Are Bacteria Just Bystanders in the Pathogenesis of Inflammatory Jaw Conditions?

He, Puhan; Francois, Kevin; Missaghian, Nima; Le, Anh D.; Flynn, Thomas R.; Shanti, Rabie M.

doi:10.1016/j.joms.2022.03.012

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…One cohort study comparing mandibular osteomyelitis to osteoradionecrosis noted that opportunistic infections (including but not limited to Candida spp.) were more frequently observed in the latter (30% compared with 12.5%) 19 . All of our specimens growing fungal elements were of Candida species, more than three‐quarters of which were specifically Candida albicans .…”

Section: Discussionmentioning

confidence: 59%

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Mandibular Osteoradionecrosis: Defining the Microbial Milieu and Antimicrobial Resistance at the Time of Rescue Flap Surgery

et al. 2023

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ObjectiveTo report the microorganisms and their antibiotic sensitivity profile from tissue cultures and stains at the time of anterolateral thigh fascia lata (ALTFL) rescue flap for management of mandibular osteoradionecrosis (ORN).MethodsRetrospective chart review of patients who underwent ALTFL rescue flap for native mandibular ORN between 2011 and 2022.ResultsTwenty‐six cases comprising 24 patients (mean age 65.4 years, 65.4% male) with mandibular ORN from whom tissue cultures and gram stain were obtained at the time of ALTFL rescue flap. 57.7% grew bacterial species, while 34.6% grew fungal species. Multibacterial speciation was noted in 26.9% of cultures. A combination of bacterial and fungal growth was also seen in 15.4% of cases. All gram‐positive cocci (GPC) were pansensitive to antibiotics except for one case of Staphylococcus aureus, which was resistant to levofloxacin. Gram‐negative bacilli (GNB) species were isolated in 50.0% of cases. All fungal growth was due to Candida species. No growth was noted in 23.1% of cases. Multidrug resistance was noted in 53.8% of cases when GNB was isolated.ConclusionWe report 76.9% of our cases of mandibular ORN had microbial growth from tissue cultures obtained at the time of the ALTFL rescue flap. Fungal growth was noted in a substantial number of cases and should be obtained as a specimen when pursuing culture‐driven antibiotic therapy. Most GPCs were pansensitive to antibiotics, while GNBs were often the harbinger of multidrug resistant mandibular ORN.Level of evidence4. Laryngoscope, 2023

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Section: Discussionmentioning

confidence: 59%

“…were more frequently observed in the latter (30% compared with 12.5%). 19 All of our specimens growing fungal elements were of Candida species, more than threequarters of which were specifically Candida albicans.…”

Section: Discussionmentioning

confidence: 96%

Mandibular Osteoradionecrosis: Defining the Microbial Milieu and Antimicrobial Resistance at the Time of Rescue Flap Surgery

et al. 2023

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“…In the maxilla, the size of lesions related to teeth with no endodontic treatment, in the bucco-lingual and occluso-apical dimensions, was significantly larger than that in lesions of endodontically treated teeth. This finding was expected since the source of infection, necrotic tissue, and microorganisms are still present in teeth without endodontic treatment [ 4 , 7 , 25 ]; thus, the lesion size and speed of lesion expansion are expected to be higher in teeth with active infection and no endodontic treatment. The present results found no significant correlation between the lesion size and endodontic treatment of the respective teeth in the mandible.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of microorganisms in carious teeth or exposure of pulp tissue to oral microorganisms are the main causes of pulpitis and the development of periapical (PA) lesions. Persistent irritation by the microorganisms results in widespread inflammation in the pulp tissue, which can lead to pulpal necrosis [ 4 ]. Next, the microorganisms invade the apical and PA region through the root canal and cause an inflammatory PA lesion [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pattern of Endodontic Lesions of Maxillary and Mandibular Posterior Teeth: A Cone-Beam Computed Tomography Study

et al. 2022

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The pattern of expansion of endodontic lesions in the jaws has been less commonly addressed in the literature. For this reason, the aim of this study is to assess the pattern of endodontic lesions of maxillary and mandibular posterior teeth using cone-beam computed tomography (CBCT). This cross-sectional study was conducted on 317 endodontic lesions of posterior teeth on CBCT scans retrieved from a radiology center in Qazvin, Iran, from 2020 to 2022. Endodontic lesions were assessed on sagittal, coronal, and axial sections by an endodontist and dental student using the Romexis software. The largest lesion diameter was measured occluso-apically, mesiodistally, and buccolingually. Lesion size was analyzed based on age, gender, jaw, tooth type, and presence/absence of root filling by independent samples t-tests and a one-way Analysis Of Variannce (ANOVA). The largest diameter of lesions in the maxilla and mandible was recorded in the occluso-apical dimension followed by buccolingual and mesiodistal dimensions (p > 0.05). The pattern of lesions was the same in teeth with and without endodontic treatment, but it was significantly different in maxillary and mandibular endodontically treated teeth in the occluso-apical and buccolingual dimensions (p < 0.05). No significant correlation was noted with tooth type or jaw except for maxillary and mandibular first molar lesions, which were significantly different in the occluso-apical dimension (p < 0.05). Lesion size in all three dimensions was significantly greater in males than females (p < 0.05), and was the highest in the occluso-apical dimension in both genders. In the maxilla, the mean lesion size significantly decreased in the mesiodistal dimension with age (p < 0.05). In conclusion, the largest lesion diameter in the maxilla and mandible was found in the occluso-apical dimension, indicating the role of bone density in the pattern of lesions.

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“…Medullary bone destruction results in localized vascular compromise that limits both effective host response to the infectious process as well as limiting repair of injured osseous tissue [ 10 , 11 , 12 , 13 , 14 ]. Moreover, the effectiveness of antibiotics is similarly limited due to poor vascularity of the affected bone.…”

Section: Introductionmentioning

confidence: 99%

Adjunctive Plasma Rich in Growth Factors in the Treatment of Osteomyelitis and Large Odontogenic Cysts Prior to Successful Implant Rehabilitation: Case Report

DuVal,

Alkhraisat

2023

Dentistry Journal

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Osteomyelitis of the jaws presents a clinical challenge to conventional treatment, often requiring multiple surgical interventions resulting in significant deformity and presenting significant problems to satisfactory rehabilitation. While benign odontogenic cysts, such as the radicular cyst, are generally predictably treated, they can cause significant localized bone destruction and thus can present significant problems in satisfactory rehabilitation. In this case report, patients were treated combining conventionally appropriate surgical debridement and oral antibiotics with adjunctive plasma rich in growth factors (PRGF). Patients showed a complete soft tissue and osseous regeneration to their pre-pathologic state, with successful implant rehabilitation. PRGF appears to be highly successful in minimizing or eliminating osseous deformities normally associated with conventional treatment of osteomyelitis of the jaw and treatment of large odontogenic cysts. Future trials must be performed to confirm these results in comparison to controls using conventional treatment alone.

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Are Bacteria Just Bystanders in the Pathogenesis of Inflammatory Jaw Conditions?

Cited by 7 publications

References 26 publications

Mandibular Osteoradionecrosis: Defining the Microbial Milieu and Antimicrobial Resistance at the Time of Rescue Flap Surgery

Mandibular Osteoradionecrosis: Defining the Microbial Milieu and Antimicrobial Resistance at the Time of Rescue Flap Surgery

Pattern of Endodontic Lesions of Maxillary and Mandibular Posterior Teeth: A Cone-Beam Computed Tomography Study

Adjunctive Plasma Rich in Growth Factors in the Treatment of Osteomyelitis and Large Odontogenic Cysts Prior to Successful Implant Rehabilitation: Case Report

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