Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction of Risk Using Serum CTX Testing, Prevention, and Treatment

Use of the plasma CTX for assessing the bone activity of the mandible among osteopenic and osteoporotic patients

“…All this evidence is concordant with the literature, 21 in which CTX is indicated as an efficient and reliable clinical method for monitoring not only the metabolic activity of bone tissue but also the therapeutic efficacy of the drugs used in treating osteoporosis. 13,22 It is important to emphasize that correlations must be made while always taking into account each patient's clinical information since, otherwise, errors may be made in interpreting the data.…”

Adverse Effects of Bisphosphonates: Implications for Osteoporosis Management

“…In their report of 30 cases of ONJ associated with oral bisphosphonate use, Marx et al 17 suggested that serum CTX levels be used to stratify patients receiving bisphosphonate therapy as having low, moderate, or high risk of developing ONJ. Unfortunately, the described report did not include any control patients who were receiving bisphosphonates but did not have ONJ, nor were any indices of bone remodeling on any patient before bisphosphonate initiation available.…”

Dental extractions and bisphosphonates: the assessment, consent and management, a proposed algorithm

“…27 In BONJ the most common pathogens, based on culture and sensitivity tests, are considered to be Actinomyces, Eikenella and Moraxella species. 28 Therefore penicillin V (phenoxymethylpenicillin) 500 mg four times per day is a suitable antibacterial drug. In penicillin allergic patients, doxycycline 100 mg once daily is suitable.…”