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Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers
Background and objective The most common risk factor for bisphosphonate-related osteonecrosis of the jaws (BRONJ) is dentoalveolar surgery. It has been suggested that reduced serum C-terminal telopeptide (CTX) can determine the degree of osteoclast suppression and may predict the development of BRON...
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| Published in: | Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2010-10, Vol.110 (4), p.509-516 |
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| description | Background and objective The most common risk factor for bisphosphonate-related osteonecrosis of the jaws (BRONJ) is dentoalveolar surgery. It has been suggested that reduced serum C-terminal telopeptide (CTX) can determine the degree of osteoclast suppression and may predict the development of BRONJ after dentoalveolar surgery. Although there are many radiographic appearances associated with BRONJ, there are little data that describes changes preceding dentoalveolar surgery. The objective of this retrospective study was: 1) to investigate if reduced serum CTX values (i.e., |
| doi_str_mv | 10.1016/j.tripleo.2010.04.023 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_755405696</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1079210410002532</els_id><sourcerecordid>755405696</sourcerecordid><originalsourceid>FETCH-LOGICAL-c515t-fc2b0b9eeeb28b93fadc99804619dbec9643f3543a3954a6b94733f17ea298ce3</originalsourceid><addsrcrecordid>eNqFkktv1DAQxy0Eou3CRwD5gjhl8TOJOYDQqjykSiBRpN4sx5l0nc3GW09S1G-Po11A4sLBGmv0n9dvhpAXnK054-Wbfj2lcBggrgXLPqbWTMhH5JxrURfS6JvH-c8qUwjO1Bm5QOwZY6U05ik5E6yslGLqnMC3BG3wUxhvaQq4o11MtAl42MbljW6CIsGQTUsjThBH8CliQBo7Om2B9u4nvqWb6xt6DwlnpMm1Id4md9gGT_cu7bL7GXnSuQHh-cmuyI-Pl9ebz8XV109fNh-uCq-5norOi4Y1BgAaUTdGdq71xtRMldy0DXhTKtlJraTLAypXNkZVUna8AidM7UGuyOtj3kOKdzPgZPcBPQyDGyHOaCutFdOlKbNSH5XLNJigs4cUcrcPljO7ALa9PQG2C2DLlM2Ac9zLU4W52UP7J-o30Sx4dRI49G7okht9wL86KYWqc9sr8v6og8zjPkCy6AOMPm8jgZ9sG8N_W3n3TwY_hDHkojt4AOzjnMYM23KLwjL7fbmG5Rh4vgOhpZC_AILCst4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>755405696</pqid></control><display><type>article</type><title>Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers</title><source>ScienceDirect Journals</source><creator>Fleisher, Kenneth E., DDS ; Welch, Garrett ; Kottal, Shailesh, DDS ; Craig, Ronald G., DMD, PhD ; Saxena, Deepak, MS, PhD ; Glickman, Robert S., DMD</creator><creatorcontrib>Fleisher, Kenneth E., DDS ; Welch, Garrett ; Kottal, Shailesh, DDS ; Craig, Ronald G., DMD, PhD ; Saxena, Deepak, MS, PhD ; Glickman, Robert S., DMD</creatorcontrib><description>Background and objective The most common risk factor for bisphosphonate-related osteonecrosis of the jaws (BRONJ) is dentoalveolar surgery. It has been suggested that reduced serum C-terminal telopeptide (CTX) can determine the degree of osteoclast suppression and may predict the development of BRONJ after dentoalveolar surgery. Although there are many radiographic appearances associated with BRONJ, there are little data that describes changes preceding dentoalveolar surgery. The objective of this retrospective study was: 1) to investigate if reduced serum CTX values (i.e., <150 pg/mL) were associated with BRONJ after dentoalveolar surgery; and 2) to determine if specific radiographic changes are associated with teeth that develop BRONJ after extraction. Study design A retrospective review of radiographic and/or serum CTX data was performed for 68 patients with a history of bisphosphonate therapy who either underwent dental extraction or were diagnosed with BRONJ in the Department of Oral and Maxillofacial Surgery during the period 2007-2009. Postoperative healing was assessed for 26 patients with reduced serum CTX levels (<150 pg/mL) who either underwent dental extraction or treatment for BRONJ. Preoperative radiographs were evaluated for 55 patients who either healed normally or developed BRONJ after dental extraction. Results All 26 patients (100%) who had serum CTX levels <150 pg/mL healed successfully after dentoalveolar surgery (20 patients) or after treatment for BRONJ (6 patients). Among the 55 patients who underwent radiographic evaluation, 24 patients (83%) with BRONJ exhibited periodontal ligament (PDL) widening associated with extracted teeth, whereas only 3 patients (11%) who healed normally demonstrated PDL widening. Conclusion These data suggest that radiographic PDL widening may be a more sensitive indicator than CTX testing in predicting risk of BRONJ. Current guidelines that recommend minimal surgical intervention may need to be revised to include alternative strategies for the elimination or management of this pathology.</description><identifier>ISSN: 1079-2104</identifier><identifier>EISSN: 1528-395X</identifier><identifier>DOI: 10.1016/j.tripleo.2010.04.023</identifier><identifier>PMID: 20674404</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Alveolar Bone Loss - diagnostic imaging ; Biological and medical sciences ; Bone Density Conservation Agents - adverse effects ; Bones, joints and connective tissue. Antiinflammatory agents ; Case-Control Studies ; Cohort Studies ; Collagen Type I - blood ; Dentistry ; Diphosphonates - adverse effects ; Diseases of the osteoarticular system ; Humans ; Jaw Diseases - blood ; Jaw Diseases - chemically induced ; Jaw Diseases - diagnosis ; Jaw Diseases - diagnostic imaging ; Medical sciences ; Osteonecrosis - blood ; Osteonecrosis - chemically induced ; Osteonecrosis - diagnosis ; Osteonecrosis - diagnostic imaging ; Otorhinolaryngology. Stomatology ; Peptides - blood ; Periodontal Ligament - diagnostic imaging ; Periodontal Ligament - pathology ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Radiography, Dental - methods ; Retrospective Studies ; Risk Factors ; Surgery ; Tooth Extraction - adverse effects ; Vascular bone diseases</subject><ispartof>Oral surgery, oral medicine, oral pathology, oral radiology and endodontics, 2010-10, Vol.110 (4), p.509-516</ispartof><rights>Mosby, Inc.</rights><rights>2010 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2010 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-fc2b0b9eeeb28b93fadc99804619dbec9643f3543a3954a6b94733f17ea298ce3</citedby><cites>FETCH-LOGICAL-c515t-fc2b0b9eeeb28b93fadc99804619dbec9643f3543a3954a6b94733f17ea298ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23324847$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20674404$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fleisher, Kenneth E., DDS</creatorcontrib><creatorcontrib>Welch, Garrett</creatorcontrib><creatorcontrib>Kottal, Shailesh, DDS</creatorcontrib><creatorcontrib>Craig, Ronald G., DMD, PhD</creatorcontrib><creatorcontrib>Saxena, Deepak, MS, PhD</creatorcontrib><creatorcontrib>Glickman, Robert S., DMD</creatorcontrib><title>Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers</title><title>Oral surgery, oral medicine, oral pathology, oral radiology and endodontics</title><addtitle>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</addtitle><description>Background and objective The most common risk factor for bisphosphonate-related osteonecrosis of the jaws (BRONJ) is dentoalveolar surgery. It has been suggested that reduced serum C-terminal telopeptide (CTX) can determine the degree of osteoclast suppression and may predict the development of BRONJ after dentoalveolar surgery. Although there are many radiographic appearances associated with BRONJ, there are little data that describes changes preceding dentoalveolar surgery. The objective of this retrospective study was: 1) to investigate if reduced serum CTX values (i.e., <150 pg/mL) were associated with BRONJ after dentoalveolar surgery; and 2) to determine if specific radiographic changes are associated with teeth that develop BRONJ after extraction. Study design A retrospective review of radiographic and/or serum CTX data was performed for 68 patients with a history of bisphosphonate therapy who either underwent dental extraction or were diagnosed with BRONJ in the Department of Oral and Maxillofacial Surgery during the period 2007-2009. Postoperative healing was assessed for 26 patients with reduced serum CTX levels (<150 pg/mL) who either underwent dental extraction or treatment for BRONJ. Preoperative radiographs were evaluated for 55 patients who either healed normally or developed BRONJ after dental extraction. Results All 26 patients (100%) who had serum CTX levels <150 pg/mL healed successfully after dentoalveolar surgery (20 patients) or after treatment for BRONJ (6 patients). Among the 55 patients who underwent radiographic evaluation, 24 patients (83%) with BRONJ exhibited periodontal ligament (PDL) widening associated with extracted teeth, whereas only 3 patients (11%) who healed normally demonstrated PDL widening. Conclusion These data suggest that radiographic PDL widening may be a more sensitive indicator than CTX testing in predicting risk of BRONJ. Current guidelines that recommend minimal surgical intervention may need to be revised to include alternative strategies for the elimination or management of this pathology.</description><subject>Alveolar Bone Loss - diagnostic imaging</subject><subject>Biological and medical sciences</subject><subject>Bone Density Conservation Agents - adverse effects</subject><subject>Bones, joints and connective tissue. Antiinflammatory agents</subject><subject>Case-Control Studies</subject><subject>Cohort Studies</subject><subject>Collagen Type I - blood</subject><subject>Dentistry</subject><subject>Diphosphonates - adverse effects</subject><subject>Diseases of the osteoarticular system</subject><subject>Humans</subject><subject>Jaw Diseases - blood</subject><subject>Jaw Diseases - chemically induced</subject><subject>Jaw Diseases - diagnosis</subject><subject>Jaw Diseases - diagnostic imaging</subject><subject>Medical sciences</subject><subject>Osteonecrosis - blood</subject><subject>Osteonecrosis - chemically induced</subject><subject>Osteonecrosis - diagnosis</subject><subject>Osteonecrosis - diagnostic imaging</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Peptides - blood</subject><subject>Periodontal Ligament - diagnostic imaging</subject><subject>Periodontal Ligament - pathology</subject><subject>Pharmacology. Drug treatments</subject><subject>Predictive Value of Tests</subject><subject>Radiography, Dental - methods</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Tooth Extraction - adverse effects</subject><subject>Vascular bone diseases</subject><issn>1079-2104</issn><issn>1528-395X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNqFkktv1DAQxy0Eou3CRwD5gjhl8TOJOYDQqjykSiBRpN4sx5l0nc3GW09S1G-Po11A4sLBGmv0n9dvhpAXnK054-Wbfj2lcBggrgXLPqbWTMhH5JxrURfS6JvH-c8qUwjO1Bm5QOwZY6U05ik5E6yslGLqnMC3BG3wUxhvaQq4o11MtAl42MbljW6CIsGQTUsjThBH8CliQBo7Om2B9u4nvqWb6xt6DwlnpMm1Id4md9gGT_cu7bL7GXnSuQHh-cmuyI-Pl9ebz8XV109fNh-uCq-5norOi4Y1BgAaUTdGdq71xtRMldy0DXhTKtlJraTLAypXNkZVUna8AidM7UGuyOtj3kOKdzPgZPcBPQyDGyHOaCutFdOlKbNSH5XLNJigs4cUcrcPljO7ALa9PQG2C2DLlM2Ac9zLU4W52UP7J-o30Sx4dRI49G7okht9wL86KYWqc9sr8v6og8zjPkCy6AOMPm8jgZ9sG8N_W3n3TwY_hDHkojt4AOzjnMYM23KLwjL7fbmG5Rh4vgOhpZC_AILCst4</recordid><startdate>20101001</startdate><enddate>20101001</enddate><creator>Fleisher, Kenneth E., DDS</creator><creator>Welch, Garrett</creator><creator>Kottal, Shailesh, DDS</creator><creator>Craig, Ronald G., DMD, PhD</creator><creator>Saxena, Deepak, MS, PhD</creator><creator>Glickman, Robert S., DMD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20101001</creationdate><title>Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers</title><author>Fleisher, Kenneth E., DDS ; Welch, Garrett ; Kottal, Shailesh, DDS ; Craig, Ronald G., DMD, PhD ; Saxena, Deepak, MS, PhD ; Glickman, Robert S., DMD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c515t-fc2b0b9eeeb28b93fadc99804619dbec9643f3543a3954a6b94733f17ea298ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Alveolar Bone Loss - diagnostic imaging</topic><topic>Biological and medical sciences</topic><topic>Bone Density Conservation Agents - adverse effects</topic><topic>Bones, joints and connective tissue. Antiinflammatory agents</topic><topic>Case-Control Studies</topic><topic>Cohort Studies</topic><topic>Collagen Type I - blood</topic><topic>Dentistry</topic><topic>Diphosphonates - adverse effects</topic><topic>Diseases of the osteoarticular system</topic><topic>Humans</topic><topic>Jaw Diseases - blood</topic><topic>Jaw Diseases - chemically induced</topic><topic>Jaw Diseases - diagnosis</topic><topic>Jaw Diseases - diagnostic imaging</topic><topic>Medical sciences</topic><topic>Osteonecrosis - blood</topic><topic>Osteonecrosis - chemically induced</topic><topic>Osteonecrosis - diagnosis</topic><topic>Osteonecrosis - diagnostic imaging</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Peptides - blood</topic><topic>Periodontal Ligament - diagnostic imaging</topic><topic>Periodontal Ligament - pathology</topic><topic>Pharmacology. Drug treatments</topic><topic>Predictive Value of Tests</topic><topic>Radiography, Dental - methods</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Tooth Extraction - adverse effects</topic><topic>Vascular bone diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fleisher, Kenneth E., DDS</creatorcontrib><creatorcontrib>Welch, Garrett</creatorcontrib><creatorcontrib>Kottal, Shailesh, DDS</creatorcontrib><creatorcontrib>Craig, Ronald G., DMD, PhD</creatorcontrib><creatorcontrib>Saxena, Deepak, MS, PhD</creatorcontrib><creatorcontrib>Glickman, Robert S., DMD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Oral surgery, oral medicine, oral pathology, oral radiology and endodontics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fleisher, Kenneth E., DDS</au><au>Welch, Garrett</au><au>Kottal, Shailesh, DDS</au><au>Craig, Ronald G., DMD, PhD</au><au>Saxena, Deepak, MS, PhD</au><au>Glickman, Robert S., DMD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers</atitle><jtitle>Oral surgery, oral medicine, oral pathology, oral radiology and endodontics</jtitle><addtitle>Oral Surg Oral Med Oral Pathol Oral Radiol Endod</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>110</volume><issue>4</issue><spage>509</spage><epage>516</epage><pages>509-516</pages><issn>1079-2104</issn><eissn>1528-395X</eissn><abstract>Background and objective The most common risk factor for bisphosphonate-related osteonecrosis of the jaws (BRONJ) is dentoalveolar surgery. It has been suggested that reduced serum C-terminal telopeptide (CTX) can determine the degree of osteoclast suppression and may predict the development of BRONJ after dentoalveolar surgery. Although there are many radiographic appearances associated with BRONJ, there are little data that describes changes preceding dentoalveolar surgery. The objective of this retrospective study was: 1) to investigate if reduced serum CTX values (i.e., <150 pg/mL) were associated with BRONJ after dentoalveolar surgery; and 2) to determine if specific radiographic changes are associated with teeth that develop BRONJ after extraction. Study design A retrospective review of radiographic and/or serum CTX data was performed for 68 patients with a history of bisphosphonate therapy who either underwent dental extraction or were diagnosed with BRONJ in the Department of Oral and Maxillofacial Surgery during the period 2007-2009. Postoperative healing was assessed for 26 patients with reduced serum CTX levels (<150 pg/mL) who either underwent dental extraction or treatment for BRONJ. Preoperative radiographs were evaluated for 55 patients who either healed normally or developed BRONJ after dental extraction. Results All 26 patients (100%) who had serum CTX levels <150 pg/mL healed successfully after dentoalveolar surgery (20 patients) or after treatment for BRONJ (6 patients). Among the 55 patients who underwent radiographic evaluation, 24 patients (83%) with BRONJ exhibited periodontal ligament (PDL) widening associated with extracted teeth, whereas only 3 patients (11%) who healed normally demonstrated PDL widening. Conclusion These data suggest that radiographic PDL widening may be a more sensitive indicator than CTX testing in predicting risk of BRONJ. Current guidelines that recommend minimal surgical intervention may need to be revised to include alternative strategies for the elimination or management of this pathology.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>20674404</pmid><doi>10.1016/j.tripleo.2010.04.023</doi><tpages>8</tpages></addata></record> |
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| subjects | Alveolar Bone Loss - diagnostic imaging Biological and medical sciences Bone Density Conservation Agents - adverse effects Bones, joints and connective tissue. Antiinflammatory agents Case-Control Studies Cohort Studies Collagen Type I - blood Dentistry Diphosphonates - adverse effects Diseases of the osteoarticular system Humans Jaw Diseases - blood Jaw Diseases - chemically induced Jaw Diseases - diagnosis Jaw Diseases - diagnostic imaging Medical sciences Osteonecrosis - blood Osteonecrosis - chemically induced Osteonecrosis - diagnosis Osteonecrosis - diagnostic imaging Otorhinolaryngology. Stomatology Peptides - blood Periodontal Ligament - diagnostic imaging Periodontal Ligament - pathology Pharmacology. Drug treatments Predictive Value of Tests Radiography, Dental - methods Retrospective Studies Risk Factors Surgery Tooth Extraction - adverse effects Vascular bone diseases |
| title | Predicting risk for bisphosphonate-related osteonecrosis of the jaws: CTX versus radiographic markers |
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