Bacterial diversity in medication-related osteonecrosis of the jaw.
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.


METHODS
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.
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.
Fredrik
F
Hallmer
Professor and Chairman, Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Tore
T
Bjørnland
Associate Professor, Department of Oral and Maxillofacial Surgery, Malmö University, Faculty of Odontology, Malmö, Sweden.
Gunilla
G
Andersson
Associate Professor and Head, Department of Oral and Maxillofacial Surgery Malmö University, Faculty of Odontology, Malmö, Sweden.
Jonas P
JP
Becktor
Senior Engineer, Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Anne K
AK
Kristoffersen
Associate Professor, Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
Morten
M
Enersen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000302:isolation & purification*; D015373:Bacterial Typing Techniques; D001706:Biopsy; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D009336:Necrosis / Q000382:microbiology