Information on the Serum CTX Test

A test is available to help doctors and patients determine if patients taking bisphosphonates are at risk for osteonecrosis following dental treatment. This test is called the Collagen Type-1 C-Telopeptide (CTX)The serum CTX (C-Terminal Cross-Linking Telopeptide) measures the rate of bone turnover.

This information is of great value in assessing the risk of bisphosphonate induced osteonecrosis of the jaw (ONJ) according to Marx1 indicates the following:
Laboratory Risk Assessment for Patients taking oral bisphosphonates:


CTX Value
Risk for ONJ
300 to600 pg/ml (normal) none
150 to 299 pg/ml none to minimal
101 to 149 pg/ml moderate
Less than 100 pg/ml high

DX Code- V5869

1 Marx RE. Oral and Intravenous Bisphosphonate Induced Osteonecrosis of Jaws. History, Etiology, Prevention and Treatment. Quintessence Publishing Co. Inc. Hanover Park, IL 2007. Pg. 84.

Pi Dental Center, Fort Washington, PA