Promising New Treatment Plan for Jaw Osteonecrosis

Wednesday, December 11, 2019 Dental News
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Current treatments for osteonecrosis, a complication of dental implants, are not always effective. In a new study published in JOI, researchers from the Oral Science Research Center in Korea find a promising new treatment plan for jaw osteonecrosis.

LAWRENCE, Kan., Dec. 10, 2019 /PRNewswire-PRWeb/ -- Journal of Oral Implantology – Dental implants are a key treatment for tooth loss but can result in a variety of complications. One such complication is bone tissue death, known as osteonecrosis, which can result when patients take drugs, such as bisphosphonates, for bone diseases. Current treatments for osteonecrosis are not always effective. However, a recent case study in the Journal of Oral Implantology describes the successful treatment of a patient with osteonecrosis by using a new regimen.

Researchers from the Oral Science Research Center in Korea were presented with an 85-year-old woman with osteoporosis whose 1-year-old dental implant caused pain. They performed an oral clinical examination and X-ray that revealed exposed and dead bone, swelling, redness and discharge around the implant site. During treatment they tested the initial levels of C-telopeptide (CTx), a compound that is an indicator of bone turnover (resorption of old bone and replacement with new), and osteocalcin, a protein involved in bone formation. The patient was first provided with a conventional treatment of chlorhexidine rinse, antibiotics and analgesics, but experienced no improvement after 3 months. Next, the patient was given weekly injections of teriparatide for 8 weeks and monitored for any side effects. The clinicians detailed numerous improvements that were seen throughout the treatment period as well as 6 months after the treatment. Notably, the dead bone spontaneously disappeared, wounds healed, the CTx level improved from 121 pg/mL to 294 pg/mL, and the osteocalcin level increased from 12.8 ng/mL to 18.5 ng/mL, all of which correspond to an increase in bone formation.

In most cases that have used teriparatide successfully to treat osteonecrosis, it was administered daily. However, the authors found that weekly administration helped mitigate possible side effects while still providing significant patient improvement without the need for surgery. Additionally, the authors pointed out that a weekly dose allowed medical staff to administer the drug (instead of patient injections) and more closely monitor the patient's progress, as some side effects may occur. Going forward, the authors suggested that more studies with a larger group of patients and investigation into the longer-term effects of teriparatide are needed.

Full text of the article "Treatment of Medication-Related Osteonecrosis of the Jaw Around the Dental Implant With a Once-Weekly Teriparatide: A Case Report and Literature Review," Journal of Oral Implantology, is available at https://doi.org/10.1563/aaid-joi-D-19-00040.

About the Journal of Oral Implantology The Journal of Oral Implantology is the official publication of the American Academy of Implant Dentistry and of the American Academy of Implant Prosthodontics. It is dedicated to providing valuable information to general dentists, oral surgeons, prosthodontists, periodontists, scientists, clinicians, laboratory owners and technicians, manufacturers, and educators. The JOI distinguishes itself as the first and oldest journal in the world devoted exclusively to implant dentistry. For more information about the journal or the society, please visit http://www.joionline.org

 

SOURCE Journal of Oral Implantology



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