Poster Presentation Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2025

Utility of Bone Turnover Markers and the Impact of Denosumab Cessation and Age in Patients Undergoing Dentoalveolar Surgery (119365)

Charles Inderjeeth 1 2 3 , Jess Devlin 4 , Diren C Inderjeeth 1 , Frank Chang 4 , Dieter Gebauer 4 5
  1. Geriatric Acute And Rehabilitation Medicine, Sir Charles Gairdner Osborne Park Health Care Group, Perth, Western Australia, Australia
  2. Faculty of Medicine and Dentistry, University of Western Australia, Perth, Western Australia, Australia
  3. Faculty of Medicine, Curtin Medical School, Perth, Western Australia, Australia
  4. Faculty of Dentistry, University of Western Australia, Perth, WA, Australia
  5. Royal Perth Hospital, Perth, WA, Australia

Aim:

Evaluate the correlations between BTMs and impact of medication cessation and age in patients requiring dentoalveolar surgery.

 

Method:

Statistically powered; prospective cohort of 56 patients on denosumab referred to a maxillofacial surgeon for dentoalveolar surgery. Serum CTX, serum P1NP, and urinary NTX were measured at three time points: before the drug holiday (initial), at the time of surgery (> 6 months after the last denosumab dose; PreOp), and before resuming denosumab (> 3 months post-surgery; PostOp). Data were analyzed to determine correlations between BTMs and the effects of time off medication and age.

 

Result:

Age 75.54 years (SD=8.67). 4/56 developed ONJ. Strong positive correlations were between three BTMs; correlation coefficients 0.846 (CTX and P1NP), 0.837 (CTX and NTX); 0.799 (P1NP and NTX). Linear regression models: NTX and P1NP were good predictors of CTX levels. The model using both markers explained 74.1% of the variability in CTX (R-squared=0.741), with an average error (RMSE) of 209.15. Days off medication significantly impact CTX levels (p<0.001). Age did not significantly influence BTM levels.

 

Conclusions:

CTX, P1NP, and NTX are strongly correlated, and NTX and P1NP can be used to predict CTX levels accurately in patients on denosumab therapy who require dental extractions. The duration off medication significantly affects BTM levels. Age did not affect BTM changes over timepoints. These findings provide valuable insights for managing patients on antiresorptive therapy who require invasive dental procedures and highlight the importance of monitoring BTMs to assess bone metabolism and surgical timing.