Do you recommend a particular antiresorptive/anabolic agent for patients who are at high risk for fractures but have high risk of osteonecrosis of the jaw?

Teriparatide has improved bone healing in patients with osteonecrosis of the jaw, so would be a good choice for patients at high risk of ONJ.

PTH analogues are the only osteoporotic medications that do not have the risk of ONJ. Romosozumab has antiresorptive features and has been reported to cause ONJ.

Either would be effective but there would be greater risk with Prolix.