Osteoporosis drug rebuilds bone in patients with perio disease

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A drug marketed to grow bone in osteoporosis patients also works to heal bone wounds in patients with periodontal disease, a University of Michigan study suggests (New England Journal of Medicine, October 16, 2010).

The generic name of the drug is teriparatide, and it is marketed by Eli Lilly under the brand 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 U.S. Typically, osteoporosis drugs work by preventing bone loss.

"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, D.D.S., M.S., a clinical assistant professor at the University of Michigan School of Dentistry and lead author on the study, in a press release. "Current treatments to regrow bone around teeth affected with gum disease have limited success rates."

The study took place at the School of Dentistry's Michigan Center for Oral Health Research, where patients with severe chronic periodontal disease received the traditional treatment: periodontal surgery on one-quarter of the mouth. Half of the patients took a six-week course of teriparatide by injection into the skin over the abdomen or stomach, plus calcium and vitamin D supplements, while the other half received a placebo.

After one year, researchers saw a 29% improvement in bone level measurements on x-rays in the teriparatide group, versus a 3% improvement in the placebo group -- a tenfold increase.

"I think one really interesting aspect of this study is that even a short dosing of this drug had benefits that lasted a year," said Laurie McCauley, D.D.S., M.S., Ph.D., a University of Michigan professor and chair of periodontics and oral medicine and principal investigator on the study.

Dr. McCauley's research lab has spent nearly two decades studying how parathyroid hormone works. Animal models suggest that it works even better in certain bone wound-healing situations, such as those that involve surgery, than in osteoporosis, which is a diminishing of the bone rather than a wound.

"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 Dr. McCauley, who noted that this proved true in the experimental group.

She said the next step is for 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 findings were presented October 16 at the annual meeting of the American Society for Bone and Mineral Research (ASBMR) in Toronto.

Copyright © 2010 DrBicuspid.com

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