Treatment of Medication-Related Osteonecrosis of the Jaw Around the Dental Implant With a Once-Weekly Teriparatide: A Case Report and Literature Review

J Oral Implantol. 2019 Oct;45(5):403-407. doi: 10.1563/aaid-joi-D-19-00040. Epub 2019 Aug 20.

Abstract

Managing medication-related osteonecrosis of the jaw (MRONJ) around a dental implant can be difficult. Although conservative treatment of MRONJ is recommended as the first-line form of management, many patients exhibit no improvement. The human recombinant parathyroid hormone teriparatide has recently been introduced for the management of MRONJ. Teriparatide is effective in the treatment of postmenopausal osteoporosis and is the only US Food and Drug Administration-approved anabolic agent that directly affects osteoblast function and contributes to bone remodeling. Herein we describe a case of MRONJ in an 85-year-old woman who was successfully treated with teriparatide. Teriparatide was administered once per week without any surgical interventions such as a sequestrectomy. Compared with most recently reported cases involving daily treatment with teriparatide, once-weekly administration of teriparatide may minimize side effects and patient discomfort. Once-weekly teriparatide application without sequestrectomy may be effective in the management of MRONJ around a dental implant.

Keywords: bisphosphonate; implant; osteonecrosis of the jaw; osteoporosis; teriparatide.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Bisphosphonate-Associated Osteonecrosis of the Jaw*
  • Bone Density Conservation Agents*
  • Bone Remodeling
  • Dental Implants*
  • Female
  • Humans
  • Teriparatide

Substances

  • Bone Density Conservation Agents
  • Dental Implants
  • Teriparatide