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.


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