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Dear David- After Jennifer’s success with multiple myeloma (Jen reached complete remission) she is now visiting the dark side of the moon. She began having infections from a particular tooth that continued even after a root canal.
Now her doctors tell us she will eventually have that tooth removed and she will face a high probability of necrosis of the jaw. After all this time of celebrating her victory over multiple myeloma we are reeling with what is a horrible side effect.
“The management of bisphosphonate-related osteonecrosis of the jaws (ONJ) is challenging and controversial. At present, there is no established medication treatment for the disease.
METHODS: A 78-year-old osteoporotic woman with osteonecrosis of the mandible related to alendronate therapy was referred for treatment. The disease was unresponsive to conservative therapy, including antibacterial mouth rinse, antibiotics, and minor surgical debridement. Teriparatide, a human recombinant pararthyroid hormone peptide 1-34, was then used for treatment.
RESULTS: The oral mucosa completely regrew, and pain subsided 4 weeks after the initiation of teriparatide administration. Progressive bone regeneration was found during and after the 6-month period of teriparatide therapy.
CONCLUSION: Our case demonstrated that teriparatide can be an important adjuvant in the management of advanced ONJ and should be considered prior to major resection with reconstruction. Its true value in the treatment of ONJ for noncancer patients with osteoporosis warrants future studies.