Purpose: Diffuse sclerosing osteomyelitis (DSO) is a rare disease of the jaw bone. Its treatment is challenging. Different medical and surgical treatment protocols have been proposed; however, none of these treatment protocols produce reliable results. Recently, ibandronate administration has been attempted as a treatment alternative in acute cases of DSO. Due to the similar antiresorptive effect, we sought to explore the application of the human monoclonal antibody to the receptor activator of nuclear factor kappaB ligand (RANKL), denosumab, in the treatment of DSO.
Materials and methods: One female patient with histologically verified DSO received subcutaneous injections of denosumab (Prolia® 60 mg). The further course of the disease was followed clinically and by radiography and scintigraphy.
Results: In this case, the use of denosumab displayed promising results in aiding pain relief and reducing inflammatory activity.
Conclusion: We suggest that antiresorptive treatment with denosumab can be considered as an alternative treatment for patients suffering from DSO. However further studies, with respect to clarifying the mechanisms of action and defining the necessary medication dose as well as application intervals, have to be conducted.
Keywords: Antiresorptive treatment; Denosumab; Diffuse sclerosing osteomyelitis; Jaw osteonecrosis; MRONJ; Osteoclast.
Copyright © 2017. Published by Elsevier Ltd.