IADR Abstract Archives

Etiologic Role of Bacterial Microorganisms in Medication Related Osteonecrosis of the Jaws: a Systematic Review

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is the condition of bone exposure which lasts more than 8 weeks. It can be associated with clinical symptoms like pain, erythema, and infections. In addition to the physiologic changes of the hard and soft tissue cells, Some different etiologic factors have been suggested for MRONJ but none of them is certainly accepted as the main etiologic factor. One of these factors is the local infection which can be established by bacterial microorganisms and several articles showed different bacterial strains in MRONJ patients at different MRONJ stages; Due to the importance of this issue, we aimed to systematically review the etiologic roles of bacterial microorganisms in MRONJ conditions.
Methods: An electronic search was done on March 20, 2017, at the databases of Cochrane Library, Google Scholar, PubMed (NCBI) and Scopus. Only the in-vitro studies, clinical trials, and prospective and retrospective case reports were included in this review.
Results: A meta-analysis could not be accomplished due to the lack of quantitative evidence and broad heterogeneity of study types, bacterial strains, treatment options and outcomes of these studies; so, only a qualitative analysis was done and the results were reported for the selected studies.
Conclusions: We concluded that there are several bacterial strains at different stages of MRONJ without any definite causal links between them and ONJ. Also, there are controversies about the treatment options, either to use the antibiotic therapy in association with antimicrobial agents (mouthrinses etc.) besides the standard surgical procedure or not. There need to be more quantitative results reported in future studies in order to achieve more certain notions about the etiologic role of bacterial microorganisms in MRONJ patients.
Iranian Division Meeting
2017 Iranian Division Meeting (Tehran, Iran)
Tehran, Iran
2017

Microbiology / Immunology
  • Shamsaddin, Erfan  ( Dental School, Shahid Beheshti University of Medical Sciences. , Tehran , Tehran , Iran (the Islamic Republic of) )
  • Mahboobi, Fatemeh  ( Dental School, Shahid Beheshti University of Medical Sciences. , Tehran , Tehran , Iran (the Islamic Republic of) )
  • Kargar, Kamran  ( Dental School, Shahid Beheshti University of Medical Sciences. , Tehran , Tehran , Iran (the Islamic Republic of) )
  • Latifi, Fatemeh  ( Dental School, Shahid Beheshti University of Medical Sciences. , Tehran , Tehran , Iran (the Islamic Republic of) )
    • NONE
    Poster Session
    Abstracts Presented
    qualitative evaluation of the studies
    Authors, dateMicroorganismstreatment summarytreatment failure or success
    T. H. Kim et al. 2016Actinomycessurgical therapypatients with diabetes or who were prescribed to use steroids and Parenteral medication of BP showed poorer results after surgery
    S. Panya et al. 2017Actinomycesnot mentionedsuccessful
    C. V. Real et al. 2016Actinomyces sp, Capnocytophaga sp, Neisseria sp, and other aerobes and anaerobesVariable antibiotics were used , although the combination of amoxicillin with clavulanic acid gave the best resultsnot always successful
    G. Russmueller et al. 2016Actinomyces spp.conservative pre-treatment followed by surgical removal of necrotic bone and soft tissue closure. all patients received systemic antibiotic treatment with amoxicillin (2 × 1 g/24 hours) /clavulanic acid (2 × 500 mg/24 hours) or clindamycin (3 × 300 mg/24 hours) for approximately 4 weeks between admittance and surgery.successful
    X Ji et al. 2011bacterial species, Streptococcus intermedius, Lactobacillus gasseri, Mogibacterium timidum, and Solobacterium moorei, were higher in antibiotic group; patients without antibiotics had greater amounts of P. micra and Streptococcus anginosusAntibiotic therapy with tetracycline, ciprofloxacin, amoxicillin (discounted 1 week prior to treatment) and doxycycline for 2 weeks (based on the BRONJ stages of patients)not always successful (based on the BRONJ stage)
    J. K. Brooks et al. 2015not mentionedThe patient was given discharge prescriptions of 500 mg penicillin V potassium, four times daily, for 7 dayssuccessful
    M. R. Sacnchez et al. 2015
    		not mentionedAntibiotic therapy with clindamycin and metronidazolesuccessful
    M. Kos et al. 2013P. aeroginosa and S. aureusnot applicablenot applicable
    S. Pushalkar et al. 2014P. micra, S. anginosus, A. rimae, P. stomatis and Eubacterium dominated the BRONJ lesions; P. denticola and
    S. sputigena were exclusively found in BRONJ cohort    		not mentionednot mentioned
    M. Kos et al. 2015S. mutans, S. aureus and P. aeroginosanot applicablenot applicable
    G. Gaspariniet al. 2010Streptococci, Pneumococci, Diplococci, Gonococci and Staphylococciantibiotic therapy with oral spiramycinsuccessful
    R. C. S. Póvoa et al. 2016some foci of bacterial colonies were revealed in the histologic slidesConservative surgical therapy, antibiotic therapy(500 mg amoxicillin every 8 hours for 7 days), discontinuation of denosumab usesuccessful