jheieck, I asked a trusted consultant. His response:

" [F]or patients treated with a potent anti-resorptive drug who may experience ONJ, my first choice is to switch them to an anabolic drug, usually either teriparaide (Forteo) or abaloparatide (Tymlos), in order to help heal the ONJ. However, studies show that taking teripararatide AFTER denosumab (Prolia) can cause temporary bone loss at the spine and hip, and perhaps permanent bone loss at the 100% cortical bone radius shaft.The way I would tend to manage this in a patient on Prolia would be to do conservative management of the ONJ while the patient is awaiting her next injection of Prolia, and plan to treat with teriparatide about when the next injection of Prolia was due. Not to treat her osteoporosis, but rather to help heal her ONJ. It usually heals within a 6-month treatment course. Then transition the patient to the antiresorptive drug of her choice - either oral alendronate sodium, or IV zoledronic acid (neither of which is quite as anti-resorptive as denosumab (Prolia), or transdermal estradiol at a dose of at least 37.5 mg along with micronized progesterone at an oral dose of 100 mg at bedtime."