The association of medication-related osteonecrosis of the jaw with Actinomyces spp. infection
- Resource Type
- Authors
- Rudolf Seemann; Victoria Stadler; Birgit Willinger; Thorsten Fuereder; Christos Perisanidis; Irene Sulzbacher; Kathrin Weiss; Christoph Steininger; Manuel Speiss; Guenter Russmueller
- Source
- Scientific Reports
- Subject
- Male
Pathology
medicine.medical_specialty
Microbiological culture
Article
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Actinomyces
Humans
Aged
Retrospective Studies
Multidisciplinary
biology
Actinomyces spp
Diphosphonates
Standard treatment
Osteonecrosis
Retrospective cohort study
030206 dentistry
Middle Aged
biology.organism_classification
medicine.disease
030220 oncology & carcinogenesis
Cohort
Female
Complication
Osteonecrosis of the jaw
Jaw Diseases
- Language
- English
- ISSN
- 2045-2322
Medication-related osteonecrosis of the jaw (MRONJ) represents a complication of bisphosphonate treatment that responds poorly to standard treatment. In a retrospective cohort study we investigated a possible role of Actinomyces spp. in the pathogenesis of MRONJ. Deep biopsies of necrotic bone were collected during surgical treatment of MRONJ and evaluated by histology and microbiology for the presence of Actinomyces spp. Microbiological, demographic and clinicpathological data were analyzed for risk of Actinomyces-associated MRONJ. Between 2005 and 2014, 111 patients suffering from histologically-confirmed MRONJ were identified. Actinomyces spp. were detected in 99 cases (89%) by histology and in six further patients by microbiological culture. A diverse microbial flora was found in all specimens without association with Actinomyces spp. Demographic and clinicopathological characteristics did not separate significantly Actinomyces-positive from Actinomyces-negative cases. Our observations confirm previous reports of a high prevalence of Actinomyces spp. in MRONJ in the single largest cohort available up to now. The high prevalence of Actinomyces spp. and the lack of clinicopathological risk factors underline the prominent role of Actinomyces spp. in MRONJ and may change the current understanding of MRONJ. Established prolonged antimicrobial treatment regimens against Actinomyces spp. infection could therefore be a mainstay of future MRONJ management.