Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • COVID-19 and Rheumatology
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
LetterCorrespondence

More on the Resolution of Bisphosphonate-associated Osteonecrosis of the Jaw

KUO-YANG TSAI, CHIN-SHENG HUANG, GUAN-MIN HUANG and CHEN-TUNG YU
The Journal of Rheumatology March 2010, 37 (3) 675; DOI: https://doi.org/10.3899/jrheum.091022
KUO-YANG TSAI
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
CHIN-SHENG HUANG
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
GUAN-MIN HUANG
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
CHEN-TUNG YU
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: ortho.yu@msa.hinet.net
  • Article
  • Figures & Data
  • Info & Metrics
  • References
  • PDF
  • eLetters
PreviousNext
Loading

To the Editor:

We had one case similar to that reported by Lau, et al1. The patient is a 72-year-old woman who sustained a painful fistula (Figure 1a) after dental implants 6 months before. She had taken alendronate weekly for 4 years. She underwent sequestrectomy of necrotic bone, oral antibiotics, and oral irrigation with aqueous iodine solution. After 5 months of therapy, the situation deteriorated (Figure 1b). She was started on anabolic therapy with teriparatide (20 μg) in May 2006. After 5 months of teriparatide, significant bone regeneration was found and the mandibular fistula was healing (Figures 1c and 1d). At 10 months’ followup, the panoramic radiograph showed complete resolution of the necrotic region (Figure 2).

Figure 1.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1.

(a) Painful cutaneous fistula with suppuration on right chin. (b) Panoramic radiograph taken 4 months after dental extraction shows an area of alveolar necrosis, apparently localized to the right mandibular areas (arrow). (c and d) The fistula healed with scar formation, and significant bone regeneration was noted after 5 months of therapy.

Figure 2.
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 2.

Panoramic radiograph showed complete resolution of necrotic region after 10 months of therapy.

Bisphosphonates play an important role in osteoporosis management. Even if the rate is very low2, bisphosphonate-related osteonecrosis of the jaw (BRONJ) produces significant morbidity. Prevention and treatment strategies are currently based on expert opinion and focus on maintaining good oral hygiene and conservative surgical intervention3.

Teriparatide is the only available anabolic agent for managing osteoporosis. It also shows potential for enhancing fracture healing4. Currently, there is no standard for treating BRONJ; we share our experience with satisfactory results after using teriparatide, which might be a promising solution for ONJ.

REFERENCES

  1. 1.↵
    1. Lau AN,
    2. Adachi JD
    . Resolution of osteonecrosis of the jaw after teriparatide [recombinant human PTH-(1-34)] therapy. J Rheumatol 2009;36:1835–7.
    OpenUrlFREE Full Text
  2. 2.↵
    1. Cartsos VM,
    2. Zhu S,
    3. Zavras AI
    . Bisphosphonate use and the risk of adverse jaw outcomes: a medical claims study of 714,217 people. J Am Dent Assoc 2008;139:23–30.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    1. Khan AA,
    2. Sandor GK,
    3. Dore E,
    4. Morrison AD,
    5. Alsahli M,
    6. Amin F,
    7. et al.
    Bisphosphonate associated osteonecrosis of the jaw. J Rheumatol 2009;36:478–90.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Yu CT,
    2. Wu JK,
    3. Chang CC,
    4. Chen CL,
    5. Wei JC
    . Early callus formation in human hip fracture treated with internal fixation and teriparatide. J Rheumatol 2008;35:2082–3.
    OpenUrlFREE Full Text
View Abstract
PreviousNext
Back to top

In this issue

The Journal of Rheumatology
Vol. 37, Issue 3
1 Mar 2010
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
More on the Resolution of Bisphosphonate-associated Osteonecrosis of the Jaw
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
More on the Resolution of Bisphosphonate-associated Osteonecrosis of the Jaw
KUO-YANG TSAI, CHIN-SHENG HUANG, GUAN-MIN HUANG, CHEN-TUNG YU
The Journal of Rheumatology Mar 2010, 37 (3) 675; DOI: 10.3899/jrheum.091022

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
More on the Resolution of Bisphosphonate-associated Osteonecrosis of the Jaw
KUO-YANG TSAI, CHIN-SHENG HUANG, GUAN-MIN HUANG, CHEN-TUNG YU
The Journal of Rheumatology Mar 2010, 37 (3) 675; DOI: 10.3899/jrheum.091022
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Bookmark this article

Jump to section

  • Article
    • REFERENCES
  • Figures & Data
  • Info & Metrics
  • References
  • PDF
  • eLetters

Related Articles

Cited By...

More in this TOC Section

  • Dr. Putman et al reply
  • Drs. Chung and McMahan reply
  • Drs. Meer and Ogdie reply
Show more Correspondence

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2022 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire