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Indigenous Microbiota Protects against Inflammation-Induced Osteonecrosis.

D W Williams1,2, H E Vuong3, S Kim1,2

  • 1The Shapiro Family Laboratory of Viral Oncology and Aging Research, UCLA School of Dentistry, Los Angeles, CA, USA.

Journal of Dental Research
|February 29, 2020
PubMed
Summary

The normal oral flora protects against medication-related osteonecrosis of the jaw (MRONJ). Oral bacteria play a crucial role in preventing bone necrosis, especially in patients with periodontitis.

Keywords:
antibiotic(s)boneligature-induced periodontitis/periodontal diseasemedication-related osteonecrosis of the jaw/MRONJosteoclast(s)wound healing

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Area of Science:

  • Oral microbiology
  • Bone biology
  • Pharmacology

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is linked to long-term therapies involving bisphosphonates and other agents.
  • Pathogenic bacteria are associated with advanced MRONJ, but the role of normal oral flora remains unclear.

Purpose of the Study:

  • To investigate the role of indigenous oral microbiota in the development of medication-related osteonecrosis of the jaw (MRONJ).
  • To determine if oral dysbiosis exacerbates MRONJ in the presence of periodontitis and antiresorptive therapy.

Main Methods:

  • Oral flora manipulation using antibiotics in mice.
  • Induction of ligature-induced periodontitis (LIP) and tooth extraction.
  • Histological analysis of bone necrosis, osteoclast activity, and bacterial infiltration.

Main Results:

  • Normal oral flora protected against inflammation-induced osteonecrosis following tooth extraction.
  • Antibiotic-induced oral dysbiosis exacerbated bone necrosis and osteoclast activity in mice with LIP and zoledronic acid treatment.
  • Bacterial infiltration was increased in osteonecrosis lesions compared to healed controls.

Conclusions:

  • The indigenous oral microbiota plays a protective role against medication-related osteonecrosis of the jaw.
  • Oral dysbiosis, particularly in conjunction with periodontitis and antiresorptive therapy, increases the risk and severity of MRONJ.