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Table of Contents   
LETTER TO EDITOR  
Year : 2012  |  Volume : 23  |  Issue : 3  |  Page : 432
Bisphosphonate-associated osteonecrosis of the jaws


1 Department of Oral Pathology and Microbiology, Nair Hospital Dental College, Mumbai, India
2 Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai, India

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Date of Web Publication11-Oct-2012
 

How to cite this article:
Desai RS, Shetty SJ. Bisphosphonate-associated osteonecrosis of the jaws. Indian J Dent Res 2012;23:432

How to cite this URL:
Desai RS, Shetty SJ. Bisphosphonate-associated osteonecrosis of the jaws. Indian J Dent Res [serial online] 2012 [cited 2020 Jul 8];23:432. Available from: http://www.ijdr.in/text.asp?2012/23/3/432/102251
Sir,

In reference to the article by Agarwal and Rao, [1] we would like to thank the authors for an informative review on bisphosphonate-related osteonecrosis of the jaws (BRONJ). However, we would like to add some more information on BRONJ for the benefit of readers.

Serum C-terminal telopeptide (CTX), a bone turnover marker (BTM), is used for monitoring osteoporosis drugs such as denosumab and bisphosphonates. [2] Serum CTX has been promoted by some [3],[4] but not all [5],[6] dental surgeons as a risk marker for BRONJ. The test is not intended to unambiguously identify patients who will acquire BRONJ following oral surgery; rather, CTX <0.15 ng/ml in a patient on bisphosphonate therapy (especially intravenous) is associated with an increased risk of BRONJ. In such cases, it has been suggested that the drug be discontinued prior to surgery; also, patient should be informed about the possibility of BRONJ following oral surgery. Modern medicine and better nutrition has increased life expectancy. As age advances, the probability of a patient developing osteoporosis increases, thereby raising the likelihood of the patient being on bisphosphonates. Hence, bisphosphonates should be included in the drug history.

 
   References Top

1.Agarwal P, Rao NN. Bisphosphonate-associated osteonecrosis of the jaws. Indian J Dent Res 2012;23:107-11.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Rosenquist C, Fledelius C, Christgau S, Pedersen BJ, Bonde M, Qvist P, et al. Serum CrossLaps one step ELISA. First application of monoclonal antibodies for measurement in serum of bone-related degradation products from C-terminal telopeptides of type I collagen. Clin Chem 1998;44:2281-9.  Back to cited text no. 2
[PUBMED]    
3.Marx RE, Cillo JE, Ulloa JJ. Oral bisphosphonate-induced osteonecrosis: Risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg 2007;65:2395-6.  Back to cited text no. 3
    
4.Lazarovici TS, Mesilaty-Gross S, Vered I, Pariente C, Kanety H, Givol N, et al. Serologic bone markers for predicting development of osteonecrosis of the jaw in patients receiving bisphosphonates J Oral Maxillofac Surg 2010;68:2039-356.  Back to cited text no. 4
    
5.Lee CY, Suzuki JB. CTX biochemical marker of bone metabolism. Is it a reliable predictor of bisphosphonate-associated osteonecrosis of the jaws after surgery? Part II: A Prospective clinical study. Implant Dent 2010;19:29-38.  Back to cited text no. 5
    
6.Khosla S. Letter to editor-Oral bisphosphonate- induced osteonecrosis: Risk factors, prediction of risk using serum CTX testing, prevention and treatment. J Oral Maxillofac Surg 2008;66:1320-1.  Back to cited text no. 6
    

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Correspondence Address:
Subraj J Shetty
Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Nerul, Navi Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.102251

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