Kim Jun-Young, Park Jin Hoo, Jung Hwi-Dong, Jung Young-Soo
Department of Oral & Maxillofacial Surgery, Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Korea.
J Oral Implantol. 2019 Oct;45(5):403-407. doi: 10.1563/aaid-joi-D-19-00040. Epub 2019 Aug 20.
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.
处理牙种植体周围与药物相关的颌骨坏死（MRONJ）可能具有挑战性。尽管推荐将MRONJ的保守治疗作为一线治疗方式，但许多患者并无改善。人重组甲状旁腺激素特立帕肽最近已被用于MRONJ的治疗。特立帕肽在治疗绝经后骨质疏松症方面有效，并且是唯一获得美国食品药品监督管理局批准的直接影响成骨细胞功能并有助于骨重塑的合成代谢药物。在此，我们描述了一例85岁女性的MRONJ病例，该患者接受特立帕肽治疗后获得成功。特立帕肽每周给药一次，未进行诸如死骨切除术等任何手术干预。与最近报道的每日使用特立帕肽治疗的病例相比，每周一次给药特立帕肽可能会使副作用和患者不适降至最低。不进行死骨切除术而每周一次应用特立帕肽可能对处理牙种植体周围的MRONJ有效。
