Osteoporosis Drug, Forteo, Builds Bone in Patients With Gum Disease

I came across a very interesting study the other day which has important implications for the dental profession.  Forteo, a drug marketed to grow bone in osteoporosis patients, also works to heal bone wounds in gum disease patients, a University of Michigan study suggests.  “This new approach for the treatment of periodontal disease could allow us to rebuild some of the bone that is lost due to periodontal disease, which until this point has been very difficult to achieve,” said Jill Bashutski, clinical assistant professor at the U-M School of Dentistry and first author on the study. “Current treatments to re-grow bone around teeth affected with gum disease have limited success rates.”  The findings are significant because gum disease is the leading cause of tooth loss in adults and is associated with a host of other health problems. Periodontal disease results in loss of teeth and can be devastating because it compromises speaking as well as eating, which can in turn contribute to poor nutrition.

The generic name of the drug is teriparatide and it is marketed by Eli Lilly and Co. under the trade name Forteo. It’s a type of parathyroid hormone and the only anabolic (meaning it grows bone) osteoporosis drug approved on the market in the United States. Typically, other types of osteoporosis drugs such as bisphosphonates work by preventing bone loss.  With bisphosphonates, there is a risk that long term use may lead to ONJ, osteonecrosis of the jawbone.

“There was speculation that the bone that forms in a wound like a fracture or inflammatory disease condition might be more responsive to being built back than other bone,” said McCauley, who noted that this proved true in the experimental group.McCauley said the next step is for U-M researchers to test whether the treatment could be delivered locally to target site-specific bone healing. Forteo is not FDA approved for uses other than osteoporosis, but another possible application could be to help grow bone around dental implants.

The study appeared online in the New England Journal of Medicine Oct. 16 and in the print edition Oct. 28. The study was presented Oct. 16 in Toronto at the annual meeting of the American Society for Bone and Mineral Research.

In our periodontal practice, we have used Forteo, prescribed and supervised by the patient’s medical doctor, with great success to aid in bone regeneration in severely osteoporotic patients prior to dental implant surgery. Although anecdotal, the outcomes are quite remarkable.  Has anyone else had similar experiences?  Your comments are appreciated.

Source:  Science Daily

Journal Reference:

Jill D. Bashutski, Robert M. Eber, Janet S. Kinney, Erika Benavides, Samopriyo Maitra, Thomas M. Braun, William V. Giannobile, Laurie K. McCauley. Teriparatide and Osseous Regeneration in the Oral Cavity. New England Journal of Medicine, 2010; 101016083039040 DOI: 10.1056/NEJMoa1005361