putting dental implants when you have osteoporosis

Melia, I had many implants done when younger and they worked very well. Two years ago I tried to have implants done again and the dentist told me that I had to have bone implants first, which I did, with atrocious pain! When it healed after a few months , lots of money and more pain, the dentist told me that there was still not enough bone to put the implants, and I would have to have a second bone implant! I just then rushed out of his office with the plan to never see him ever again. A lot of other dentists proposed the same thing but I refused. I know it is harder to eat with less teeth but I could not go thru that suffering again. Plus when the opioids were still legal it was easier to take the horrible pain. Now forget it for me even if I had it offered for free.

I found this information on a endodontist Laboratory Risk Assessment for Patients taking oral bisphosphonates

CTX Value Risk for ONJ
300 to 600 pg/ml (normal) none
150 to 299 pg/ml none to minimal
101 to 149 pg/ml moderate
Less than 100 pg/ml high
They do a CTX valuation.

I found this information on a endodontist Laboratory Risk Assessment for Patients taking oral bisphosphonates

CTX Value Risk for ONJ
300 to 600 pg/ml (normal) none
150 to 299 pg/ml none to minimal
101 to 149 pg/ml moderate
Less than 100 pg/ml high
They do a CTX valuation.

Thank you for the CTX table - it is very helpful. But this is what's puzzling me and I hope someone can enlighten me.

I have read that high CTX numbers imply high bone turnover and higher fracture risk. Anti-resorptives like Fosamax have the effect of slowing bone turnover leading to lower CTX numbers. It was in fact proposed in a PubMed article that the lower half of the premenopausal range be set as a target for treatment i.e. 50-190 pg/ml for CTX. So I had been under the impression that low CTX numbers are something to aim for. But judging from your table, it seems that the lower the CTX numbers, the higher the risk of ONJ. Am I missing something?

Thank you for the CTX table - it is very helpful. But this is what's puzzling me and I hope someone can enlighten me.

I have read that high CTX numbers imply high bone turnover and higher fracture risk. Anti-resorptives like Fosamax have the effect of slowing bone turnover leading to lower CTX numbers. It was in fact proposed in a PubMed article that the lower half of the premenopausal range be set as a target for treatment i.e. 50-190 pg/ml for CTX. So I had been under the impression that low CTX numbers are something to aim for. But judging from your table, it seems that the lower the CTX numbers, the higher the risk of ONJ. Am I missing something?

Per McCormick he said that the preferred range is 200-300 range.
I understand your concerns .

I'm reading bone markers related information these days...

Can it be interpreted this way: when a person is treated with an antiresorptive, both CTX and P1NP are suppressed. CTX is the one usually used for antiresorptive therapy monitoring. So when it is extremely low, below 150 worse yet below 100, there are little chances to form new bones hence little chance for healing. Normally one would need CTX and P1Np at certain level for bone remodeling.

Melia, I had many implants done when younger and they worked very well. Two years ago I tried to have implants done again and the dentist told me that I had to have bone implants first, which I did, with atrocious pain! When it healed after a few months , lots of money and more pain, the dentist told me that there was still not enough bone to put the implants, and I would have to have a second bone implant! I just then rushed out of his office with the plan to never see him ever again. A lot of other dentists proposed the same thing but I refused. I know it is harder to eat with less teeth but I could not go thru that suffering again. Plus when the opioids were still legal it was easier to take the horrible pain. Now forget it for me even if I had it offered for free.