Parathyroid Hormone for Medication‐Related Osteonecrosis of the Jaw: A Systematic Review and Meta‐Analysis

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ) is a complication of antiresorptive therapy and can be refractory to treatment. Teriparatide (TPTD) has shown promise in the management of MRONJ. We aimed to comprehensively evaluate the impact of TPTD on MRONJ prevention and healing. METHODS: We systematically searched PubMed, Web of Science, Embase, Ovid, and LILACS in December 2024 to include studies that utilized TPTD/abaloparatide MRONJ management or prevention. Correlation analysis, meta-analysis, and meta-regression analysis were conducted. Quality assessment was performed using the Joanna Briggs Institute tool. RESULTS: All studies used TPTD for MRONJ management. Twenty-eight studies with 278 participants were included (TPTD n = 161; non-TPTD n = 117). MRONJ improvement was noted in 90.1% of the TPTD-treated group and 81.2% in the non-TPTD-treated group (odds ratio 5.81). The highest resolution rates were observed among patients who received a combination of surgical and non-surgical interventions for MRONJ in both groups. CONCLUSIONS: Our results suggest a possible positive effect of TPTD on MRONJ resolution, and TPTD may have a synergistic effect when combined with surgical and non-surgical interventions. These results must be interpreted with caution since analyses were based on publications with a small number of cases and with variable outcome assessment reporting.