Teriparatide Therapy for Alendronate-Associated Osteonecrosis of the Jaw

To the Editor: An 88-year-old woman presented to our clinic with a 12-month history of pain, suppuration, and failed healing of a mandibular socket after tooth extraction, despite debridement and the administration of antibiotics. Computed tomographic imaging revealed necrosis of the left mandible consistent with the diagnosis of osteonecrosis of the jaw (Figure 1A and 1B). For 20 years, the patient had been taking prednisolone (at a dose of 5 mg per day) for the treatment of asthma. After a hip fracture 10 years earlier, she had begun taking 70 mg of alendronate per week, along with daily calcium carbonate (1500 mg) . . .