Implant Dent. 2010 Feb;19(1):29-38. doi: 10.1097/ID.0b013e3181cec8bc.
Biochemical markers of bone metabolism have been used in medicine to evaluate and provide treatment to patients with metabolic bone diseases, such as osteoporosis. Serum cross-linked C-telopeptide of type I collagen (CTX) is a marker of osteoclast activity and is used to assess the level of bone resorption. Recently, in oral and maxillofacial surgery, it was proposed that the levels of serum CTX may predict the subsequent risk of developing osteonecrosis of the jaws (ONJ) after oral surgery procedures for patients taking oral bisphosphonates (BPs). The goal of this study was to determine whether this specific serum marker of bone resorption could preoperatively predict the risk of developing ONJ from oral BPs.We hypothesized that there is no clinical correlation between the observed preoperative serum CTX values and the risk of developing ONJ. The authors examine the scientific basis (validity) of the morning fasting serum CTX test in 163 consecutive patients who underwent various oral surgery procedures in the office. The authors also review the laboratory test results and the recommended protocol based on the test values. One hundred sixty-three patients (mean age, 75.9 years) were divided into 2 groups. Group I was the control group that consisted of 109 patients taking oral BPs who did not take the CTX test preoperatively. Group 2 consisted of 54 patients taking BPs and who elected to have the CTX test performed to assess their level of risk of developing ONJ, preoperatively. Both groups of patients were observed for a period of 8 weeks for signs and symptoms of BP-associated ONJ after surgery. The clinical data at 8 weeks and beyond revealed that there was no evidence of BP-associated ONJ in all participants. We conclude that the serum CTX is not a valid preoperative test to accurately assess the level of risk of developing ONJ and is not indicated in the oral surgery patient.
骨代谢生化标志物已被用于医学领域，用于评估和治疗代谢性骨疾病患者，如骨质疏松症。血清Ⅰ型胶原交联 C 端肽（CTX）是破骨细胞活性的标志物，用于评估骨吸收水平。最近，在口腔颌面外科领域，有人提出血清 CTX 水平可能预测接受口服双膦酸盐（BPs）的口腔手术后发生颌骨坏死（ONJ）的风险。本研究旨在确定这种特定的骨吸收血清标志物是否可以术前预测接受口服 BPs 治疗的患者发生 ONJ 的风险。我们假设观察到的术前血清 CTX 值与发生 ONJ 的风险之间没有临床相关性。作者检查了在 163 例连续接受各种口腔手术的患者中，早晨空腹血清 CTX 检测的科学依据（有效性）。作者还回顾了实验室检测结果和基于检测值的推荐方案。163 例患者（平均年龄 75.9 岁）分为 2 组。I 组为对照组，包括 109 例接受口服 BPs 治疗但未进行术前 CTX 检测的患者。组 2 由 54 例接受 BPs 治疗并选择进行 CTX 检测以评估其发生 ONJ 风险的患者组成，术前。两组患者均观察 8 周，以评估术后发生与 BP 相关的 ONJ 的体征和症状。8 周及以后的临床数据显示，所有参与者均无与 BP 相关的 ONJ 证据。我们得出结论，血清 CTX 不是一种准确评估发生 ONJ 风险水平的有效术前检测方法，在口腔手术患者中不适用。
