Choi Soo Young, Yoon Dami, Kim Kang-Min, Kim Sun-Jong, Kim Heon-Young, Kim Jin-Woo, Park Jung-Hyun
Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Ewha Womans University Seoul Hospital, Seoul, Korea.
J Korean Assoc Oral Maxillofac Surg. 2024 Apr 30;50(2):103-109. doi: 10.5125/jkaoms.2024.50.2.103.
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.
特立帕肽已被证明对治疗诊断为药物相关性颌骨坏死（MRONJ）的患者有效。然而，其疗效尚未得到充分证实，不足以被接受为一种标准治疗方法。本文的目的是研究重组人甲状旁腺激素治疗MRONJ的疗效。我们报告了3例以骨质疏松症为主要疾病的MRONJ患者，他们接受了特立帕肽制剂及其他辅助措施的治疗。每位患者皮下注射特立帕肽16周、36周或60周。在特立帕肽给药期间进行了包括部分切除、死骨切除术、骨皮质剥除术和碟形手术在内的手术干预。所有3例患者在临床和影像学上均实现了病变完全消退。对于诊断为MRONJ的患者，特立帕肽治疗是改善骨病变愈合的一种有效且安全的治疗选择。这些发现表明，特立帕肽与其他疗法联合使用，尤其是与骨形态发生蛋白、富血小板纤维蛋白或抗生素疗法联合使用，可能是治疗MRONJ的有效方案。
