Bacterial diversity in medication-related osteonecrosis of the jaw

Fredrik Hallmer; Tore Bjørnland; Gunilla Andersson; Jonas P Becktor; Anne K Kristoffersen; Morten Enersen

doi:10.1016/j.oooo.2016.11.011

Bacterial diversity in medication-related osteonecrosis of the jaw

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Apr;123(4):436-444. doi: 10.1016/j.oooo.2016.11.011. Epub 2016 Dec 7.

Authors

Fredrik Hallmer¹, Tore Bjørnland², Gunilla Andersson³, Jonas P Becktor⁴, Anne K Kristoffersen⁵, Morten Enersen⁶

Affiliations

¹ Consultant, Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden; Department of Oral and Maxillofacial Surgery, Malmö University, Faculty of Odontology, Malmö, Sweden. Electronic address: Fredrik.hallmer@mah.se.
² Professor and Chairman, Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
³ Associate Professor, Department of Oral and Maxillofacial Surgery, Malmö University, Faculty of Odontology, Malmö, Sweden.
⁴ Associate Professor and Head, Department of Oral and Maxillofacial Surgery Malmö University, Faculty of Odontology, Malmö, Sweden.
⁵ Senior Engineer, Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
⁶ Associate Professor, Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.

PMID: 28159588
DOI: 10.1016/j.oooo.2016.11.011

Abstract

Objective: The aim was to study the association between microflora and medication-related osteonecrosis of the jaw (MRONJ) by using culture-independent molecular techniques to detect bacteria in necrotic bone lesions.

Study design: Included were 18 consecutive patients with MRONJ, 10 with osteoporosis and 8 cancer patients. Bone biopsies were retrieved from the center of the necrotic bone and from visually healthy bone, and 16 S rRNA gene fragments from bacterial DNA were amplified with polymerase chain reaction.

Results: The study revealed a diversity of bacteria represented by 16 S rRNA sequences in all the necrotic bone samples and in 60% of the visually healthy bone. Eight dominating taxa groups were identified at the genus level: Porphyromonas, Lactobacillus, Tannerella, Prevotella, Actinomyces, Treponema, Streptococcus, and Fusobacterium.

Conclusions: The necrotic bone lesions contained mainly anaerobic bacteria, representative of periodontal microflora, suggesting that a periodontal infection in combination with antiresorptive treatment could initiate osteonecrosis.

MeSH terms

Adult
Aged
Aged, 80 and over
Bacteria / isolation & purification*
Bacterial Typing Techniques
Biopsy
Bisphosphonate-Associated Osteonecrosis of the Jaw / microbiology*
Female
Humans
Male
Necrosis / microbiology