C-terminal cross-linking telopeptide as a serologic marker for bisphosphonate-related osteonecrosis of the jaw: review of 2 cases.

With the increasing use of the bisphosphonate class of drugs, dental professionals are encountering more cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The C-terminal cross-linking telopeptide (CTX) assay is a serologic test to predict the risk of BRONJ. This paper examines the effectiveness of CTX as a biochemical marker for BRONJ and its utility to the dentist in establishing appropriate treatment plans for patients with a history of bisphosphonate use. Alternative means of assessing the risk of BRONJ are discussed, and 2 case vignettes are presented to demonstrate dental treatment planning for patients with a history of bisphosphonate use, in the context of specific CTX results.