Strontium ranelate therapy in a postmenopausal girl with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report.
Clin Interv Growing older. 2017;12:1089-1093
Authors: Pan WL, Chen PL, Lin CY, Pan YC, Ju YR, Chan CP, Hsu RW
Bisphosphonates (BPs) suppress bone resorption and improve bone energy, thus decreasing the danger of fracture. Oral BPs are extensively used for the prevention and therapy of osteoporosis and osteopenia. Right here, we describe the case of a postmenopausal girl who took oral alendronate for >Three years for osteoporosis. The affected person offered on the clinic with sharp jaw ache and swelling on the left mandible four months after extraction of the third molar. Scientific examinations recognized an infected mucosal opening with pus over an space of necrotic bone. Preliminary photographs of cone beam computed tomography revealed a sequestrum on the extracted socket. The situation didn’t enhance after 1 week of antibiotic therapy; due to this fact, the alendronate therapy was terminated and the affected person was prescribed strontium ranelate as a substitute. The affected person regularly recovered and, on the 2-year follow-up, the positioning of BP-related osteonecrosis of the jaw healed fully as decided by each scientific and cone beam computed tomography measures. The bone mineral densities within the femoral neck and lumbar backbone improved after 1 yr, and have been maintained on the Three-year follow-up. The serum C-terminal cross-linking telopeptide values additionally regularly elevated from the preliminary 130 pg/mL to 320 pg/mL on the Three-year follow-up. Taken collectively, this case helps the usage of strontium ranelate instead therapy for postmenopausal ladies who obtain long-term oral BP therapies and are in danger for severe issues of BP-related osteonecrosis of the jaw.
PMID: 28744112 [PubMed – indexed for MEDLINE]