug therapy; D019379:Teriparatide / Q000008:administration & dosage / Q000627:therapeutic use*; D014081:Tooth Extraction
D050071:Bone Density Conservation Agents; D015921:Dental Implants; D004164:Diphosphonates; D019379:Teriparatide; D019386:Alendronate