Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

Whei-Lin Pan,1,2 Pi-Lun Chen,2 Cho-Ying Lin,1,2 Yi-Chun Pan,2 Yuh-Ren Ju,1,2 Chiu-Po Chan,1,2 Robert WW Hsu2,3 1Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; 2Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; 3Department of Or...

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Autores principales:	Pan WL, Chen PL, Lin CY, Pan YC, Ju YR, Chan CP, Hsu RW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Bisphosphonate-related osteonecrosis of the jaw BRONJ Bisphosphonates Strontium ranelate Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/5fa9082d1ff743838123591dbc87e04b
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spelling	oai:doaj.org-article:5fa9082d1ff743838123591dbc87e04b2021-12-02T00:07:12ZStrontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report1178-1998https://doaj.org/article/5fa9082d1ff743838123591dbc87e04b2017-07-01T00:00:00Zhttps://www.dovepress.com/strontium-ranelate-treatment-in-a-postmenopausal-woman-with-osteonecro-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Whei-Lin Pan,1,2 Pi-Lun Chen,2 Cho-Ying Lin,1,2 Yi-Chun Pan,2 Yuh-Ren Ju,1,2 Chiu-Po Chan,1,2 Robert WW Hsu2,3 1Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; 2Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; 3Department of Orthopedics, Chang Gung Memorial Hospital, Taipei, Taiwan Abstract: Bisphosphonates (BPs) suppress bone resorption and increase bone strength, thus reducing the risk of fracture. Oral BPs are widely used for the prevention and treatment of osteoporosis and osteopenia. Here, we describe the case of a postmenopausal woman who took oral alendronate for >3 years for osteoporosis. The patient presented at the clinic with sharp jaw pain and swelling on the left mandible 4 months after extraction of the third molar. Clinical examinations identified an inflamed mucosal opening with pus over an area of necrotic bone. Initial images of cone beam computed tomography revealed a sequestrum at the extracted socket. The condition did not improve after 1 week of antibiotic treatment; therefore, the alendronate treatment was terminated and the patient was prescribed strontium ranelate instead. The patient gradually recovered and, at the 2-year follow-up, the site of BP-related osteonecrosis of the jaw healed completely as determined by both clinical and cone beam computed tomography measures. The bone mineral densities in the femoral neck and lumbar spine improved after 1 year, and were maintained at the 3-year follow-up. The serum C-terminal cross-linking telopeptide values also gradually increased from the initial 130 pg/mL to 320 pg/mL at the 3-year follow-up. Taken together, this case supports the use of strontium ranelate as an alternative treatment for postmenopausal women who receive long-term oral BP treatments and are at risk for serious complications of BP-related osteonecrosis of the jaw. Keywords: bisphosphonate-related osteonecrosis of the jaw, BRONJ, bisphosphonates, strontium ranelatePan WLChen PLLin CYPan YCJu YRChan CPHsu RWDove Medical PressarticleBisphosphonate-related osteonecrosis of the jawBRONJBisphosphonatesStrontium ranelateGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1089-1093 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Bisphosphonate-related osteonecrosis of the jaw BRONJ Bisphosphonates Strontium ranelate Geriatrics RC952-954.6
spellingShingle	Bisphosphonate-related osteonecrosis of the jaw BRONJ Bisphosphonates Strontium ranelate Geriatrics RC952-954.6 Pan WL Chen PL Lin CY Pan YC Ju YR Chan CP Hsu RW Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
description	Whei-Lin Pan,1,2 Pi-Lun Chen,2 Cho-Ying Lin,1,2 Yi-Chun Pan,2 Yuh-Ren Ju,1,2 Chiu-Po Chan,1,2 Robert WW Hsu2,3 1Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan; 2Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan; 3Department of Orthopedics, Chang Gung Memorial Hospital, Taipei, Taiwan Abstract: Bisphosphonates (BPs) suppress bone resorption and increase bone strength, thus reducing the risk of fracture. Oral BPs are widely used for the prevention and treatment of osteoporosis and osteopenia. Here, we describe the case of a postmenopausal woman who took oral alendronate for >3 years for osteoporosis. The patient presented at the clinic with sharp jaw pain and swelling on the left mandible 4 months after extraction of the third molar. Clinical examinations identified an inflamed mucosal opening with pus over an area of necrotic bone. Initial images of cone beam computed tomography revealed a sequestrum at the extracted socket. The condition did not improve after 1 week of antibiotic treatment; therefore, the alendronate treatment was terminated and the patient was prescribed strontium ranelate instead. The patient gradually recovered and, at the 2-year follow-up, the site of BP-related osteonecrosis of the jaw healed completely as determined by both clinical and cone beam computed tomography measures. The bone mineral densities in the femoral neck and lumbar spine improved after 1 year, and were maintained at the 3-year follow-up. The serum C-terminal cross-linking telopeptide values also gradually increased from the initial 130 pg/mL to 320 pg/mL at the 3-year follow-up. Taken together, this case supports the use of strontium ranelate as an alternative treatment for postmenopausal women who receive long-term oral BP treatments and are at risk for serious complications of BP-related osteonecrosis of the jaw. Keywords: bisphosphonate-related osteonecrosis of the jaw, BRONJ, bisphosphonates, strontium ranelate
format	article
author	Pan WL Chen PL Lin CY Pan YC Ju YR Chan CP Hsu RW
author_facet	Pan WL Chen PL Lin CY Pan YC Ju YR Chan CP Hsu RW
author_sort	Pan WL
title	Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
title_short	Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
title_full	Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
title_fullStr	Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
title_full_unstemmed	Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
title_sort	strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/5fa9082d1ff743838123591dbc87e04b
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Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report

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