Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Adjunctive recombinant human parathyroid hormone agents for the treatment of medication-related osteonecrosis of the jaw: a report of three cases

  • Soo Young Choi (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital) ;
  • Dami Yoon (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital) ;
  • Kang-Min Kim (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital) ;
  • Sun-Jong Kim (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Seoul Hospital) ;
  • Heon-Young Kim (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital) ;
  • Jin-Woo Kim (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Seoul Hospital) ;
  • Jung-Hyun Park (Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital)
  • Received : 2023.10.20
  • Accepted : 2024.02.14
  • Published : 2024.04.30
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Abstract

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

Keywords

Acknowledgement

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI22C1377).

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