Surgical protocol in patients at risk for bisphosphonate osteonecrosis of the jaws: clinical use of serum telopetide CTX in preventive monitoring of surgical risk

Aim of the study: this study explores the association between cross linked telopetide test (CTX) and individual surgical risk of osteonecrosis in patients taking oral bisphosphonate. Materials and Methods: 32 patients receiving bisphosphonate were treated surgically. Patients were divided into three groups according to type of drug administrated and were subjected to a treatment of oral surgery, such as simple avulsions and reclamation of the oral cavity, upon evaluation of CTX values and antibiotic prophylaxis. Results: within the sample of 32 patients, 12 patients had been treated with bisphosphonates for several years and none developed osteonecrosis of the jaw upon surgery. As for CTX, patients treated with oral bisphosphonates showed a mean value of serum C-telopetides of 0.2869 ng/ml. The mean value of CTX did not differ significantly between patients taking oral bisphosphonates and healthy patients not treated with bisphosphonates. Conclusion: none of the patients subjected to preoperative antibiotic prophylaxis developed osteonecrosis of the jaw after surgery. The pharmacological and surgical protocol tested appeared valid in the prevention of osteonecrosis associated to bisphosphonates