bone turnover test

I had a blood test for a bone turn over rate before a tooth extraction, to determine how fast or slowly I would heal, since I had been on actonel some years ago The dentist said at my rate of 280 I would heal but anyone with bone turn over of 150 or less would have problems
this is the first time such a test was done on me and I'm thinking it might be a better indicator of fracture risk than a BMD test

my test results: CTX 280 ng/L.... CTx 0.28ug/L
notes: post menopausal women with
CTX levels < 400ng/L have low bone turnover

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CTx is the c-terminal telopeptite cross-link that is released from the bone collagen matrix as it is degraded by osteoclasts. I have never heard of using it to predict who will heal from a tooth extraction using cutpoints. Can your dentist provide some references? It would be good for the rest of us to read up on it. CTX measures bone resorption, not bone formation, so I don't understand how it would be directly related to healing.

But bone absorption markers tell only how fast old bone is being broken down. If new bone is being made just as fast, or even faster (as in the case of Forteo) a high bone turnover rate does not necessarily mean bone loss. Absent or extremely low values are more of a concern if suppressed for an extremely long time beause it causes old bone to remain and become more brittle.

While most things slow down as we age, and for women who go through the menopause, the one thing that speeds up after menopause is bone reporption and CTX levels will be abnormally high and that is how anti-resoptive medicatons work, by supressing bone turnover to pre-menopausal rates, but not zero.

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after learning that I had been on actonel and xrays revealed bone infection behind the tooth , my dentist referred me to a specialist surgeon at the dental hospital, who ordered the blood test before proceeding with the extraction
the only reference I have is on the copy of the results
female reference ranges (CTx ng/L)
pre menopausal <570
post menopausal without HRT <1010

I don't pretend to understand it but I hope the specialist knows what he's on about and if he thinks this is a good measure of how well the bone is going to heal, then I thought this test would be beneficial along side the BMD

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I am thinking the "specialist surgeon at a dental hospital" is an oral surgeon? I asked an osteoporosis specialist what he thought and he feels none of these tests are proven to predict bone loss or even bone building success aside from dexa scans. he felt it might have been more protective or informational for them than for you. But everyone has an opinion and it didnt hurt you so good luck with the dental work.

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you are thinking right, I saw an oral surgeon because he was the best to deal with extractions after bisphophonates
I don't believe he would have done the CTx test if it didn't tell him anything .
I have never heard of an 'osteoporosis expert', what ever he is,he is right ...there is no test the predicts bone loss
or bone building success especially the Dexa which can only measure bone density.

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