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Stomatologija 2022; 24 (3): 63-70 208 KB

Management of bisphosphonate-related osteonecrosis of the jaw using teriparatide treatment: A systematic review

Abdulla Varoneckas¹, Rokas Gelažius¹, Vykintas Pliavga², Marijus Leketas¹, Ričardas Kubilius¹, Mariam Varoneckaitė²

Summary

Objective. To systematically review the current literature and determine whether the additional TPTD administration for patients with BRONJ is an effective treatment modality.

Material and methods. The systematic review was registered in the PROSPERO (CRD42021242796) and conducted according to the PRISMA statement. An electronic search was performed using MEDLINE (PubMed), ScienceDirect, The Cochrane Library and LILACS databases using a combination of the keywords "Bisphosphonate-Associated Osteonecrosis of the Jaw"[Mesh], “treatment” to identify studies published from 2010.

Results. The authors found 8 articles that met the inclusion criteria of this systematic review. According to two studies, TPTD was statistically significantly associated with a greater BRONJ lesion resolution, compared to control group (p<0.05). However, one article showed no significant difference in proportion of resolved lesions (p=0.478). Regarding the effectiveness of TPTD treatment according to administration frequency, daily injection group showed no significant changes in the clinical stage of BRONJ, no difference in the percentage of bone formation on patients osteolysis, compared to weekly injections. Concerning bone resorption/regeneration markers, all the included studies showed that bone resorption markers significantly increased after 3-month TPTD administration. In a study which used multivariate analysis between TPTD and non-TPTD groups using age, BMI, duration of BP usage, the difference in s-OC values after 3 months of the treatment was significant (p<0.05).

Conclusion. This review provides evidence for the potential benefits of additional TPTD administration for patients with BRONJ being an effective treatment modality.

Key words: teriparatide, diphosphonates, bisphosphonate-associated osteonecrosis of the jaw, osteonecrosis.

Received: 27 04 2022

Accepted for publishing: 26 09 2022

¹Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania

²Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania

Address correspondence to Abdulla Varoneckas, Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Savanoriu pr. 276-38, Kaunas, Lithuania.

E-mail address: abudzio@gmail.com



	Baltic Dental and Maxillofacial Journal

2022, Vol. 24, No. 3 CONTENTS REVIEW Management of bisphosphonate-related osteonecrosis of the jaw using teriparatide treatment: A systematic review Abdulla Varoneckas, Rokas Gelažius, Vykintas Pliavga, Marijus Leketas, Ričardas Kubilius, Mariam Varoneckaitė 63-70 SCIENTIFIC ARTICLES Short-term postoperative changes in temporomandibular joints and masticatory muscles of Angle class II patients after mandibular advancement surgery: Clinical findings Heleia Nestal Zibo, Aleksei Baburin, Tiia Tamme, Ülle Voog-Oras 71-79 Photobiomodulation laser therapy in pemphigus vulgaris oral lesions: A randomized, double-blind, controlled study Francesca Amadori, Elena Bardellini, Federica Veneri, Alessandra Majorana 80-84 CASE REPORT Bardach’s triple-legged rotation flap as single-staged 3D helical upper-third reconstruction: A technical note Annette Wunsch, Andreas Neff, Jean-Paul Meningaud, Keskanya Subbalekha, Nattapong Sirintawat, Poramate Pitak-Arnnop 85-88 © 2023 Stomatologija		Stomatologija 2022; 24 (3): 63-70 208 KB Management of bisphosphonate-related osteonecrosis of the jaw using teriparatide treatment: A systematic review Abdulla Varoneckas¹, Rokas Gelažius¹, Vykintas Pliavga², Marijus Leketas¹, Ričardas Kubilius¹, Mariam Varoneckaitė² Summary Objective. To systematically review the current literature and determine whether the additional TPTD administration for patients with BRONJ is an effective treatment modality. Material and methods. The systematic review was registered in the PROSPERO (CRD42021242796) and conducted according to the PRISMA statement. An electronic search was performed using MEDLINE (PubMed), ScienceDirect, The Cochrane Library and LILACS databases using a combination of the keywords "Bisphosphonate-Associated Osteonecrosis of the Jaw"[Mesh], “treatment” to identify studies published from 2010. Results. The authors found 8 articles that met the inclusion criteria of this systematic review. According to two studies, TPTD was statistically significantly associated with a greater BRONJ lesion resolution, compared to control group (p<0.05). However, one article showed no significant difference in proportion of resolved lesions (p=0.478). Regarding the effectiveness of TPTD treatment according to administration frequency, daily injection group showed no significant changes in the clinical stage of BRONJ, no difference in the percentage of bone formation on patients osteolysis, compared to weekly injections. Concerning bone resorption/regeneration markers, all the included studies showed that bone resorption markers significantly increased after 3-month TPTD administration. In a study which used multivariate analysis between TPTD and non-TPTD groups using age, BMI, duration of BP usage, the difference in s-OC values after 3 months of the treatment was significant (p<0.05). Conclusion. This review provides evidence for the potential benefits of additional TPTD administration for patients with BRONJ being an effective treatment modality. Key words: teriparatide, diphosphonates, bisphosphonate-associated osteonecrosis of the jaw, osteonecrosis. Received: 27 04 2022 Accepted for publishing: 26 09 2022 ¹Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania ²Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania Address correspondence to Abdulla Varoneckas, Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Savanoriu pr. 276-38, Kaunas, Lithuania. E-mail address: abudzio@gmail.com