Nicotinamide (NAM), a water-soluble derivative of vitamin B3, has emerged as a potential therapeutic agent for bonerelated disorders. In particular, it promotes bone metabolism and alleviates delayed tooth eruptions associated with cleidocranial dysplasia (CCD). NAM serves as a precursor for nicotinamide adenine dinucleotide, a key coenzyme involved in cellular metabolism that plays an essential role in oxidative phosphorylation and mitochondrial function. Recent research has highlighted the capacity of NAM to enhance osteogenic differentiation and regulate the interaction between osteoblasts and osteoclasts, which is critical for maintaining bone homeostasis. Moreover, the effect of NAM in preventing delayed tooth eruptions in CCD models underscores its potential as a noninvasive therapeutic option. Considering its safety profile and therapeutic potential, NAM is a promising candidate for longterm treatment of bone diseases and prevention of age-related bone disorders.

Main Text
    1. General features of nicotinamide
    2. Role of NAM in NAD+ biosynthesis and cellmetabolism
    3. Role of NAM in sirtuin regulation and bonemetabolism
    4. Medical significance and therapeutic potential ofNAM
NAM Metabolism in Tooth Eruption
    1. Genetic factors influencing delayed tooth eruption
    2. NAM rescues delayed tooth eruption in cleidocranialdysplasia
NAM Metabolism in Osteogenesis
    1. Problems in osteogenesis and NAM metabolism
    2. Regulation of NAM metabolism linked to osteoblastdifferentiation
Conclusion
Funding
Conflicts of Interest
References

• Heein Yoon(Department of Molecular Genetics and Dental Pharmacology, Dental Multiomics Center, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea)
• Woo-Jin Kim(Department of Molecular Genetics and Dental Pharmacology, Dental Multiomics Center, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea)
• Young-Dan Cho(Department of Periodontology, Seoul National University Dental Hospital, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Republic of Korea)
• Hyun-Mo Ryoo(Department of Molecular Genetics and Dental Pharmacology, Dental Multiomics Center, Dental Research Institute, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea) Corresponding author