Per my humble understanding, . CTX must be adequate to facilatate healing of bone. it is when CTX is too low that you have to be concerened about dental work, injury healing or surgery. Bisphosphnates lower CTX - thats thier job. but if it gets too low. micrfractures can cause problems, bones can get brittle etc... becasue the remodeling is not happening as normal .

We are all different and have different Bone marker baselines. On Tymlos my CTX is 535 ( dissolver) /p1NP 90 ( builder) . Which is good relationshiop for me. We are all different. Tymlos activates both aspects of bone remodleing - and shuld be stopped when building processes ( p1NP) start to slow done and dissolving processes( CTX) get too high in relationship. But many other factors must be analysed also. I suggest reading Great Bones by Dr Keith McCormick for further information - its detailed but stay with it. There is much to leran to help you find you way to health. Blessings.