Park JH, Cho S, Kim SJ, et al. - For the prevention and early diagnosis of osteonecrosis of the jaw (ONJ), individuals with abnormally low serum levels of tartrate-resistant acid phosphatase isoform 5b (TRACP 5b) and high serum levels of Dickkopf-related protein 1 (DKK1) should be monitored closely before and after dentoalveolar surgery.

• Researchers designed a prospective study including a total of 76 patients who met the inclusion criteria; 33 were assigned to the ONJ group, and 43 patients without ONJ signs or symptoms after dentoalveolar surgery were assigned to the control group.

• The results showed that at both T0 and T1, the mean tartrate-resistant acid phosphatase isoform 5b (TRACP 5b) levels were significantly lower in the ONJ group and the mean Dickkopf-related protein 1 (DKK1) levels were significantly higher than the corresponding values for the control group.

• In linear mixed model analysis, results demonstrated significant group effects over time for serum TRACP 5b and DKK1 after adjusting for demographic, pharmacological, and diagnostic variables.

• It was shown that the lower serum levels of TRACP 5b under a specified cut-off value (≤ 2.899 U/L) at T0 indicated a 20.40-fold elevated risk of ONJ development.