Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
Identifieur interne : 000055 ( Main/Exploration ); précédent : 000054; suivant : 000056Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report
Auteurs : Whei-Lin Pan [Taïwan] ; Pi-Lun Chen [Taïwan] ; Cho-Ying Lin [Taïwan] ; Yi-Chun Pan [Taïwan] ; Yuh-Ren Ju [Taïwan] ; Chiu-Po Chan [Taïwan] ; Robert Ww Hsu [Taïwan]Source :
- Clinical Interventions in Aging [ 1176-9092 ] ; 2017.
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.
Url:
DOI: 10.2147/CIA.S141753
PubMed: 28744112
PubMed Central: 5513807
Affiliations:
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last="Pan">Whei-Lin Pan</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-12-1089">Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Periodontics, Chang Gung Memorial Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation></author><author><name sortKey="Chen, Pi Lun" sort="Chen, Pi Lun" uniqKey="Chen P" first="Pi-Lun" last="Chen">Pi-Lun Chen</name><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation></author><author><name sortKey="Lin, Cho Ying" sort="Lin, Cho Ying" uniqKey="Lin C" first="Cho-Ying" last="Lin">Cho-Ying Lin</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-12-1089">Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Periodontics, Chang Gung Memorial Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang 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Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation></author><author><name sortKey="Chan, Chiu Po" sort="Chan, Chiu Po" uniqKey="Chan C" first="Chiu-Po" last="Chan">Chiu-Po Chan</name><affiliation wicri:level="1"><nlm:aff id="af1-cia-12-1089">Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Periodontics, Chang Gung Memorial Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation></author><author><name sortKey="Hsu, Robert Ww" sort="Hsu, Robert Ww" uniqKey="Hsu R" first="Robert Ww" last="Hsu">Robert Ww Hsu</name><affiliation wicri:level="1"><nlm:aff id="af2-cia-12-1089">Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="af3-cia-12-1089">Department of Orthopedics, Chang Gung Memorial Hospital, Taipei, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Department of Orthopedics, Chang Gung Memorial Hospital, Taipei</wicri:regionArea><wicri:noRegion>Taipei</wicri:noRegion></affiliation></author></analytic><series><title level="j">Clinical Interventions in Aging</title><idno type="ISSN">1176-9092</idno><idno type="eISSN">1178-1998</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>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.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Marx, Re" uniqKey="Marx R">RE Marx</name></author><author><name sortKey="Stern, D" uniqKey="Stern D">D Stern</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ruggiero, Sl" uniqKey="Ruggiero S">SL Ruggiero</name></author><author><name sortKey="Dodson, Tb" uniqKey="Dodson T">TB Dodson</name></author><author><name sortKey="Fantasia, J" uniqKey="Fantasia J">J Fantasia</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Paiva Fonseca, F" uniqKey="Paiva Fonseca F">F Paiva-Fonseca</name></author><author><name sortKey="Santos Silva, Ar" uniqKey="Santos Silva A">AR 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last="Chan">Chiu-Po Chan</name><name sortKey="Chan, Chiu Po" sort="Chan, Chiu Po" uniqKey="Chan C" first="Chiu-Po" last="Chan">Chiu-Po Chan</name><name sortKey="Chen, Pi Lun" sort="Chen, Pi Lun" uniqKey="Chen P" first="Pi-Lun" last="Chen">Pi-Lun Chen</name><name sortKey="Hsu, Robert Ww" sort="Hsu, Robert Ww" uniqKey="Hsu R" first="Robert Ww" last="Hsu">Robert Ww Hsu</name><name sortKey="Hsu, Robert Ww" sort="Hsu, Robert Ww" uniqKey="Hsu R" first="Robert Ww" last="Hsu">Robert Ww Hsu</name><name sortKey="Ju, Yuh Ren" sort="Ju, Yuh Ren" uniqKey="Ju Y" first="Yuh-Ren" last="Ju">Yuh-Ren Ju</name><name sortKey="Ju, Yuh Ren" sort="Ju, Yuh Ren" uniqKey="Ju Y" first="Yuh-Ren" last="Ju">Yuh-Ren Ju</name><name sortKey="Lin, Cho Ying" sort="Lin, Cho Ying" uniqKey="Lin C" first="Cho-Ying" last="Lin">Cho-Ying Lin</name><name sortKey="Lin, Cho Ying" sort="Lin, Cho Ying" uniqKey="Lin C" first="Cho-Ying" last="Lin">Cho-Ying Lin</name><name sortKey="Pan, Whei Lin" sort="Pan, Whei Lin" uniqKey="Pan W" first="Whei-Lin" last="Pan">Whei-Lin Pan</name><name sortKey="Pan, Yi Chun" sort="Pan, Yi Chun" uniqKey="Pan Y" first="Yi-Chun" last="Pan">Yi-Chun Pan</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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