Background : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
Oral bisphosphonates (BPs) are used to treat osteoporosis, Paget’s disease, and osteogenesis imperfecta. They are most widely used for treatment of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) was first reported by Marx in 2003 [1]. The risk of BRONJ in osteoporotic patients treated with BPs remains low compared with that of oncology patients [2]. Recent studies have indicated that the relative incidence of BRONJ in patients with osteoporosis is higher than previously thought [3]. Madrid and Sanz [4] suggested that the placement of dental implants in patients treated with oral bisphosphonates was not associated with the onset of BRONJ; they found no relationship between the treatment and the survival of implants. However, more recently, an increasing number of peri-implant BRONJ cases have been described [5–9]. Peri-implant BRONJ currently is considered an additional complication related to oral implants, along with nerve injury, bleeding, sinus perforation, implant ingestion/aspiration, peri-implantitis, and mucositis [6].
We present a case of a severely osteoporotic woman with BRONJ around her dental implants, who was treated successfully with teriparatide and sequestrectomy.
Serial posts:
- Background : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
- Case presentation : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [1]
- Case presentation : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [2]
- Discussion : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [1]
- Discussion : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [2]
- Conclusions : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
- References : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [1]
- References : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [2]
- References : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report [3]
- Author information : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
- Rights and permissions : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
- About this article : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implants: a case report
- Fig. 1. a Extraoral photograph showing an extraoral fistula in the right mandibular region. b Intraoral photograph showing an intraoral fistula on the lingual side of the distal dental implants associated with mucosal inflammation and a purulent discharge : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant
- Fig. 2. a Panoramic radiograph showing marked alveolar bone resorption surrounding the dental implant replacing the right mandibular first molar (arrow). b Sagittal CT view. c Coronal CT view : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant
- Fig. 3. a Panoramic radiograph showing the sequestrum separation after 5 months of teriparatide therapy (arrows). b Sagittal CT view. c Coronal CT view : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant
- Fig. 4. a Preoperative intraoral photograph. b Intraoperative photograph of the sequestrectomy. c Removal of the dental implant with a specimen of the necrotic bone : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant
- Fig. 5. a Extraoral photograph 5 months after the sequestrectomy. b Intraoral photograph 5 months after the sequestrectomy. : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant
- Fig. 6. a Panoramic radiograph 16 months after the sequestrectomy. b Sagittal CT view. c Coronal CT view. d 3D CT view : Treatment with teriparatide for advanced bisphosphonate-related osteonecrosis of the jaw around dental implant