Parathyroid hormone applications in the craniofacial skeleton.
Parathyroid hormone (PTH) is known for its ability to 'build' bone, with research in this area centered on its use as an osteoporosis therapeutic. Recent interest has developed regarding its potential for regenerative applications such as fracture healing and osseous defects of the oral cavity. Many years of investigation using murine gene-targeted models substantiate a role for signaling at the PTH/PTH-related protein (PTHrP) receptor (PPR) in intramembranous bone formation in the craniofacial region as well as in tooth development. Pre-clinical studies clearly support a positive role of intermittent PTH administration in craniofacial bones and in fracture healing and implant integration. A few human clinical studies have shown favorable responses with teriparatide (the biologically active fragment of PTH) administration. Favorable outcomes have emerged with teriparatide administration in patients with osteonecrosis of the jaw (ONJ). New delivery strategies are in development to optimize targeted application of PTH and to help maximize local approaches. The promising host-modulating potential of PTH requires more information to further its effectiveness for craniofacial regeneration and osseous wound-healing, including a better delineation of cellular targets, temporal effects of PTH action, and improved approaches for local/targeted delivery of PTH.
Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
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HL
Chan
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McCauley
D000818:Animals; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001847:Bone Diseases / Q000188:drug therapy*; D001861:Bone Regeneration / Q000187:drug effects; D004195:Disease Models, Animal; D005147:Facial Bones / Q000187:drug effects*; D006801:Humans; D010020:Osteonecrosis / Q000188:drug therapy; D010281:Parathyroid Hormone / Q000627:therapeutic use*; D012886:Skull / Q000187:drug effects*; D019379:Teriparatide / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D010281:Parathyroid Hormone; D019379:Teriparatide