Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw: a case report and narrative review

Northwest Dent. 2013 Jan-Feb;92(1):12-8.

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Alendronate / adverse effects
  • Alendronate / therapeutic use
  • Biomarkers / blood
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / drug therapy*
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / etiology
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Diseases, Metabolic / drug therapy
  • Collagen Type I / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Maxillary Diseases / drug therapy
  • Maxillary Diseases / etiology
  • Middle Aged
  • Peptides / blood
  • Teriparatide / therapeutic use*
  • Tooth Extraction

Substances

  • Biomarkers
  • Bone Density Conservation Agents
  • Collagen Type I
  • Peptides
  • collagen type I trimeric cross-linked peptide
  • Teriparatide
  • Alendronate