Antibiotic effects on bacterial profile in osteonecrosis of the jaw

Abstract

OBJECTIVE Oral infection is considered to play a critical role in the pathogenesis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) and antibiotic therapy has become a mainstay of BRONJ therapy. This study was aimed to investigate the effect of antibiotics on bacterial diversity in BRONJ tissues. MATERIALS AND METHODS The bacterial profile from soft tissues associated with the BRONJ lesion was determined using 16S rRNA-based denaturing gradient gel electrophoresis (DGGE) and sequencing. Twenty BRONJ subjects classified as stage 0 to 2 were enrolled in this study and patient groups were divided into an antibiotic cohort (n=10) treated with systemic antibiotic and a non-antibiotic cohort (n=10) with no prior antibiotic therapy. RESULTS The DGGE fingerprints indicated no significant differences in bacterial diversity of BRONJ tissue samples. Patients on antibiotics had higher relative abundance of phylum Firmicutes with bacterial species, Streptococcus intermedius, Lactobacillus gasseri, Mogibacterium timidum and Solobacterium moorei whereas patients without antibiotics had greater amounts of Parvimonas micra, and S. anginosus. Thirty percent of bacterial populations were uncultured (yet-to be cultured) phylotypes. CONCLUSION This study using limited sample size indicated that oral antibiotic therapy may have a limited efficacy on the bacterial population associated with BRONJ lesions.

HIV Infection and Microbial Diversity in Saliva

“…The DGGE assay is commonly used in studies of microbial ecology, microbiology, and environmental microbiology (36)(37)(38). Previously, we showed that the assay can provide rapid assessment of the oral bacterial community without cultivation, can differentiate the major components of the microbial profile, and enabled longitudinal monitoring of changes in microbial flora in the same subjects (35,(39)(40)(41)(42). In this study, we applied DGGE to all bacterial genomic DNA samples.…”

Therapy for bisphosphonate-related osteonecrosis of the jaw: a systematic review

“…It mainly accelerates healing. [10][11][12] What one can observe in the available therapies is that all of them aim to control infection, include the removal of necrotic tissue and attempt to accelerate healing, which is consistent with in vitro studies that show that bisphosphonates are toxic to soft tissues and, consequently, compromise complete healing. 2 Soft tissue damage may expose bone and enable secondary infection, …”

“…On the other hand, another study concluded that no specific pathogen is associated with BRONJ, although antibiotics used as single therapy effectively reduce the wound size and sometimes promote total remission; the outcome may be influenced by the BRONJ stage. 11 Surgical debridement is considered a conservative approach since it only removes visible necrotic tissue without traumatizing healthy areas. Its objective is to reduce the extension of microorganism colonization in the wound bed.…”

“…[1][2][3][4][5][6][7] Local and systemic antimicrobial drugs have been used independently or along with surgery, and sometimes associated with therapies that accelerate healing, such as laser therapy, hyperbaric oxygen, and platelet -rich plasma. [8][9][10][11][12][13][14] This systematic review aimed to assess the treatments available for BRONJ.…”

Bisphosphonate-Related Osteonecrosis of the Jaws: a real Challenge for Dentists

“…BRONJ is more common in the posterior mandible than the maxilla, in a ratio of 2: 1 (33) and it is related to dental extraction (20,34), trauma to the mouth caused by incorrectly adjusted prostheses (35), oral infection (36), poor oral hygiene (37),dentoalveolar procedures on the bone (38), diabetes and smoking (20,39).…”