title: Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw: a case report and narrative review.
abstract: Bisphosphonates (BP), potent antresorptive agents, play a key role in managing osteolytic bone disorders including osteoporosis, Paget's disease, bone metastasis, and multiple myeloma. However, their long-term administration is associated with increased risk for bisphosphonate-related osteonecrosis of the jaw (BRONJ) development. At present, there is no curative therapy for BRONJ, and patients are often treated palliatively with antibiotics, antimicrobial mouth rinses, and debridement of necrotic bone. This article highlights a new treatment modality that may be beneficial to a subset of osteoporosis patients suffering from BRONJ. Here we report a BRONJ case that was initially unresponsive to conservative treatment, but subsequently responded to teriparatide (recombinant human PTH1-34) therapy.
authors.affiliation: Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis, Minnesota, USA. thumb002@umn.edu
authors.forename: Vivek
authors.initials: V
authors.lastname: Thumbigere-Math
authors.forename: Rajaram
authors.initials: R
authors.lastname: Gopalakrishnan
authors.forename: Bryan S
authors.initials: BS
authors.lastname: Michalowicz
mesh_terms: D019386:Alendronate / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000188:drug therapy* / Q000209:etiology; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy; D024042:Collagen Type I / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008439:Maxillary Diseases / Q000188:drug therapy / Q000209:etiology; D008875:Middle Aged; D010455:Peptides / Q000097:blood; D019379:Teriparatide / Q000627:therapeutic use*; D014081:Tooth Extraction
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D019379:Teriparatide; D019386:Alendronate