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https://hdl.handle.net/2440/50647
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dc.contributor.author | Kunchur, R. | - |
dc.contributor.author | Need, A. | - |
dc.contributor.author | Hughes, T. | - |
dc.contributor.author | Goss, A. | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | Journal of Oral and Maxillofacial Surgery, 2009; 67(6):1167-1173 | - |
dc.identifier.issn | 0278-2391 | - |
dc.identifier.issn | 1531-5053 | - |
dc.identifier.uri | http://hdl.handle.net/2440/50647 | - |
dc.description | Crown copyright © 2009 Published by Elsevier Inc. | - |
dc.description.abstract | <h4>Purpose</h4>The aim of this study was to determine, in a clinical setting, the effectiveness of the C-terminal cross-linking telopeptide test (CTX) test in the prevention and management of osteonecrosis of the jaws (ONJ) in patients taking bisphosphonates.<h4>Patients and methods</h4>A total of 348 patients underwent a fasted morning CTX test. Of these, 222 were patients at risk of ONJ who had been referred for extractions, 15 had ONJ, and 113 were controls.<h4>Results</h4>The 215 patients taking long-term oral bisphosphonates were older (71 +/- 11.6 years), were predominantly women with osteoporosis, and were medically compromised. The average CTX value was 238 +/- 144 pg/mL, with 98 having a value less than 200 pg/mL. One patient with a CTX value of 126 pg/mL developed ONJ after an extraction. Seven intravenous bisphosphonate patients underwent extractions with no cases of ONJ developing. The CTX value was 329 +/- 354, with 4 less than 200 pg/mL. Fifteen patients developed ONJ, 12 after extractions and 3 spontaneously. Of these, 7, who were still taking a bisphosphonate at presentation, had a CTX value of 116 pg/mL. A CTX value of less than 150 pg/mL did not correlate with the clinical risk factors of age, gender, comorbidities, bone disease, or bisphosphonate duration. A statistically significant difference in the CTX value was found for those taking alendronate compared with those taking risedronate (P < .0001). If the bisphosphonate was ceased, the CTX value increased at approximately 25 pg/mL per month.<h4>Conclusions</h4>The CTX test is not predictive of the development of ONJ for an individual patient but does identify those in the "risk zone," which is a value of less than 150 pg/mL to 200 pg/mL. If medically appropriate, the bisphosphonate can be ceased so that the CTX value increases to bring the patient out of the "risk zone." | - |
dc.description.statementofresponsibility | Ranjit Kunchur, Allan Need, Toby Hughes and Alastair Goss | - |
dc.description.uri | http://www.elsevier.com/wps/find/journaldescription.cws_home/623146/description#description | - |
dc.language.iso | en | - |
dc.publisher | W B Saunders Co | - |
dc.source.uri | http://dx.doi.org/10.1016/j.joms.2009.02.004 | - |
dc.subject | Humans | - |
dc.subject | Osteoporosis | - |
dc.subject | Osteonecrosis | - |
dc.subject | Jaw Diseases | - |
dc.subject | Chronic Disease | - |
dc.subject | Diphosphonates | - |
dc.subject | Alendronate | - |
dc.subject | Etidronic Acid | - |
dc.subject | Collagen Type I | - |
dc.subject | Peptides | - |
dc.subject | Tooth Extraction | - |
dc.subject | Administration, Oral | - |
dc.subject | Injections, Intravenous | - |
dc.subject | Risk Factors | - |
dc.subject | Predictive Value of Tests | - |
dc.subject | Age Factors | - |
dc.subject | Sex Factors | - |
dc.subject | Immunocompromised Host | - |
dc.subject | Aged | - |
dc.subject | Aged, 80 and over | - |
dc.subject | Middle Aged | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.subject | Bone Density Conservation Agents | - |
dc.subject | Biomarkers | - |
dc.subject | Risedronic Acid | - |
dc.title | Clinical Investigation of C-Terminal Cross-Linking Telopeptide Test in Prevention and Management of Bisphosphonate-Associated Osteonecrosis of the Jaws | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1016/j.joms.2009.02.004 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Hughes, T. [0000-0001-8668-7744] | - |
dc.identifier.orcid | Goss, A. [0000-0002-2658-3836] | - |
Appears in Collections: | Aurora harvest Dentistry publications |
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