The role of microbial biofilms in osteonecrosis of the jaw associated with bisphosphonate therapy.
Microbial biofilms have been observed and described in bone specimens of patients with bisphosphonate (BP)-associated osteonecrosis of the jaw (BONJ) and investigators are more recently suggesting that this condition essentially represents an osteomyelitis of the jaw clinically, with greater susceptibility in some patients on BP therapy. This article explains the role of microbial biofilms in BONJ and also discusses associated factors in the disease pathogenesis, which include BP effects on bone remodeling, anti-angiogenesis, matrix necrosis, microcracks, soft tissue toxicity, and inflammation and wound healing. Recent findings suggest a key role for microbial biofilms in the pathogenesis of BONJ; this has important therapeutic implications because biofilm organisms represent a clinical target for prevention and treatment efforts aimed at reducing the significant morbidity and costs associated with this condition.
Kumar
Satish K S
SK
Clinical Dentistry, Orofacial Pain and Oral Medicine Center, Division of Diagnostic Sciences, School of Dentistry, University of Southern California, Los Angeles, CA, USA.
Gorur
Amita
A
Schaudinn
Christoph
C
Shuler
Charles F
CF
Costerton
J William
JW
Sedghizadeh
Parish P
PP
D018441:Biofilms; D016723:Bone Remodeling; D004164:Diphosphonates / Q000009:adverse effects*; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000382:microbiology; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D010020:Osteonecrosis / Q000139:chemically induced* / Q000382:microbiology; D014945:Wound Healing
D004164:Diphosphonates